中國疫苗市場報告 F&S_China Vaccine Market_052910

“ We Accelerate Growth” Healthcare Practice, China CHINESE VACCINE MARKET 2 Confidential to Olympus Capital MARKET OVERVIEW 3 Confidential to Olympus Capital Healthcare & Demographic Indicators Particulars China (2007) Population 1,321.8 Birth rate (per 1000) 12.1 Population growth rate 5.3% Infant Mortality rate (per 1000) 19.0 Life expectancy (female) 73.3 Life expectancy (male) 69.6 Healthcare Infrastructure Public Hospitals 15,616 Private Hospitals 3,575 Health Clinics (government) 122,023 Private Clinics 156,844 Estimated number of pediatricians 116,275 Estimated number of GPs NA Healthcare Financing Total Healthcare Expenditure (USD) bn 152.9 Public Healthcare Expenditure (USD) bn 48.4 Private Healthcare Expenditure (USD) bn 104.5 Per Capita Healthcare Expenditure (USD) 116.0 Public Health Care Delivery Services State-owned hospitals can be categorized into public, military, teaching and corporate institutions. Public hospitals are further divided into 3 different tiers by the Ministry of Health (MOH) with Tier I being the lowest tier and Tier III as the top tier in terms of facility, level of service provided and type of hospital administration. Healthcare Expenditure The ratio of GDP used for healthcare expenditure is stable, keeping 4.7% or so, which means the growth healthcare expenditure is close to that of GDP. With the increasing of GDP and improving of life quality, the healthcare expenditure will be rapidly increased in the next 5 years. Chinese GDP is very close to UK and FR, but its ratio used for healthcare expenditure is lower and quite lower in healthcare expenditure per capital. To reach the level of advanced countries, the development of Chinese healthcare still has a long way, which implicates that the healthcare market is promising in China. 4 Confidential to Olympus Capital Healthcare & Reimbursement Scenario Current Status of Reimbursement There is currently no universal health insurance coverage in China. A basic rural medical insurance scheme was put into place in 1998 for urban residents, while a small percent of rural residents are covered under a cooperative medical care system. The State Council has announced plans to achieve comprehensive medical insurance coverage for most of the population by 2010. Additionally, private health insurance is burgeoning with the entry of foreign insurance companies post-World Trade Organisation. Private health insurance coverage is expected to expand rapidly in the urban areas, while the government sponsored social hea lth insurance is expected to be more significant for rural areas. Urban Healthcare Insurance A basic Medical Insurance System for urban employees was put into place in 1998, and combines social mutual assistance progra ms with personal insurance accounts. This compulsory scheme covers all urban employers and employees, enterprises, state administrative departments, ins titutions, and organizations and their staff, all of whom have an obligation to pay insurance premiums. Currently, approximately 6.0 percent is contributed by the e mployers, while employees contribute 2.0 percent of their personal wages. Outpatient services are generally reimbursed from personal accounts, while hospitalization and outpatient services for major chronic diseases are reimbursed from mutual accounts. This scheme currently covers Chinas urban population of approximately 110 million. Currently, statistics in dicate that 44.8 percent of the urban population remains uninsured. However, the State Council has announced that it expects all urban residents to be covered unde r medical insurance by 2010. Private Healthcare Insurance Private healthcare insurance is expected to achieve significant growth due to the high demand for health care insurance from the Chinese market. High medical costs is one of the primary social concerns of the Chinese public, therefore they are very receptive to private health insura nce. In addition to foreign firms, local and joint venture firms have also been targeting the healthcare market. Companies such as PICC Health Insurance Co. Ltd. hopes to cash-in on this as the market has a huge growth potential and is estimated to generate USD 36 billion by end of 2008. Rural Healthcare Insurance Healthcare insurance coverage for Chinas rural population is implemented through a voluntary healthcare insurance scheme. A rural resident who has not purchased public health insurance is liable for all his or her own medical expenses, and has no access to any public health welfare. In 2003, the state government launched a trial rural cooperative medical care system in some provinces. In 2005, this system achieved a coverage of 671 counties and 177 million rural residents representing 19.7 percent of Chinas total rural population. The State Council has reiterated its commitment to establish a comprehensive rural health care network by 2010, with the aim of ensuring primary healthcare services to the rural population. Although, the central government has spent a total of USD 375 million as of 2006, to establish health clinics in townships th roughout the central and western regions of China. 5 Confidential to Olympus Capital Chinese Vaccine Market is Estimated at 1.81 billion $ in 2009 and is Growing Rapidly with a CAGR of 23.1% 0 . 7 9 0 . 9 7 1 . 2 8 1 . 4 9 1 . 8 1 2 . 2 3 2 . 7 4 3 . 3 7 4 . 1 5 5 . 1 1 6 . 2 8 012345672005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015Revenue($Billion)Y e a rSource: Frost & Sullivan Chinese Vaccine Market (2005 2015) 6 Confidential to Olympus Capital Central government is strengthening its attention on vaccination Recently the central government decides to expand the national vaccination program from previous 5 vaccine to 12 vaccine, ie: include MCV, JEV, HAV, MMR, Haemorrhagic Fever Vaccine, Anthrax Vaccine, Leptospire vaccine to national vaccination program, which means the central government will procure 7 more vaccines. Increasing government financing Total annual investment from central government is only about USD 40 million before 2008, it is planned to reach USD 400 mill ion in 2008 for the enlarged vaccination program. Baby boom in recent years The new born baby boom since the year of 2005, MOH reports that there are around 17 million new born baby in 2006, and the nu mber is increased to 2300-2500 in 2007. the large infant population will stimulate the vaccine market. Willingness to pay out of pocket Chinese people are more willing to pay for vaccination, the vaccine market in China keeps high growth rate of 15% in recently years, thats because the increasing awareness of vaccination in public and the elevating spending capacity for healthcare expenditure Increasing R&D expenditure R&D expenditure in terms of bioscience has reach about 285 million and its expected to continue to increase, which will prom ote the vaccine market development Key Market Drivers Rank Driver Short Term 1-2 Years Medium Term 3-4 Years Long-Term 5 Years 1 Central government is strengthening its attention on vaccination High High High 2 Increasing in government financing Medium High High 3 Baby boom in recent years High High Medium 4 Willingness to pay out of pocket High Medium Low 5 Increasing R&D expenditure Low Low Medium 7 Confidential to Olympus Capital Key Market Restraints Rank Driver Short Term 1-2 Years Medium Term 3-4 Years Long-Term 5 Years 1 China has become the largest vaccine producer Low Medium Medium 2 The 33 qualified local vaccine manufacturers and other global giants leads to strong competitiveness Low Medium Medium 3 Price pressure induced by the enlarged government procurement Low Medium Low China has become the largest vaccine producer Chine has become the largest vaccine producer in 2007 with the annual production of 1 billion doses. The production is expected to be further expanded since some of the manufacturers are launching new production line. However the large production is focusing on several normal vaccines such as influenza, rabies vaccine etc. most of the local manufacturers face the problem of over-capacity production. The 33 qualified local vaccine manufacturers and other global participants leads to strong competitiveness Currently there are 33 qualified local vaccine manufacturers in China, they are able to produce a sum of 49 kinds of vaccines . With governments enhancing attention on R&D, these local manufacturers tend to have stronger R&D ability The local manufacturers performs well at government-dominated vaccine market for the lower price Global participants are perceived to be higher technological to provide products of better quality. Since December, 2007, 2 k inds of mandatory vaccines (BCG and Poliovirus vaccine) are open to foreign companies, which means global companies start to have access to Chinese nati onal vaccination program. Price pressure induced by the enlarged government procurement With the expansion of national vaccination program, the government procurement will cover 12 kinds of vaccines. The procureme nt process is expected to limit the vaccine price 8 Confidential to Olympus Capital Current Market Trends and Highlights Hepatitis A, influenza, Japanese B encephalitis, meningitis, Measles, Mumps and Rubella The market size for vaccines of the above diseases are expected to increase largely in a short run because of The expansion of national vaccination program for children to include the above mentioned diseases. The baby boom in China in recent years creates a large demographic segment for pediatric vaccinations. Hemorrhage fever, anthrax, leptospirosis The market size for vaccines of the above disease are expected to increase modestly because The expansion of national vaccination program for high risk population increase national procurement volume However the total target population limits the total need for these vaccine, as demand is seasonal and/or dependant on outbreaks. 9 Confidential to Olympus Capital KEY MARKET CONDITIONS 10 Confidential to Olympus Capital Vaccine Classification in China Category I vaccine Freely offered by government Mandatory vaccination by qualified population. National category I vaccine is initiated by central government and financed by central government Regional category I vaccine is initiated by regional government and financed by regional government Category II vaccine Generally paid out of pocket Volunteer immunization Some rural areas reimburse 20% of the vaccination fee for certain kinds of vaccine such as Hepatitis B (adult), chicken pox, rabies vaccine. Vaccine Classification (China) VACCINE CLASSIFICATION Vaccines in the Chinese market are divided into category I and category II by the CDC. Category I vaccines are provided free and are mandatory while category II are self-paid and voluntary. There are only 5 kinds of national category I vaccines before, however this has been expanded to 12 since the year of 2008. With the enhancing attention to immunization or disease prophylaxis from central government, the regional government is expected to include more vaccines into its regional category I group as well. 35.8% 64.2% Vaccine Market Revenues (2009) USD : 1.81 billion Category I vaccine Category II vaccine11 Confidential to Olympus Capital Vaccination Schedules in China Chinese National Vaccination Program for Children (2008) Vaccine Age new born 1 mth 2 mth 3 mth 4 mth 5 mth 6 mth 8 mth 18 mth 24 mth 30 mth 3 years 4 years 6 years Hepatitis B vaccine 1st 2nd 3rd BCG 1st Poliovirus vaccine 1st 2nd 3rd 4th DTP 1st 2nd 3rd Diphtera and tetanus vaccine 1st Measles vaccine 1st 2nd MMS 1st 2nd MCV 1st and 2nd 3rd 4th JEV (Attenuation) 1st 2nd JEV (Inactivate) 1st & 2nd 3rd 4th HAV (Attenuation) 1st HAV (Inactivate) 1st 2nd Chinese National Vaccine Program for High Risk Population (2008) Vaccine Time Interval Since First Vaccination Day 0 7-10 days 14 days 6 mth Haemorrhagic Fever vaccine 1st 2nd 3rd Anthrax Vaccine 1st Leptospire vaccine 1st 2nd 12 Confidential to Olympus Capital Chinese National Vaccination Program for Children Chinese National Vaccination Program for High Risk Population Vaccine Name Vaccine Name (added since 2008) Vaccine Name (added since 2008) BCG (Bacillus Calmete Guerin) MCV (Meningococcal Vaccine) Haemorrhagic Fever Poliovirus vaccine JEV (Japanese Encephalitis Vaccine) Anthrax Vaccine DTP (Dipteria, Tetanus, Whooping Cough) HAV (Hepatitis A Vaccine) Leptospire vaccine Measles MMR (Measles, Mumps and Rubella) Hepatitis B (Neonatal) Category I Vaccines has been Expanded Since 2008 Source: MOH 13 Confidential to Olympus Capital Category II Vaccines Accounts for over Half of Total Market in Terms of Value and is Expanding Fast 0 . 0 0 0 . 5 0 1 . 0 0 1 . 5 0 2 . 0 0 2 . 5 0 3 . 0 0 3 . 5 0 4 . 0 0 4 . 5 0 5 . 0 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015R e v e n u e ( $ B i l l i o nC a te go r y I C a te go r y I ICh i n e s e V a c c i n e M a r k e t b y Ca t e g or y ( 2 0 0 5 2015)14 Confidential to Olympus Capital Vaccination Channel Point of neonatal vaccination Point of vaccination The government set point of vaccination at Community medical center in towns Village medical settings in rural areas The most important channel The government set point of vaccination at all clinics with obstetrical department take responsibility of neonatal vaccination such as BCG, neonatal hepatitis B vaccine Temporary point of vaccination This is set for special group of population such as floating population In-house vaccination In poor communication or remote areas such as pasture, offshore island, mountain areas, people are offered in-house vaccination POV is the Most Important Vaccination Channel Source: MOH 15 Confidential to Olympus Capital POV Physicians Attitude to Different Brands Source: POV doctor FGD guideline Main considerations when choosing brand Usually, physicians do not recommend vaccines. Price and imported/domestic are the most often provided information from physicians Whether to recommend Too busy, no more time to recommend No higher profit incentive due to similar profit from different products In physicians opinion, price and imported/domestic are the main concern of vaccinees, so they always only mention price and imported/domestic. Reasons for not recommending Lets take flu vaccine as an example: when recommending, following information is always mentioned: GSK & Pasteur - relative cheaper, old brand, more clinical experience (Most physicians think there is no difference between them, esp. in price, technology and quality). Novartis - less painful, no preservative, new generation, safer Local brands - similar efficacy with low price How to recommend Considerations Details 1.Safety The foremost factor, because severe adverse event bring bad social impression and complicated treatment 2.Efficacy This factor is hard to validate, so it is judged based on feedback from vaccinees 3.Price For some kind of vaccines (e.g. flu vaccine), the gap between domestic and imported is not very large 16 Confidential to Olympus Capital Vaccines Can be Distributed to POV from Suppliers, Distributors and CDC According to the Regulation. Manufacturer CDC POV Distributor CDC POV POV POV Source: MOH 17 Confidential to Olympus Capital CDC Access Actually Restraints Vaccine Uptake to Large Extent Province vaccine list (Decided by province CDC) City vaccine list (Decided by city CDC) District vaccine list (Decided by district CDC) POV vaccine list (Decided by district CDC) Province CDC decides the province vaccine list (vaccines that can be sold in the province) through public bidding. Province CDC procure vaccines from manufacturers according to the vaccine list Not all the launched products can be sold in certain province City CDC decides the city vaccine list through public bidding. All the vaccines in city vaccine list must be chosen from province vaccine list City CDC procure vaccines from province CDC. (Price gap exist except Shanghai) Not all the launched products can be sold in certain city District CDC decides the district vaccine list through public bidding. All the vaccines in district vaccine list must be chosen from city vaccine list District CDC procure vaccines from city CDC. (Price gap exist except Shanghai) Not all the launched products can be sold in certain district All the vaccines in POV vaccine list must be chosen from district CDC vaccine list, in Shanghai, vaccine brands are set by district CDC, usually one local brand and one imported brand in each POV for each kind of vaccine. POV procure vaccines from district CDC. (Price gap exist in all cities) Not all the launched products can be sold in certain city Source: MOH 18 Confidential to Olympus Capital COMPETITIVE LANDSCAPE 19 Confidential to Olympus Capital Multinational companies and local giants with annual revenue of 30 million 70 million USD Multinational companies GSK, Sanofi, MSD, Norvatis Local giants Six biological institutions affiliated to China National Biotec Group, a key state enterprise managed by State-owned Assets Supervision and Administration Commission of the State Council , ie. Shanghai/Changchun/Lanzhou/Chengdu/Beijing/Wuhan institution of biological products Chinese local companies with the annual revenue of no more than 15 million USD Changchun Changsheng Shenzhen Kangtai Beijing Sinovac Liaoning Chengda Zhejiang Tianyuan Jiangsu Ealong Henan Hualan Shenzhen Neptunus Interlong Yunnan Walvax Dalian