Lions Health: China healthcare plus digital tech could equal pharma nirvana

CANNES, FRANCE—China is already floating in an ocean of data, and the sea level is rising every day. But in many ways, these are uncharted waters—and that’s an opportunity for drugmakers who can figure out how to navigate them.

Consider this: Everything from buying food to learning about chronic obstructive pulmonary disease to giving money to street beggars can be done on WeChat. That’s millions of data points every day. In healthcare alone, 9 of 10 patients in China agree when asked to hand over their records for R&D purposes.

“There are large datasets around lung cancer that are a treasure trove,” said Claire Gillis, international CEO at WPP Health, ahead of a China-focused session here.

“If data were the new oil, China would be Saudi Arabia,” she added. “The question is what to do with it.”

And for pharma, there’s a more basic problem, and that’s a lack of healthcare infrastructure. Many doctors aren’t college-educated, there’s little primary care on offer and hospital physicians typically see 160 to 200 patients a day, Gillis said.

“There’s a disconnect where healthcare isn’t as sophisticated as consumers want it to be,” Gillis said, and getting access to good care requires education that isn’t necessary elsewhere.

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It’s not as sophisticated as drugmakers would like it to be, either, and that’s simultaneously a problem and an advantage. Lack of infrastructure means there’s no existing-but-flawed system that needs to be blown up and replaced; in technologies such as telemedicine, China could theoretically leapfrog the U.S. or Europe.

The government has already moved to foster trust in telemedicine by requiring all digital visits to come after an initial face-to-face consultation, Jun Wu, chairman of the China-focused investment fund Cenova Ventures and Gillis’ co-presenter, said during their Tuesday session.

And China is ready to take advantage of digital healthcare. Some 89% of doctors in China are equipped for telemedicine, 44% of Chinese said they’d prefer a remote doctor visit and 94% of healthcare professionals use digital health tech or tracking apps. Just 74% of doctors in the U.S. do, according to the Future Health Index recently released by Philips.

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Coupled with government initiatives to ease new drugs to market, that spells opportunity for pharmas that can figure out how to work best within digital healthcare.

“It’s going to take some innovation, but China will be a powerhouse going forward. Approvals have already ramped up,” she said. “And innovation is mushrooming up all over the place.”

Take nearsightedness. It’s one of the biggest problems in China, Gillis said, but the country lacks opticians, so it’s not easy to get a vision test. Lasik surgery is all but unheard of. But one company developed a handheld device that can diagnose retinal problems anywhere, which means there's no need to visit a healthcare provider. 

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On the even higher-tech end of the spectrum? Chimeric antigen receptor T cell (CAR-T) treatments, which are just launching in the U.S. and Europe. They’re very expensive—Novartis’ Kymriah lists in the U.S. for $475,000 a year, for instance—and they’ve proven tricky for Big Pharma to manufacture. Because of the sheer size of the market in China, CAR-Ts could be delivered at much lower cost per patient, provided the tech can be worked out.

“It’s really tough, personalized medicine,” Gillis said, “and China is looking at how to make it faster, cheaper and more widely available to people, and they can do that because of their innovations and the need.”

Even the shortage of primary care could be an opportunity for drugmakers to step in and help. Typically, people self-diagnose and then seek care at a hospital, where they wait hours to see a doctor. For acute illnesses, that approach might work, but people with chronic disease “get sicker without knowing it,” said Gillis, who’s a medical economist in addition to an ad executive. “In a disease like diabetes where you don’t necessarily have symptoms, you’re too sick to fix once symptoms arise. And that’s very expensive to treat.”

Enter disease awareness, which can be delivered over WeChat, not just to patients, but to doctors. WPP has been able to capture particular groups of doctors on platforms where they communicate—including WeChat—“so we can talk to them directly,” Gillis noted, provided those communications follow the rules for drug promotions.

And then there are the data—aka real-world evidence—which patients are “quite happy to hand over to get better treatment,” Gillis said onstage.

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Companies are providing all sorts of healthcare services that the government facilities don’t, such as follow-up care, patient support and treatment updates, Wu said. In return, they’re asking patients to provide their own longitudinal data for R&D using real-world evidence.

And more than 90% of patients say yes. “This is extraordinarily powerful, the sheer size of the population, as more and more medicines are available in China, they’re concentrating on real-world evidence” to feed into studies that can deliver broader labels and, perhaps more important, the kind of data that could persuade private insurers to step in and cover expensive drugs for the appropriate patients.

Over the next five to 10 years, private insurance is going to “explosively grow” in China, Wu predicted, to cover expensive medicines and to offer better medical access.

“There’s innovation everywhere, disruption everywhere,” Gillis said. “It’s going to be extraordinary to see.”