Shortage of vaccines for tetanus and pertussis in China

Shortages of tetanus and pertussis vaccine may affect people living in China

Why is there a shortage of tetanus vaccine in China?
The local manufacturer of Tetanus-diphtheria vaccine (Td) does not plan to continue producing this vaccine, at least until mid 2013, due to low demand of use in China. The low demand is mainly because the China immunization schedule does not include the 10 years booster for all adults. Tetanus vaccine for children is still in the China immunisation schedule. It is offered as DTaP and DT for different ages of children.

What can be done if I had an accident causing open and dirty wounds and I know I do not have tetanus immunity?
[Our hospital] has the tetanus immunoglobulin that our doctor can administer intramuscularly to prevent possible tetanus infection.

What is the reason for the shortage Tdap (Boostrix) vaccine?
Boostrix is manufactured by GSK Belgium. This imported vaccine is discontinued in the China market, but still available globally elsewhere.

How soon are these vaccine shortages going to affect us?
Very soon. Remaining stock of Td vaccine expires on December 23rd, 2012; remaining Tdap (Boostrix) stock expires on January 31st, 2013.

Who will be most affected by the Boostrix shortage?
Adolescents and adults (i.e. parents, siblings, grandparents, childcare providers and healthcare personnel) who have or anticipate having close contact with infants younger than 12 months of age and pregnant women who previously have not received Tdap. US Advisory Committee on Immunization Practices (ACIP) recommends this group of people to be vaccinated against pertussis (also known as whooping cough) with Tdap vaccine (Boostrix), because pertussis causes high risk of pneumonia and death in young infants, especially < 3 months-old if infected.
Source: United Healthcare Shanghai

China launches national anti-smoking plan

Anti-smoking plan aims to cut China's smoking rate to 25% of population by 2015

China has published a plan to reduce the world’s largest population of smokers as part of a 2005 treaty, without implementing recommendations such as warning labels that include photos of rotten teeth and diseased lungs.
China plans to cut the number of smokers to 25 percent of the population by 2015 from 28.1 percent in 2010, according to the plan published by the Ministry of Industry and Information Technology yesterday, seven years after the country signed the treaty that recommends the graphic warning labels.
The government will “comprehensively” prohibit smoking in public places and ban ads, promotion and sponsorship by tobacco companies, according to the plan. There is no mention of tax rates in the plan.
China has more than 300 million smokers, including half the adult male population, and about 740 million people are exposed to second-hand smoke risks, the ministry said. The tobacco industry accounts for 20 million jobs and contributed 6 percent of fiscal revenues in 2010, the ministry said.
“The plan carries a heavy smell of cigarettes,” Wu Yiqun, a director at the Beijing-based ThinkTank Research Center for Health Development. “It’s a compromise result between the tobacco industry and the Health Ministry, and it seems the tobacco side has the upper hand.” The State Tobacco Monopoly Administration was involved in the plan’s preparation.
Wu, a former deputy director at the Chinese Center for Disease Control and Prevention, singled out the lack of graphic photos as a weakness. Australia, Canada and most European Union members have introduced such warnings or have agreed to do so, according to the World Health Organization website.
“It means China’s tobacco control efforts will be weak compared to mainstream international practices,” Wu said. The lack of any plan to increase taxes on tobacco is another weakness, she said.
The WHO recommended in March that China should almost triple excise taxes on tobacco products to 70 percent from 26 percent, to dissuade young people from taking up the habit. Half of the country’s smokers spend 5 yuan (80 cents) or less for a packet of 20 cigarettes, the WHO said.
Smoking, which is linked to 1 million deaths a year in China, is endangering the labor force, Health Minister Chen Zhu said in April.
Using cigarettes as gifts or gestures of friendship is still a popular practice in the country, and many poor regions rely on the industry to generate jobs and fiscal revenue, the industry ministry said.
Cigarette production and consumption in China both increased by 3 percent last year, according to data from Bloomberg Industries. China’s share of world cigarette consumption increased to 40 percent last year from 35 percent in 2006. Consumption in the rest of the world has declined steadily since 2000.
The brother of Chinese Vice Premier Li Keqiang should be removed from his post as a top official in China’s state-owned tobacco monopoly to avoid conflicts of interest, according to a report published by the Washington-based Brookings Institution in October. Li last month took the No.2 position in China’s new leadership and is now oversees public health.
China’s new tobacco plan was jointly prepared by the ministries of industry, health, finance and foreign affairs; and the general administrations of tobacco, customs, safety and industry and commerce.
Source: Bloomberg

Use of new liver cancer drug sorafenib doubles

Use of Nexavar (sorafenib, from Bayer and Onyx Pharmaceuticals) has nearly doubled in first-line advanced hepatocellular carcinoma (HCC) patients in China in 2012 from 2011, according to new findings.
“Nexavar quickly became the standard of care for HCC in Western markets when it was first approved five years ago; however, Chinese physicians have historically relied on 5-FU-based regimens,” said Neesha Suvarna, a consultant with Kantar Health, adding: “Our most recent physician survey data shows that Nexavar adoption is increasing in China. While the utilization of Nexavar in HCC is smaller in China compared with the West, the growth trend we observe suggests that there is a high potential for growth.”
In addition, Kantar Health’s research found that use of Alimta (pemetrexed, from Eli Lilly is gradually increasing in non-squamous non-small cell lung cancer (NSCLC) patients in China since its approval in 2011. Also gaining in use are EGFR biomarker testing and EGFR-targeting agents, such as Tarceva (erlotinib, Genentech/Roche/Astellas) and Iressa (gefitinib, AstraZeneca) in Chinese patients who are EGFR-mutant.
Chinese doctors slowly adopting Western treatment practices
“China has traditionally faced a drug approval and adoption lag, and our recent data suggests that Chinese physicians are slowly adopting Western treatment practices,” said Dr Suvarna, adding: “There are multiple barriers to adoption, including the high price of agents and lack of reimbursement. However, support from patient access programs, increasing patient education and availability of cheaper drugs or generics might all play a role in slowly revolutionizing treatment practices in China.”
Source: Pharma Letter

China will drive growth in interventional cardiology

The Asia Pacific interventional cardiology market will grow at a strong average rate of 12% per year through 2017, with growth driven by China, a new report claims.
Most of this growth will come from increased numbers of procedures in China and India, while procedural growth in Australia and South Korea will be flat, according to Millennium Research Group. Competition and reimbursement restrictions will push average selling prices (ASP) down in all national markets.
The United States and Europe will also see flat procedural growth and declining ASPs. As a result, manufacturers are looking to India and China for market expansion and revenue growth. Both countries have a large population base with increasing disposable incomes and increasing rates of diseases such as coronary artery disease (CAD), diabetes and hypertension that increase the number of required coronary interventions.
There are a number of obstacles to expansion in these markets, however. China, for example, has a number of strong local competitors, with the majority of revenue going to local companies such as Ji Wei and Lepu Medical. Local companies tend to offer considerably cheaper devices, and have good long-term relationships with hospitals and doctors. Foreign companies are increasingly making attempts to level the playing field in China by creating local manufacturing, local training centers, expanding their sales force, or through mergers and acquisitions.
“China is a particularly strong adopter of drug-eluting stents (DES),” said MRG Analyst Mirel Giugaru. “DES are the biggest revenue earners in any interventional cardiology market. Patients are becoming highly aware of DES, and perceive them as the best available treatment option, creating strong demand. A number of local competitors offer DES in China, so penetration of the technology is high. In India, by contrast, DES adoption is lower, because the price of the devices is unaffordable for a large segment of the population.”
Prices in China will continue to drop as the government increasingly relies on local tendering systems to control costs. Sources indicate that it is planning to cut DES prices by about 15 percent in the near future.
Millennium Research Group’s Asia Pacific Markets for Interventional Cardiology Devices 2013 report includes unit, installed base, average selling price and revenue information, along with market drivers and limiters and competitive landscape for coronary stents, percutaneous transluminal coronary angioplasty (PTCA) balloon catheters, and accessory devices sold in Australia, China, India and South Korea.
Read more: PharmiWeb

China-US joint venture for Clinical Research Organisations

WuXi PharmaTech, the contract research organisation with operations in China and the US, is forming a joint venture with fellow CRO PRA to provide a broad range of Phase I-IV clinical-trial services in the Chinese market, including Hong Kong and Macau.
The two companies will combine their respective clinical operations into an independent contract research organisation jointly owned by its parents. Among the services on offer are clinical-trial monitoring, project management, regulatory strategy and submissions, data management, biostatistics, drug-safety reporting and medical monitoring.
WuXi will contribute clinical and regulatory experience from its China-based clinical organisation, which covers all regions of the country and has employees working in 16 Chinese cities, as well as offices in Shanghai, Beijing and Guangzhou.
The company will also supply laboratory services to the joint venture through a preferred-provider arrangement.
PRA will bring to the joint venture “a wealth of global resources and clinical-research expertise, reflected in more than 3,100 studies conducted over the last five years and contributions to 40 approved drugs in several therapeutic areas”, the partners noted.
The US-headquartered CRO will also support the venture with its staff based in China and its global technology capabilities, encompassing data capture, trial management and other information-technology systems.
WuXi and PRA will market the joint venture’s services to their respective customers.
“PRA’s global experience and technical expertise and WuXi’s operational experience and knowledge in China are a perfect fit,” commented Colin Shannon, president and chief executive (CEO) of PRA.
Dr Ge Li, chairman and CEO of WuXi PharmaTech, said the two companies were building “the leading clinical-trial services operation in China”.
The local pharmaceutical market is the now the third largest in the world and is “growing very rapidly”, he added.
“Biopharmaceutical companies increasingly need sophisticated clinical-trial management services to gather the highest-quality data in Chinese patients to complete Chinese and international regulatory filings as quickly and successfully as possible.”
PRA recently opened a second office in China to accommodate its continued growth in that country and the wider Asia Pacific region.
Source: Pharma Times

China poised to become biopharm giant

by Grace Ng
In November 2010, a bold prediction that China was poised to become the global leader in life sciences innovation by 2020 was met with incredulity from many in the West.
"When our thought paper was published, the reaction from people in charge of R&D in the US and Europe was typically: "Oh, you must be kidding"," recalled George Baeder, who was leading consultancy Monitor Group's Asia life sciences practice at the time.
Others, who were more aware of the rapid changes in China, figured this scenario could well take place - in 20 to 30 years.
Two years later, few are resisting the idea any more.
"It's quite the reverse - there is a real focus on Western companies figuring out how to participate in the shift to China that is underway," said Mr Baeder, now senior vice-president of Asia Pacific consulting at Quintiles. "If anything, it's happening faster."
In recent years, virtually every big-name pharmaceutical firm has started R&D operations here.
Among them are Merck Sharp &Dohme, which plans to invest US$1.5 billion in R&D here over the next five years, and Bayer Healthcare, which moved the global authority for its primary care business from Berlin to Beijing.
And to serve the burgeoning demand from both local and multinational firms in China for services from managing clinical trials to preparing regulatory submissions and biostatistics, Quintiles has set up a US$14 million headquarters in Shanghai in June, among other expanded facilities.
China's draw lies not just in its massive health-care demand.
Analysts say firms can potentially invent, test and bring a drug to market faster and more cheaply here than in the West.
"China's talent and cost advantages are the reasons for more Western giants expanding here," said market trends company Zero2IPO group general manager Feng Suqiang.
The world's No 2 economy is building up a pool of China-born, Western-trained life sciences PhD holders to drive the sector.
At least 80,000 such scientists have already returned to China, according to the 2010 Monitor report, which predicted an acceleration of this trend.
Meanwhile, the local authorities are dangling preferential rental and tax rates on cutting-edge facilities to house brand-name or promising companies.
At least a dozen local governments from Shijiazhuang city in the north to Suzhou in the south have set up biotech parks of late, up from just five in 2010.
But what could really prove to be China's advantages as a biotech hub is the recent launch of new products such as Conmana.
A cancer drug entirely developed in China by Zhejiang Beta Pharma, Conmana has drawn attention after being shown to be faster-acting and more effective than a foreign anti-cancer drug in comparative trials. It reportedly took just six years to be developed and brought to the market, at a cost of only about $30 million.
In contrast, the average cost of developing an approved drug in the traditional way is over $1.9 billion and clinical trials can take 13.5 years, according to a report this month by Office of Health Economics, a British think-tank.
Mr Baeder expects that when word gets out about Beta Pharma's more cost-effective process, potentially through a stock market listing next year, the "financial community is suddenly going to see a completely different way of developing products".
The traditional model has typically started with developing a drug in the West and then conducting clinical trials across a few dozen markets - a large-scale process that jacks up costs.
But now, firms may opt to conduct the whole process in China, which offers the largest population on Earth for collecting clinical trial data, and the biggest market in many drug categories.
And a poster boy for this new model is Beta Pharma. Its successful listing could help convince investors that China has the potential to create a more vigorous pipeline of new products.
This in turn could spark "a stampede of companies trying to figure out how to leverage China as the focal point for new product development", said Mr Baeder.
And it may not be too long before China makes the next breakthrough discovery.
"One notable area where China is already making certain headway globally is in genome sequencing," pointed out Lin Hui-Yi, the China research head for consultancy Grail Research.
Baeder added that China could see the creation of "truly innovative medicine being used to treat patients as part of clinical trials within the next six to seven years".
Still, some analysts, such as Feng, are sceptical.
China has the talent and technology, but lacks the capital to create a breakthrough product, he noted. "A widespread problem for Chinese firms is that their financial clout is insufficient."
Enter state funding.
Beijing has pledged to raise funding for life sciences to 2 trillion yuan ($320 billion) up to 2015.
And some local governments are playing venture capitalists to support biotech firms. Among the latest ventures is the 250 million yuan Henan Broadhi Biological Fund, which counts the Henan provincial government and China's top economic planning agency as key investors.
All this has also whetted the appetite of private investors.
In the first half of this year, eight private equity deals in China's biomed sector worth $620 million were inked, two-thirds of the $953 million invested for the whole of last year, said consultancy AVCJ Research.
Read more: China Daily

Chinese trial results sink hopes for niacin as lipid therapy

Niacin (Tredaptive) caused higher rates of myopathy in Chinese patients

Results from a Chinese trial have forced Merck to drop plans to seek U.S. regulatory approval for the lipid modifying drug niacin after it failed to reduce the risk of heart attacks and strokes, while increasing the risk of adverse health events.
The company also recommended doctors not start new patients on the combination of niacin and an anti-flushing drug (Tredaptive) in the approximately 40 countries where it is sold outside the U.S.
The negative outcome deals a blow to Merck, which has been trying to bring new drugs to market to help offset patent expirations for top drugs that have triggered sales-eroding generic competition.
The drug's failure also reinforces questions about the effectiveness of niacin - the key component of Tredaptive, as well as the broader strategy of seeking to raise levels of good cholesterol as a way to combat cardiovascular disease.
Tredaptive is a single-pill combination of niacin, a B vitamin that has been available for more than half a century, with a Merck-developed compound called laropiprant. Niacin is known primarily for increasing levels of good cholesterol, which theoretically should help ward off heart attacks and other cardiovascular events. Niacin also has been shown to lower bad cholesterol and triglycerides, a fatty substance in the bloodstream.
Laropiprant is designed to inhibit a common side effect of niacin, a reddening of the skin known as flushing.
Merck believed the flushing side effect has hampered the use of niacin and that combining it with laropiprant would make the drug more palatable to patients.
Merck initially applied in 2007 for U.S. Food and Drug Administration approval of Tredaptive, based on studies showing it improved cholesterol levels and inhibited flushing. But the FDA declined to approve it, asking Merck to wait for the outcome of a study called "HSP2-Thrive."
HPS2-Thrive tested whether adding Tredaptive to a regimen including simvastatin—which belongs to an older class of cholesterol-lowering drugs known as statins—reduces cardiovascular risk compared with the statin therapy alone.
The University of Oxford's clinical trial service unit conducted the HPS2-Thrive study, which enrolled about 25,670 patients at high risk of heart attack and related cardiovascular events. Of those enrolled, 14,741 were from Europe—the U.K. and Scandinavia—and 10,932 were from China, Merck said. Patients in the study were followed for a median of 3.9 years.
Merck said Thursday that Tredaptive plus statin therapy didn't significantly reduce the risk of the combination of coronary deaths, nonfatal heart attacks, strokes or procedures known as revascularizations, compared with statin therapy.
There was a statistically significant increase in the incidence of some types of nonfatal serious adverse events in the group that received Tredaptive.
The Oxford Clinical Trial Service Unit said in a separate statement posted online that it would present full results in the first quarter of 2013. One of the study investigators, Richard Haynes, said: "It has long been known that niacin causes a number of side effects, and the HPS2-Thrive study allows these to be explored in more detail."
The Oxford researchers earlier said that the Chinese patients seemed to be more prone to myopathy with niacin
Source: WSJ

Bribing of Chinese doctors costs Eli Lilly a $29 million fine

In the latest instance in which a drugmaker was caught making bribes overseas, Eli Lilly was charged by the US Securities and Exchange Commission with violating the Foreign Corrupt Practices Act because its subsidiaries made improper payments to foreign government officials to win millions of dollars of business in China as well as Russia, Brazil, and Poland.
The FCPA forbids US companies from bribing foreign government officials. However, in China, employees at the Lilly falsified expense reports in order to provide spa treatments, jewelry, and other improper gifts and cash payments to government-employed physicians.
A Lilly subsidiary in Russia used offshore “marketing agreements” to pay more than $7 millions to third parties chosen by government customers or distributors, despite knowing little or nothing about the third parties beyond their offshore address and bank account information, according to an SEC statement.
The SEC alleges Lilly became aware of possible FCPA violations, but did not curtail the use of marketing agreements for more than five years. Lilly subsidiaries in Brazil, China, and Poland also made improper payments to government officials or third-party entities associated with government officials. Lilly agreed to pay more than $29 million to settle the SEC’s charges.
Read more: Pharmalot

Shenzhen gene sequencers find clues to autism

Shenzhen's BGI genome centre has found mutation hotspots in people with autism

An international team, including a Shenzhen-based gene sequencing company, has discovered that "random" mutations in the genome are not quite so random after all. 
Their study, to be published in the journal Cell on December 21, shows that the DNA sequence in some regions of the human genome is quite volatile and can mutate ten times more frequently than the rest of the genome. Genes that are linked to autism and a variety of other disorders have a particularly strong tendency to mutate.
Clusters of mutations or "hotspots" are not unique to the autism genome but instead are an intrinsic characteristic of the human genome, according to principal investigator Jonathan Sebat, PhD, professor of psychiatry and cellular and molecule medicine, and chief of the Beyster Center for Molecular Genomics of Neuropsychiatric Diseases at UC San Diego.
"Our findings provide some insights into the underlying basis of autism—that, surprisingly, the genome is not shy about tinkering with its important genes" said Sebat. "To the contrary, disease-causing genes tend to be hypermutable."
Sebat and collaborators from Rady Children's Hospital-San Diego and BGI genome center in China sequenced the complete genomes of identical twins with autism spectrum disorder and their parents. When they compared the genomes of the twins to the genomes of their parents, the scientists identified many "germline" mutations (genetic variants that were present in both twins but not present in their mother or father).
Nearly 600 germline mutations – out of a total of 6 billion base pairs – were detected in the 10 pairs of identical twins sequenced in the study. An average of 60 mutations was detected in each child.
"The total number of mutations that we found was not surprising," said Sebat, "it's exactly what we would expect based on the normal human mutation rate." What the authors did find surprising was that mutations tended to cluster in certain regions of the genome. When the scientists looked carefully at the sites of mutation, they were able to determine the reasons why some genomic regions are "hot" while other regions are cold.
"Mutability could be explained by intrinsic properties of the genome," said UC San Diego postdoctoral researcher Jacob Michaelson, lead author of the study. "We could accurately predict the mutation rate of a gene based on the local DNA sequence and its chromatin structure, meaning the way that the DNA is packaged."
The researchers also observed some remarkable examples of mutation clustering in an individual child, where a shower of mutations occurred all at once. "When multiple mutations occur in the same place, such an event has a greater chance of disrupting a gene," said Michaelson.
The researchers surmised that hypermutable genes could be relevant to disease. When they predicted the mutation rates for genes, the authors found that genes that have been linked to autism were more mutable than the average gene, suggesting that some of the genetic culprits that contribute to autism are mutation hotspots.
The authors observed a similar trend for other disease genes. Genes associated with dominant disorders tended to be highly mutable, while mutation rates were lower for genes associated with complex traits.
Read more: Eurekalert

Chinese "herbal" slimming pills contain thyroid extract and cause hyperthyroidism

Chinese herbal slimming pills sold over the counter and via the internet have been found to contain dangerous levels of thyroid tissue. 
Australian path lab scientists made the discovery after a woman developed hyperthyroidism from taking the slimming pills she had bought online from a Chinese supplier. She presented to her doctor after collapsing and showed typical signs of hyperthyroidism such as palpitations, sweating, tremor and weakness of the arms and legs. Her thyroid tests showed she had hyperthyroidism and she admitted to taking a Chinese medicine "Qian Zhi Su" for three months. Analysis of the pills showed they contained thyroid-like tissue, possibly from pigs.
Source: Pathology

Breast cancer gene ESR1 found in Chinese women

A polymorphism near the oestrogen receptor gene (ESR1) (rs2046210) is associated with a risk of breast cancer in Chinese women, researchers from Wuhan have confirmed.
A case control study carried out at the Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, compared 461 cases of breast cancer and 537 controls from a Chinese Han population. It found that the rs2046210 A allele was significantly associated with breast cancer risk, with an increased risk of 32% This was confirmed in a meta-analysis integrating the current study and previous publications with a total of 53,379 cases and 55,493 controls. It found  a significant association between this polymorphism and breast cancer risk  in the overall population and especially among Asians. The increased risk was 14% higher overall and 27% higher among Asians.
Read more: PLOS One

Recurrent stroke risk with metabolic syndrome

Chinese patients who have a stroke are at increased risk of a recurrent stroke if they have metabolic syndrome, Beijing researchers have shown.
In a study of more than 700 patients with ischaemic stroke, researchers from the Department of Neurology at Beijing's Tiantan Hospital, followed patients up at 3-month intervals for one year to monitor development of recurrent stroke or death. Metabolic syndrome was identified in 26% of the stroke patients and these patients had a higher rate of stroke recurrence (7%) than patients without metabolic syndrome (4%).
However, there was no difference in mortality (3.3% versus 3.5%, respectively).
Source: PLOS One

Room for improvement on cataract surgery

Rural Chinese hospitals could increase their cataract surgical output and quality but health managers are a major barrier to change, new research shows.
A survey of attitudes to improving cataract surgery posed questions to hospital administrators, doctors, and nurses at 28 county hospitals in Guangdong Province. It found that all groups identified a critical need for enhanced management training for hospital directors.
Doctors and nurses suggested reducing surgical fees to enhance uptake of cataract surgery , though administrators were resistant to this. While doctors saw the need to improve equipment, administrators felt current material conditions were adequate. The hospital staff surveyed believed that patient satisfaction was generally high, but this finding was in contrast with other studies in the area, highlighting a potential area for intervention, the researchers say.
Source: Investigative Ophthalmology

Bayer in China: interview with new leader

Bayer's new China boss, Alok Kanti

The interview with Alok Kanti was held in his office on the 22nd floor of the Bayer Center on Beijing's East Third Ring Road.
From being an intern in Canada in 1994 to taking up the leading position in China, the company's fastest-growing market, the 46-year-old Indian never imagined he would work in 27 countries around the world for Bayer. He has become an expert in adapting to variation - various jobs, various markets. Kanti calls himself Mr Flexibility.
To date, high turnover, especially in the sales sector, and difficulties attracting talented people, particularly in the research and development unit, are the greatest challenges to multinational pharmaceutical companies in China.
Kanti admits this is true for his company, but said he believes the performance-based system at Bayer makes the company competitive in terms of remuneration with a positive culture to help talent develop professionally.
Although the new leader at Bayer HealthCare China seems confident in his management ability in China, the emerging market is still a place with opportunities and challenges. As Vice-Premier Li Keqiang said, the country's reform of its healthcare system has entered "uncharted waters", which can be taken to mean there are many uncertainties in the market.
China's market is changing rapidly due to medical reform, economic development, increasing incomes, as well as rising consciousness about health.
Kanti said the company will make progress as the market evolves, but he himself does not really want to change much at Bayer HealthCare China, "as it already has a lot of talented people, capability and focus on execution".
A report conducted by international business management and strategy advisory firm Boston Consulting Group said county-level hospitals and community healthcare centers in China have the greatest potential now. Annual growth of the two channels exceeded 30 percent over the last three years.
"Bayer has done well in the community healthcare sector, making up 4.8 percent of the market in 2010, the second-largest among all domestic and multinational companies in China," said Magen Xia, principal of BCG Greater China.
She attributed the success to the Bayer Health House program, which was initiated in 2006. Each "house" acts as a platform for diabetes education, free doctor consultancy services and communication with patients. The program has set up more than 400 such houses in hospitals and communities in 30 cities around China.
Chronic disease treatment is one of the competitive edges of Bayer HealthCare, which it has been making efforts to explore and will continue to do so.
Kanti took the example of hypertension: "About 18 to 20 percent of the population suffers from hypertension, so treating these people not only improves the outcome for the country per se but also creates opportunities for us."
Kanti believes there are lower treatment rates but faster growth, which "doubles the excitement of the market".
BCG's Xia said the favorable scenario for multinational companies is that more hypertension patients have switched from local to multinational brands in the 30 richest cities around China.
In the county-level hospital sector, involving around 10,000 facilities in 2,000 counties and lower-tier cities, local companies are still key players. Only Denmark-based Novo Nordisk AG entered the top 20 list in 2010, taking a 0.8 percent market share.
Kanti said that Bayer is making lower-tier cities one of its priorities in China.
The company is divided into three regions: north, south and west. Each is responsible for its own lower-city market expansion. It helps the company cope with China's vastness and diverse geographic and demographic conditions and helps increase efficiency.
Bayer HealthCare started its Go West Project in 2007 and has invested 20 million yuan to provide free training for doctors and hospital heads in poverty-stricken areas, another move by the company to work with the government to develop China's healthcare infrastructure.
While the emerging sectors are not easy to handle, a BCG report said the large size and fragmentation of the market is the first challenge any multinational company faces. Others include policy issues, inconsistency in the criteria for the nation's Essential Drugs List and market access to key provinces and municipalities.
They all challenge the pharmaceutical company's market judgment and decision making.
Kanti said the most important thing for him to do is to understand the market and the people. During his first six months in China, he traveled a lot and talked to people a lot.
"We have a large organization of 6,500 people around the nation. It is important to listen and maximize the creativity and drive momentum these people created for the organization," he said.
The people, the company's innovative new medicines and a very rich product portfolio on chronic diseases that the aging Chinese population needs most can support continuous growth for Bayer HealthCare in China, he added.
Readmore: China Daily

A US oncologist's impressions of a Chinese medical school

Paul R Helft, MD

by  Paul R. Helft, MD
I just returned from a week-long trip to Southeastern China, where I visited a large and well-respected Chinese medical school in the city of Guangzhou in Guangdong Province.
My University has a relationship with this sister school in China, Sun Yat-sen University, and I was lucky to receive an invitation from the faculty involved in the medical school bioethics curriculum, because the group is in the process of revising their undergraduate ethics curriculum. I got to meet with faculty, the dean of education for the medical school, many undergraduate medical students, post-graduate residents, and students from the integrated schools of public health and nursing.
I visited one of the affiliated specialty hospitals (specializing in liver disease and liver transplantation) and got experience as a patient in the main university hospital, where I was treated by a traditional Chinese physician for back pain after registering as a patient in the Chinese health care system.
As is nearly always the case with international travel, and especially in a place so different from what we are accustomed to in the United States, the whole experience was delightfully eye-opening, both for those dimensions of medical care and education that struck me as remarkably similar, as well as those that seemed wholly foreign. One of the more striking things I learned about the undergraduate ethics curriculum at this medical school, which in its original form has been in place for nearly ten years, was that most of it was based on cases and principles derived from Western references. This was striking to me, given how radically different Chinese culture is from US and Western culture (as if either of these were homogeneous enough to make such a statement!). Take abortion or transplant ethics, for example. Abortion is widespread and commonplace in China, in part because of the one child per family policy that is in place for families who reside in urban areas. Many Chinese people consider themselves atheists. How could the debate about abortion, which polarizes along lines such as those represented by the pro-life and pro-choice viewpoints in the Western world, possibly have the same outlines in such a different culture? Procuring organs for transplant, as another example, is not done on a completely voluntary basis in China. So the ethical framework for organ procurement and transplantation is just different, and analysis of a case based on Western experiences will have a completely different valence. One suggestion I talked a lot about during my meetings with faculty was to develop a curriculum based on Chinese cases, using a Chinese framework. This suggestion was not popular.
I stood in several long lines to register to become a patient, to obtain a medical record document, to be evaluated by one physician, then to be treated by another. It was clear to me that no one has his or her own physician. I stood in line again to pick up a prescription that had been entered into a computer by the treating physician and was then sent electronically to one of about 30 pharmacy windows, where it was ready for me when I arrived there to pick it up.
Even though throngs of people stood in line everywhere (including to get into the parking garage—police had created a special lane of traffic along the boulevard just to handle those awaiting entry), it did not feel inordinately chaotic, and I didn’t identify anyone who appeared upset or witness anyone complaining (although I might have missed this, given how limited my Chinese language skills are). I was told by students and residents and faculty that the sense of communitarianism that permeates Chinese culture would make it unusual for any one person or family to demand special treatment.
I did not leave China with the sense that there was very much about the Chinese healthcare or medical education system that we should adopt, but as we enter an era of healthcare reform after decades of prioritizing doctors’ individual rights and authority, as well as patients’ expanded ability to demand treatments no matter how expensive, I wonder where we will get a bit more communitarian spirit, and I begin to see many of the choices we will have to make in the light of our collective and interconnected lives. I remain anxious that our prospects for being successful at this are limited.
Dr. Helft is an Associate Professor of Medicine at the Indiana University School of Medicine; his clinical work is based in the Gastrointestinal Oncology Program at the Indiana University Melvin and Bren Simon Cancer Center. Dr. Helft is also director of the Charles Warren Fairbanks Center for Medical Ethics at Indiana University Health in Indianapolis.
Source: Cancer Network

Podcast for learning some medical Chinese ...

Not news as such, but a great podcast on the use of medical terms that you might need for a hospital visit in China. From those wonderful people at PopUp Chinese.
cheers - Michael

Carcinogens in Shenzhen food supply pose cancer risk

High levels of carcinogenic aromatic hydrocarbons have been found in vegetable, pork and rice samples collected from Shenzhen. The cancer risk from exposure to polycyclic and halogenated aromatic hydrocarbons was estimated to be between "serious" and "acceptable", with children facing the highest cancer risk, followed by adolescents, seniors and adults.
Read more: Science of the Total Environment

Beijing TB more common but has milder symptoms

A study of TB genotypes in China has found that about two thirds are caused by the 'Beijing' genotype.
The Beijing genotype was more common in younger people and in those living in urban areas, while people of Uyghur and Zhuang ethnicity were less likely to have the Beijing infection. A high rate of chest symptoms such as haemoptysis was seen in the one third of patients with the non-Beijing genotype.
Source: BMC Infectious Diseases.

Antibiotics found in the Yellow Sea

Significant levels of the antibiotics erythromycin, sulfamethoxazole and trimethoprim have been found in the offshore waters of the Bohai Sea and the Yellow Sea. Researchers from the State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences say that although the concentrations were low, they nevertheless posed ecological risks  to some sensitive aquatic organisms, including Synechococcus leopoliensis and Pseudokirchneriella subcapitata.
Source: Environmental Pollution

Albuminuria shows J-curve with BP

A J-shaped relationship exists between the risk of albuminuria and BP for both systolic and diastolic BP, a Shanghai study has shown.
Researchers at the Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine investigated the single and combined effects of systolic (SBP) and diastolic blood pressure (DBP) on albuminuria (urinary albumin-to-creatinine ratio of at least 17 and 25 mg/g in men and women, respectively) in Chinese. The J-shaped relationship showed nadir levels of 110 mmHg and 70 mmHg, a level far below the currently recommended target BP of 140/90 or 130/80 mmHg.
Read more: Blood Pressure