This article was also published on Medical Device Summit
China’s meteoric economic development over the past 30 years has resulted in massive environmental pollution. Although national and local governments are taking steps to reduce the amount of pollution around the country, the issue remains a hot topic in China. Pollution leads to a variety of health issues, especially heart and respiratory diseases. Environmental deterioration will continue to be an increasingly serious issue in China over the next several decades. So, Western medical device and pharmaceutical companies should see a growing market for devices and drugs that effectively mitigate and treat pollution related diseases.
A former Chinese Heath Minister and the current president of the Chinese Medical Association, Chen Zhu, claims that air pollution in China leads to the premature deaths of up to 500,000 people very year. However, other research has estimated the number to be 1.2 million. According to the World Bank and Chinese government, health problems and premature deaths due to air pollution cost China up to $300 billion annually.
OPPORTUNITIES FOR WESTERN COMPANIES
Pollution’s increasing impact on health in China is leading to growing opportunities for medical device and drug manufacturers to market products that can treat pollution related illnesses and/or mitigate the effects of pollution. These illnesses include cancer, heart disease and respiratory infections.
Although China has only about 20% of the global population, it accounts for almost 30% of cancer deaths worldwide. Approximately 3.6 million Chinese are diagnosed with cancer every year — 70% of whom die. Cancer, in particular lung cancer, has been linked with air pollution.
Lung cancer has skyrocketed in China due in large part to both the heavy pollution and the high percentage of heavy smokers. Among Chinese lung cancer patients, it has been reported that non-smokers outnumber smokers. This is the exact opposite of the rest of the world.
One study showed that over the past 30 years, although tobacco smoking has remained relatively constant, the rate of lung cancer — and the number of deaths — has grown almost five-fold. Cancer rates in the suburbs, where there is less pollution, are also much lower.
Lung cancer has the highest mortality rate of all cancers in China, and lung cancer rates are growing almost 30% annually. In 10 years, China will have the largest number of lung cancer patients in the world. Thus, medical devices and pharmaceutical treatments for lung cancer should do very well in the Chinese market. These products include surgical instruments, radiation therapy equipment, chemotherapy drugs and other targeted therapies.
Both medical devices and pharmaceutical products that treat heart diseases like ischemic heart disease, heart attack, heart failure and arrhythmia should also see growing market demand in China. Medical device products used in the treatment of heart disease include pacemakers, implantable cardioverter defibrillators, left ventricular assist devices and cardiac resynchronization therapy devices. Drugs — like blood thinners, angiotensin converting enzyme inhibitors, beta blockers, antiplatelet drugs, nitrates, diuretics, clot busting agents, blood cholesterol-lowering agents, vasodilators and calcium channel blockers — are also expected to do well in China as pollution-related heart disease incidence grows.
For pollution-related respiratory conditions like allergic rhinitis, health authorities recommend antihistamines, decongestants, nasal corticosteroid sprays, eye drops and leukotriene inhibitors. Similarly, inhaler and nebulizer medical devices that dispense anti-inflammatories (often corticosteroids), bronchodilators and theophylline are common treatments for asthma, another respiratory illness that can be caused by pollution.
Many with respiratory conditions also use electronic indoor air filters and humidifiers to relieve their symptoms. Portable oxygen systems and concentrators can assist those with chronic respiratory issues, as can home ventilators for breathing support. N95 respirators, devices that closely fit the face and efficiently filter up to 95% of small airborne particles, can also be used preventatively to keep pollution from entering the body. Companies selling medical products to treat or mitigate the effects of respiratory conditions in China should see continued market growth as pollution worsens.
On days when urban smog is the heaviest in China, it has been anecdotally reported that more than 20% of a city’s residents will wear face masks when they go outside. Doctors advise their patients to wear masks when pollution is substantial, encouraging consumption of the product. The face mask industry in China is worth billions of dollars — but tests have shown that many products currently on the market provide almost no protection from pollution.
The China Consumers Association recently tested 37 different types of face masks; only 9 met the required standards for filtering particulates and ease of breathing. The most expensive mask, priced at $32, performed no better than one of the cheapest masks that sells for $0.15. In China, face masks are categorized as personal protective equipment for medical or industrial purposes — meaning that there are no quality standards for personal use face masks.
In 2013, Taobao, China’s largest online shopping site, reported that Chinese consumers spent almost $150 million on products to counteract pollution, such as air purifiers and face masks. Taobao said that the number of people buying face masks had almost doubled from the previous year.
Hundreds of millions of Chinese are desperate for any medical products that can help reduce the health risks of pollution. As pollution related illnesses become more common throughout China, quality Western medical device and pharmaceutical products that block and/or treat the effects of pollution should find strong market demand in China.
POLLUTION IN CHINA
More than 80% of Chinese report being deeply concerned about the country’s severe air, ground water, river, and soil pollution. Air pollution has become a particularly important issue: less than 1% of China’s 500 largest cities have an air quality level that meets World Health Organization (WHO) standards. The WHO advises that the daily value for small particulates (PM 2.5) should be 20 micrograms per cubic meter or less. The average national intensity in Chinese cities was 72 micrograms per cubic meter in 2013; levels in some areas hit 1,000 micrograms per cubic meter.
The Chinese government strengthened emissions reduction targets in early 2014. Heavily polluted cities like Beijing will have to reduce air pollution by 25% per year. In March 2014, Chinese Premier Li Keqiang vowed to “declare war” on pollution and announced a variety of new measures to control the problem. In April 2014, China’s top legislature voted to adopt significant revisions to China’s 1989 Environmental Protection Law. The regulations also call for the prevention and control of diseases related to pollution.
Beijing has been a frontrunner at the municipal level, implementing its new Air Pollution Prevention Regulation on March 1, 2014. Although, local governments have not often enforced pollution legislation, lax local enforcement is starting to improve. In December 2013, a group of cities in Liaoning province were fined $9 million for pollution emissions. From January to April 2014, Beijing authorities fined more than 650 industrial facilities a total of almost $25 million for breaking environmental regulations.