NPC & CPPCC Delegates Urge Advancements in Domestic Medical Devices, Genetic Counseling Workforce, and Internet Drug Transaction Regulation

As the "Two Sessions" entered the group discussion phase over the past two days, VCBeat has compiled a selection of healthcare-related topics, hoping that the issues raised by deputies will draw attention from both the government and the public.

On the morning of March 4, during the group discussion of Medical and Health Group No. 45, Committee Member Hu Shengshou stated that while China’s medical device market is substantial in size, its level of innovation remains low. In particular, high-end medical devices are largely dependent on imports, which fails to align with China’s current vigorous promotion of the innovation-driven development strategy.Therefore, as a key proposition in the supply-side reform of the healthcare sector, accelerating the industrialization of medical devices is imperative.

In fact, it was CPPCC member Jiao Hong who proposed discussing supply-side structural reform in the healthcare sector. Jiao Hong stated that focusing on supply-side structural reform for research and deliberation was identified as a key work priority of the National Committee of the Chinese People’s Political Consultative Conference (CPPCC) in 2017, as outlined in the work report of its Standing Committee. Against this backdrop, discussions among CPPCC members from the medical and health sectors would carry greater practical significance.

Zhou Xuedong lamented, “We call for accelerating the industrialization of medical devices, particularly the localization of the medical industry. As a dentist, it is disheartening to see that over 80% of the consumables used in our clinical practice rely on imports, while domestically produced products are largely limited to items such as disposable paper cups and mouthwash.”

In contrast, dental implants used in clinical practice at hospitals in China are most expensive when sourced from Switzerland, with prices reaching as high as RMB 80,000 per implant. What does this mean? If a person were to receive a full set of dental implants, the cost would be equivalent to that of a BMW car.”

Huang Jiefu stated that the tasks facing supply-side reform in China’s healthcare services are arduous and complex. Only through systematic reform measures that coordinate public hospital reform, tiered diagnosis and treatment, and payment method reform is China more likely to establish a high-quality, cost-effective healthcare system.

“According to the national plan, by2020In [year], China's health services industry can reach8trillion, expected to2030The annual health services industry scale can reach16trillion. However, at present, the integration and all approaching5Trillion-yuan market: Influenced by factors such as overseas medication purchases, medical tourism, and medical immigration, the domestic market is experiencing a supply-demand imbalance in the health services industry, from5trillion to16The trillion-yuan market still has substantial room for growth, presenting numerous opportunities for the development of the health services industry.。”

This is positive news released from the perspective of national healthcare reform by Zhang Boli, an academician of the China Academy of Chinese Medical Sciences and a member of the National Healthcare Reform Executive Committee, during the Two Sessions. During the meetings, Zhang Boli presented his reflections on the new healthcare reform along with three key recommendations, repeatedly emphasizing the importance of voices from the grassroots level.

According to publicly available online information obtained by VCBeat, it has been eight years since the launch of China’s new healthcare reform in 2009, during which substantial progress has been made at the macro level. The United States achieves a life expectancy of 79 years for its citizens with 18% of GDP allocated to healthcare, and average per capita pharmaceutical expenditure stands at $9,400. In contrast, China achieves a life expectancy of 76 years with only 5% of GDP invested in healthcare, while average per capita pharmaceutical costs are merely a fraction of those in the U.S., at $400. By comparison, the life expectancy of American citizens is only three years higher than that of Chinese citizens. Meanwhile, China’s child mortality rate and health insurance coverage have both reached levels comparable to those of advanced countries worldwide.

Academician Zhang Boli pointed out: Macro-level progress cannot obscure micro-level problems. Specifically, throughout the healthcare reform process, persistent issues have included poor medical environments, the weakening of primary care, and challenges in medical education and professional working conditions. To address these problems, it is necessary to clarify the following lines of thought:

First,Healthcare Reform Must Properly Balance the Roles of Government and Market. With the market playing a leading role, the government should exercise macroeconomic regulation by knowing what to do and what not to do. From comprehensive health coverage before liberation to the gradual deregulation after the reform and opening-up, the state is transforming its role. Basic healthcare is both a matter for citizens and a responsibility of the state. It is essential to rationally allocate the division of labor between the government and the market to address the optimal mix in healthcare delivery, thereby making healthcare reforms more effective.

Second, uphold the baseline and ensure basic coverage.The difficulties and high costs associated with accessing medical care stem primarily from the expense of consulting renowned specialists and the challenges and costs of seeking treatment at large hospitals; such issues are not prevalent in primary care institutions or Level I and II hospitals. Therefore, by ensuring that basic medical insurance fulfills its fundamental role and safeguards this essential baseline, many of these problems can be effectively addressed.

At the same time, allow the liberalization of certain high-end private social medical institutions to meet the needs of consumer groups seeking premium specialized medical and nursing care.

Currently, the individual contribution to personal medical insurance accounts in China stands at only 2% of wages, with this portion being deposited into the account by both the state and employers. In comparison, many foreign countries typically maintain a 1:1 ratio between employer and employee contributions, whereas China’s ratio is approximately 4:1, with individuals bearing 2% and employers contributing 8%–12%. Therefore, it is advisable to moderately increase the individual contribution rate to 4%, while also appropriately raising the annual reimbursement cap. This adjustment is particularly important for serious illnesses, ensuring that coverage extends up to the cap to prevent poverty caused by medical expenses.

“Basic coverage and high-end services can coexist without conflict; since market mechanisms are in place, they should be fully activated to adapt completely to the market,” pointed out Zhang Boli.

Third,Addressing the Challenges of Three-Medical-System Coordination from a Grassroots PerspectiveThe “Three-Medical Linkage” (healthcare, medical insurance, and pharmaceuticals) presents the most challenges, particularly for the pharmaceutical industry. New measures are continuously being introduced in areas such as drug registration, the National Reimbursement Drug List, payment methods, and classified reforms. While there are more Western medicine enterprises than traditional Chinese medicine (TCM) enterprises, TCM faces even more issues, including those related to the approval system, classical formulas, and injections. These are all practical realities. It is essential to recognize that the Three-Medical Linkage reform is still ongoing; although numerous challenges remain, adjustments are being made rapidly.

Pharmaceuticals are special commodities that prioritize quality. Requirements such as consistency evaluation and clinical assessment aim to eliminate deficiencies and enhance quality. How can we further improve? In general, this involves aligning with international standards on one hand, and addressing technical challenges to elevate quality on the other.

“Many people are aware that the renowned American actress Angelina Jolie underwent a mastectomy. Through genetic testing and professional counseling, she learned that she carried a gene mutation, which significantly increased her risk of developing cancer.”Unfortunately,Currently, it is still not easy to find professional genetic counselors in China to interpret genetic testing data. China has not yet established a training system for genetic counselors.”

He Lin, a member of the National Committee of the Chinese People's Political Consultative Conference and an academician of the Chinese Academy of Sciences, believes that there is currently a significant shortage of talent in China's genetic counseling industry.

“Genetic testing and genetic counseling are two sides of the same coin. Without genetic counseling to interpret the genetic code, sequencing merely yields a pile of digital garbage,” said He Lin. Currently, there is a massive accumulation of genetic testing data that is overwhelming and difficult to interpret. Although China’s gene technology leads in certain areas, there is a shortage of genetic counseling professionals, and the genetic counseling industry remains in its very early stages.

He Lin speculated,China currently faces a shortage of at least 20,000 to 50,000 genetic counselors.. With the widespread adoption of the two-child policy, there has been an increase in the number of advanced maternal age pregnancies, which in turn raises the likelihood of newborns suffering from genetic disorders. The involvement of professional genetic counseling can effectively reduce the birth of infants with congenital defects. He Lin suggests that developing the genetic counseling industry and cultivating genetic counseling professionals should be incorporated as part of the Healthy China Initiative, and that the state should promptly establish a professional framework for this occupation.

Xie Zilong, Chairman of Laobaixing Pharmacy Chain Co., Ltd. and a Deputy to the National People's Congress, statedCurrently, the operating environment for online pharmacies in China is imperfect, and regulations are inadequate. It is recommended that a comprehensive opening of the online pharmacy sector be predicated on the establishment of robust supporting regulatory frameworks.At this year’s Two Sessions, he will submit the “Proposal on Enacting the Internet Drug Transaction Law.”

VCBeat has learned that,As of January 22, 2017, the CFDA website showed a total of 831 "Internet Drug Transaction Service Qualification Certificates," including 41 Class A certificates (third-party platforms), 195 Class B certificates (B2B websites established by pharmaceutical manufacturers and distributors), and 598 Class C certificates (B2C websites applied for by retail chains).。

Xie Zilong stated that drug quality is influenced by multiple factors, with storage and transportation playing a significant role. He emphasized the need for drug regulatory authorities to innovate their regulatory approaches and adopt more advanced methods and tools to strengthen oversight of online drug sales.

Given the complexity of online pharmaceutical sales,Most developed countries have not yet fully liberalized the online sale of pharmaceuticals.In countries with a high degree of marketization, such as the United States, the liberalization of online pharmacies is supported by a comprehensive safeguard system. State Boards of Pharmacy in the U.S. are responsible for the accreditation and daily administration of online pharmacies and their pharmacists, while the National Association of Boards of Pharmacy (NABP) handles the certification of high-quality online pharmacies. Federal agencies conduct regulatory oversight according to their respective functional mandates, and specialized legislation, such as laws protecting consumers in online drug sales, has been enacted to provide consumers with dedicated legal recourse.

In contrast, the operating environment for online pharmacies in China is underdeveloped, with inadequate regulations. The Drug Administration Law lacks provisions governing online drug sales, there are significant disparities in market entry conditions and regulatory requirements across different regions, and a specialized logistics system is absent.

To this end, Xie Zilong suggested,Establish and improve the legal and regulatory framework, and strengthen the online supervision workforce.In light of the characteristics and potential issues associated with online drug sales, it is essential to establish and refine a regulatory legal framework to ensure that such activities are conducted in accordance with the law. Priority should be given to accelerating the enactment of the Internet Drug Transaction Law, followed by the gradual improvement of laws, regulations, and industry guidelines governing online drug transactions. This will better guide and regulate the development of online pharmacies and safeguard the legitimate rights and interests of consumers.

Strengthen the development of online regulatory teams and improve the regulatory system. The food and drug administration authorities shall establish specialized teams for online pharmaceutical supervision, equipped with appropriate regulatory tools. Under the unified management and coordinated division of responsibilities by the China Food and Drug Administration (CFDA), these teams will oversee online pharmaceutical business activities.

Delegates’ speeches and discussions are ongoing; VCBeat will continue to closely follow healthcare-related topics...

Source: Xinhua News Agency, County Health, China.org.cn Finance, People's Daily Central Kitchen, CPPCC Network, and other websites; compiled by VCBeat.