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China Healthcare SectorHandbook Dec-2010: Identifying the Long-Term Leaders

Contents
National Health Expenses (NHE)5
Government Spending Driving Growth in National Health
Expenses6
Central vs. Provincial Government Spending on NHE7
Medical Expenses and Costs of Hospital Visits8
Drug Costs Are a Key Component of Hospital Visits9
Hospital System10
Increase in Investments in Private Hospitals11
Government Is Upgrading the Hospital System12
Physicians and Nurses (Health Pr ofessionals) Are Clustered in
Government-Owned Hospitals13
Hospital Traffic Largely Biased Towards Large Hospitals14
Hospital Traffic Largely Biased Towards Large Hospitals (cont’d)15
Hospital Visits Have Increased, Driven by Improved Healthcare
Coverage16
Overall View of Medical Coverage Program17
Medical Coverage Penetration Is High, but Payout to New Rural
Cooperative Program Is Low18
Medical Insurance Fund Payout Will Increase19
Demographic Shift20
China’s Population Is Aging20
Top 10 Causes of Death in China21
Increasing Incidence of Tumors22
Increase in Death Rate from Tumors23
Increasing Incidence of Chronic Circulatory Diseases and Death
Rate of Cardiovascular Diseases24
sFDA’s Shift of ApprovalStandards Toward New Drugs25
Analysis of China’s Pharmaceutical Market26
China’s Hospital Drug Market27
Analysis of Market for Essential Drug List (EDL)28
Traditional Chinese Medicine (TCM) Market29
Detailed Analysis of Therapeutic Drugs31
Top 20 Drug Companies Based on Analysis of Prescription Data
from 420 hospitals in 22 Major Cities34
Top 20 Hospital Drugs Based onAnalysis of Prescription Data
from 420 hospitals in 22 Major Cities35
Top Therapeutic Categories and Regional Markets Based on
Prescription Data from 420 Hospitals in 22 Major Cities36
Analysis of Anti-Cancer Market and Anti-Cancer Drugs39
Top-Selling Anti-Cancer Drugs by Drug Name and Manufacturers40
Top-Selling Anti-Cancer Drugs – Plant Alkaloids42
Top-Selling Anti-Cancer Drugs – Antimetabolite43
Top-Selling Anti-Cancer Drugs – Alkylating Agents44
Top-Selling Other Anti-Cancer Drugs45
Analysis of Markets for Cardiovascular Drugs46
Top-Selling Cardiovascular Drugs – by Drugs and Manufacturers47
Top-Selling Cardiovascular – Vasodilators50
Top-Selling Cardiovascular– Calcium Antagonists51
Top-Selling Cardiovascular – Angiotensins52
Top-Selling Cardiovascular – Blood-Lipid Lowering Drugs53
Top-Selling Cardiovascular – Anti-Angina Drugs54
Top-Selling Cardiovascular – Beta Blockers55
Analysis of Market for Endocrine Drugs56
Top-Selling Endocrine Drugs – by Companies57
Analysis of Diabetes Market58
Current Treatment Paradigm for Diabetes Has Many Options58
Current Insulin Market Size in China is ~Rmb3.5bn59
Insulin Market Is Dominated by Novo Nordisk60
Premixed Products Are Better Sellers in the Chinese Market61
Marketed Insulin Products in China62
Annual Costs of Insulin Ranges from Rmb1,300 to Rmb11,00063
Top-Selling Endocrine Drugs – Oral Antidiabetic64
Top-Selling Endocrine Drugs – Insulin65
Top-Selling Endocrine Drugs – Hypothalamic Hormone66
Analysis of the An tibiotics Market67
Antibiotics Is the Largest Drug Class in China’s Pharmaceutical
Market67
Antibiotics Classes68
Breakdown of Antibiotics Market69
Antibiotics Drug Classes70
Antibiotics – Top-Selling Drugs71
Antibiotics – Leading Pharma Companies72
Top-Selling Antibiotics – Cephalosporin73
Top-Selling Antibiotics – Benzylpenicillin74
Top-Selling Antibiotics – Quinolone75
Top-Selling Antibiotics – Other Lactams76
Top-Selling Antibiotics – M acrolide and Lincosamides77
Top-Selling Antibiotics – Anti-Hepatitis B Drugs78
Biologics – Shining Stars with Strong Growth Potential79
Top-Selling Biologics – Monoclonal Antibodies80
Top-Selling Biologics – Recombinant Interferons81
Top-Selling Biologics – Recombinant Interleukins82
Analysis of Market for Blood and Hematopoietic System Drugs83
Top-Selling Blood and Hematopoietic System Drugs –
Intravenous Infusion84
Top-Selling Blood and Hematopoietic System – Anticoagulants85
Top-Selling Blood and Hematopoietic System – Antianemic86
Analysis of Markets for Digestive System Drugs87
Top-Selling Digestive System Drugs and Manufacturers88
Top-Selling Digestive System Dr ugs – Proton Pump Inhibitor89
Top-Selling Digestive System Drugs – Hepatopathy90
Top-Selling Digestive System Drugs – Antiemetic91
Analysis of Markets for Central Nervous System Drugs92
Top-Selling Central Nervous System Drug Names93
Leading Central Nervous System Drug Companies94
Top-Selling Central Nervous System – Other Nervous System
Drugs95
Top-Selling Central Nervous System Drugs – Cerebrovascular96
Top-Selling Central Nervous System Drugs – Dementia97
Top-Selling Central Nervous System Drugs – Analgesics98
Top-Selling Central Nervous System Drugs – Antiparkinsonism99
Analysis of Markets for Immunomodulator Drugs100
Top-Selling Drugs for Immunostimulant101
Top-Selling Drugs for Immunosuppressant102
Analysis of Markets for Respiratory System Drugs103
Leading Respiratory System Drug Companies104
Top-Selling Drugs for Respiratory System – Expectorant105
Top-Selling Drugs for RespiratorySystem – Antasthmatic Inhalant106
Top-Selling Drugs for Respiratory System – Antasthmatic107
Analysis of Market for Mental Disorder Drugs108
Top-Selling Mental Disorder Drugs – Antidepressant109
Top-Selling Mental Disorder Drugs – Antipsychotic Drugs110
Top-Selling Mental Disorder Drugs – Sedative111
Analysis of Markets for Urinary System Drugs112
Drug Distribution Industry113
With Multiple Layers, China’s Drug Distribution System Lacks
Efficiency113
Drug Distribution Value Chain114
Industry Is Gravitating Towards Large Players115
The Pharmaceutical Markets in the US, EU and Japan Have
Been Increasingly Consolidated116
Competitive Landscape in Drug Distribution118
Drugstore Overview119
China Medical Equipment and Devices120
Industry Sales y/y Growth Slowed in 2010121
Patient Monitoring Devices122
Global PMD Markets123
The U.S PMD Market124
China’s Ultrasound Market125
China’s Ultrasound Market Is Highly Competitive126
Drug-Eluting Stent Market127
Domestic Growth Rate for PCI Procedures128
More Hospitals/Doctors Will Be Able to Perform PCI surgery129
Stent Cost Accounts for Over 60% of PCI Cost130
Stent Price Cuts131
Reimbursement Policies Favor Domestic Brands132
Sales and Marketing Strategies133
Stent Market Shares by Key Players134
Overview of DES Pipeline135
Global Orthopedic Market136
Chinese Orthopedic Market137
Breakdown of Chinese Trauma and Spine Market138
Dialysis Market139
Expecting the Number of Maintenance Dialysis Patients to Grow139
Competitive Landscape in the Dialyzer Market in China140
Kidney Dialysis Is a Growing Market141
Dialysis Centers Are Getting Crowded142
China Contract Research Organization (CRO)143
Key Players and Value Chain in China’s Contract Research
Organization (CRO) Market143

China vs. India – Split Opinion144
China and India CRO: Dragon vs. Elephant?145
Comparison of Outsourcing Environment for China vs. India146
Deep Dive into China’s CRO Market147
Citi Estimate of Outsourcing Ma rket in China (US$ millions)148
Toxicology Outsourcing Facing Numerous Hurdles149
Global R&D Spending Outlook150
Global R&D Spending151
Citi R&D Outsourcing Survey152
Survey Suggests That 10-20% of the Total R&D Work Is
Outsourced154
Appendix A-1160