But at the same time, with the continuous improvement of medical facilities in China, the number of medical institutions is also rising, pharmacies are gradually developing the layout of chronic disease management, and residents are gradually aware of their health and prevent chronic diseases through health checkups. In addition, the rise of the Internet chronic disease management model has greatly facilitated the management and treatment of patients with chronic diseases.
Major listed companies in chronic disease management industry: Ping An Good Doctor (0 1833. HK), Ali Health (0024 1. HK), Yu Yue Medical (002223), etc.
The core data of this paper: the main chronic diseases in China and their number of patients, the number of medical and health institutions, the number of retail pharmacies and their growth.
1, demand side (overview of patients and diseases)
-The base of patients with chronic diseases will still expand.
The Report on Nutrition and Chronic Diseases of Residents in China (2020) shows that in 20 19 years, the prevalence rate of hypercholesterolemia among residents aged 40 and above in China was 8.2%; The prevalence rate of COPD was 13.6%, and it was 9.9% in 20 15 years, which increased by more than one third. It is estimated that the prevalence of hypercholesterolemia and chronic obstructive pulmonary disease among residents aged 40 and above in China will continue to rise in 2020 compared with the previous year.
With China's economic and social development and the continuous improvement of health service level, the average life expectancy of residents has been continuously improved, and the survival time of patients with chronic diseases has been continuously extended. In addition, the aging population, urbanization, accelerated industrialization and the prevalence of behavioral risk factors have affected the incidence of chronic diseases, and the base of patients with chronic diseases in China will continue to expand. At the same time, the proportion of deaths due to chronic diseases will continue to increase. In 20 19, chronic diseases accounted for 88.5% of the total number of deaths in China, and cardiovascular diseases, tumors and chronic respiratory diseases accounted for 80.7%. The prevention and control work still faces great challenges. In addition to death, chronic diseases are often accompanied by complications, which greatly affect the quality of life of patients. Take diabetes as an example. Long-term cumulative damage of retinal small vessels will lead to retinopathy and may lead to blindness. The survey shows that the proportion of diabetic eye complications in hospitalized patients is 34.3%, and about 1. 1% patients are blind.
The data shows that among the patients with chronic diseases in China, the number of patients with hypertension alone has exceeded 300 million. Overall, the number of patients with chronic diseases in 20 19 years totaled 845 million. Considering the population overlap of these patients, it is prospectively estimated that in 20 19 years, the population of patients with chronic diseases in China will be about 500-600 million, and the prevalence rate will be about 35%-45%. It is predicted that by 2026, the incidence of cancer, diabetes and hypertension will increase to 0.7%, 14.4% and 27.8% respectively.
The Medium and Long-term Plan for the Prevention and Treatment of Chronic Diseases in China (20 17-2025) issued by the General Office of the State Council mentioned that by 2025, the risk factors of chronic diseases will be effectively controlled, and the premature mortality rate of people aged 30-70 due to cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases and diabetes will be reduced by 20% compared with 20 15 years.
In the future, the pressure of aging population will further increase the burden of chronic diseases in China. China is in the accelerated stage of population aging. In 2020, the population aged 65 and above will be 1.9 1 billion, accounting for 13.5% of the total population. It is estimated that by 2050, this number will reach 329 million, accounting for 23.6%.
-The premature mortality rate of major chronic diseases is decreasing year by year.
The premature mortality rate of major chronic diseases is decreasing year by year, and the labor loss caused by chronic diseases is obviously reduced. The Report on Nutrition and Chronic Diseases of China Residents (2020) shows that in 20 19, the premature mortality rate of China residents due to cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases and diabetes was 16.5%, which was 2 percentage points lower than that of 20 18.5%.
-The situation of prevention and control of chronic diseases is still grim.
According to the Report on Nutrition and Chronic Diseases of China Residents (2020), unhealthy lifestyles of residents are still widespread. The energy supply ratio of dietary fat continues to rise, exceeding the recommended upper limit of 30% in rural areas for the first time. The daily consumption of edible salt and oil in each family is still far higher than the recommended value. At the same time, the proportion of residents eating out has increased, and the oil and salt in canteens, restaurants and processed foods should be paid attention to. The problem that children and teenagers often drink sugary drinks has become prominent. /kloc-the smoking rate of people over 0/5 years old and the drinking rate of adults within 30 days exceed one quarter, and there is a general problem of insufficient physical activity.
In addition, the problem of overweight and obesity among residents is increasingly prominent, and the incidence of chronic diseases is still on the rise. The overweight and obesity rate of urban and rural residents of all ages continues to rise, and more than half of the adult residents are overweight or obese. The overweight and obesity rates of children and adolescents aged 6- 17 and under 6 years old reach 19% and 10.4% respectively. Compared with 20 15, the prevalence of hypertension, diabetes, hypercholesterolemia, chronic obstructive pulmonary disease and cancer increased.
Facing the still grim situation of chronic disease prevention and control, the CPC Central Committee and the State Council attached great importance to it, incorporated the comprehensive prevention and control strategy of chronic diseases into the "Healthy China 2030" planning outline, incorporated reasonable diet and prevention and control of major chronic diseases into the Healthy China Action, and further focused on the main nutrition and chronic disease problems faced by the people at present. The government, society and individuals (families) worked together to actively and effectively promote health through measures such as popularizing health knowledge, participating in health actions and providing health services.
At present, China's tumor spectrum is in a transitional stage from developing countries to developed countries, such as lung cancer, colorectal cancer and breast cancer with high incidence in developed countries, and digestive tract tumors with high incidence in developing countries, such as esophageal cancer, gastric cancer and liver cancer, have declined compared with the 1970s and 1980s, but the overall burden is still heavy, and the overall situation of tumor prevention and treatment is still grim. The five-year survival rate of cancer in China has increased from 30.9% to 40.5% in recent ten years, but there is still a gap with developed countries. To promote the development of cancer screening, early diagnosis and early treatment, one is to continuously expand the supply of screening services, the other is to continuously improve the ability of screening services, actively explore and popularize appropriate screening technologies, and the third is to continuously raise people's awareness of cancer prevention.
-Chronic diseases are characterized by "three highs and three lows"
With the rapid development of China's economy and society, the incidence, mortality and disability rate of chronic non-communicable diseases remain high, while the awareness rate, treatment rate and control rate are low. The main pain points focus on the low awareness and control rate of patients, mainly due to the small coverage of disease diagnosis, uneven diagnosis level and poor self-prevention awareness of patients.
Taking hypertension as an example, the awareness rate of hypertension among residents aged 65,438+08 and above in China was 34.5% in 2007 and is expected to be 45.5% in 2020. The treatment rate of hypertension among residents aged 0/8 and above in China/KLOC was 24.8% in 2007, and it is expected to be 43.6% in 2020. The control rate of hypertension among residents aged 0/8 and above in China was 26.9% in 2007, and it is expected to be 42. 1% in 2020. It can be seen that from 2007 to 2020, the awareness rate and treatment rate of hypertension among residents aged 0/8 and above in China have been greatly improved, but the overall level is still at a low level.
2. Supply side
There are many participants in China's chronic disease management market, including health management institutions and physical examination institutions before consultation, medical institutions during consultation and diagnosis, and offline pharmacies.
-The diagnosis and treatment system for chronic diseases has been gradually improved, and the number of medical institutions has increased.
With the sustained and rapid development of China's national economy and the continuous improvement of residents' living standards, people's demand for health services is increasing, and the medical services and pharmaceutical markets are expanding rapidly.
In 2020, the total number of medical and health institutions in China will reach 102.3, an increase of10.54 compared with 20 19. Among them, there are 35,000 hospitals, an increase of 0. 1 10,000 compared with 20 19; There are 97 1 10,000 primary medical and health institutions, an increase of10.7 million compared with 20 19; There are 6,543,800+4,000 professional public health institutions, a decrease of 2,000 compared with 2065,438+09.
By the end of March 20021,the number of medical and health institutions in China had reached 1.026 million. Compared with the end of March 2020, there are 17273 medical and health institutions in China, including170 hospitals, 17572 grass-roots medical and health institutions and 1624 professional public health institutions. ?
By the end of March, 20021year, there were 36,000 hospitals, including 24,000 public hospitals 1.2 million and 24,000 private hospitals. Compared with the end of March 2020, the number of public hospitals decreased by 76 and the number of private hospitals increased by 1246.
There are 973,000 primary medical and health institutions, including 35,000 community health service centers (stations), 36,000 township hospitals, 609,000 village clinics and 263,000 clinics. Compared with the end of March 2020, there are more community health service centers (stations), fewer township hospitals, more clinics and fewer village clinics. ?
There are 65,438+4,000 professional public health institutions, including 3,387 centers for disease control and prevention and 2,936 centers for health supervision. Compared with the end of March 2020, the number of centers for disease control and prevention decreased by 13, and the number of health supervision centers (centers) decreased by 59. There are 3000 other institutions.
From the perspective of chronic disease management, hospitals are the most important treatment channels for patients with chronic diseases. While the number of medical institutions is increasing, we should also improve the chronic disease management medical system to facilitate patients to seek medical treatment. The treatment of chronic diseases is mainly long-term medication, especially prescription drugs. However, for patients with chronic diseases such as hypertension, hyperlipidemia and diabetes, there is still a big gap with prescription drugs.
Patients with chronic diseases often need to take drugs regularly for a long time to control their condition, but most drugs need professional medical diagnosis and can only be obtained by prescription. Although graded diagnosis and treatment is still in progress, it has not been fully rolled out, and it is difficult for patients to obtain drugs through medical institutions around them. Good drugs have high technical barriers, unbalanced supply and limited channels for consumers to obtain drugs. Therefore, it is common for many people to queue up for registration in the hospital early in the morning. Prescribe the medicine once, and the dosage is basically maintained for one month. If there is no community hospital near the patient's residence or the drugs in the community hospital are incomplete, the old patients will go to the big hospital to solve the problem, and the old patients will become "families with difficulty in prescribing drugs".
In March, 20021,the National Health and Family Planning Commission issued the Notice on Doing a Good Job in the Management of Long-term Prescriptions for Chronic Diseases, which clarified the catalogue of diseases that can be prescribed for a long time, the scope of medication, the management system, safety notification and other requirements, so as to reduce the number of patients taking drugs. For patients with chronic diseases whose condition is stable, relevant drugs can be prescribed once within 12 weeks. This means that compared with the past, most patients with chronic diseases can reduce the number of times they go to the hospital to prescribe drugs, which is a progress in the exploration of chronic disease management mode in medical service institutions in China.
—— Management layout of chronic diseases in pharmacies
From 2009 to 20 18, the number of retail pharmacies in China showed an overall growth trend. According to the Annual Report of Drug Supervision Statistics for 20 19 released by the State Administration of Pharmaceutical Products recently, by the end of 20 19, there were 544,000 pharmaceutical licensed enterprises in China, including 670 retail chain enterprises and 290,000 retail chain stores. There are 234,000 retail pharmacies. Compare the data of120165438 at the end of October (567 retail chains1,255000 chain stores; 234,000 retail pharmacies) In 20 19 years, the total number of pharmacies increased by 7. 16%, that is, 35,000, of which the number of chain stores increased by 13.73%, hitting a new high since 20 16 years. On the other hand, the single store is not satisfactory, with a zero growth of 20 19. The chain rate increased from 49.4% of 20 16 to 55.34%, and the number of chain stores continued to exceed that of individual pharmacies. In 2020, the number of retail pharmacies is expected to be 605 thousand.
Offline chain pharmacies are also interested in the field of chronic disease management. Health home (605266. SH) In the first quarterly report this year, it was revealed that since the end of last year, the company has comprehensively promoted the big data project of chronic disease management in stores, providing customers with rapid self-test and health management services for many important items related to chronic diseases, such as blood sugar, blood pressure, uric acid and blood lipid.
The four major chain pharmacies in China, Lin, the common people, Fengda Pharmacy and Yinxintang, have also laid out the management of chronic diseases.
-residents' health awareness has improved, and health check-up institutions have developed by spurt.
In recent years, people's living standards have improved, and residents' health awareness has been continuously improved, and they have gradually realized the importance of chronic disease management. As well as the impact of consumption upgrading, many residents began to take the initiative to prevent chronic diseases through health checkups. Therefore, the market demand of the national health examination industry is strong, and the health examination institutions show a blowout development trend.
According to the Blue Book of Health Management 20 19 (hereinafter referred to as the Blue Book) jointly published by the Health Management Research Center of Central South University and the Social Science Literature Publishing House of Xinzhiyuan Health Management Research Institute in Zhongguancun, the number of health checkups in China reached 575 million in 20 18, accounting for 42% of the total population. According to the data of National Bureau of Statistics, the number of health checkups in China medical examination market in 20 19 was about 444 million, an increase of 2.07% compared with 20 19. Affected by the epidemic, the number of nucleic acid tests will increase in 2020, or the number of health checkups will be affected to some extent. It is estimated that the number of outpatients in medical and health institutions in China may reach 455 million in 2020.
Generally speaking, there are many kinds of chronic diseases, such as hypertension, coronary heart disease, diabetes, fatty liver and so on. With the change of living and eating habits, the incidence of chronic diseases is increasing gradually, which has a direct impact on the health of our people. In addition, most patients do not know enough about the disease, or their awareness of self-health protection is weak, and their family's economic situation is poor, which makes them not pay attention to their own condition, or fail to use drugs correctly according to the doctor's advice, which leads to further deterioration of their condition and endangers their life safety. In recent years, physical examination is helpful to improve the detection rate of chronic diseases, help patients get early diagnosis and treatment, control the progress of the disease and accelerate physical recovery.
-The rise of the Internet chronic disease management model.
With the development of the new generation of information technology, the Internet chronic disease management model came into being. Health service institutions can use cloud computing, big data and other technologies to build a public information platform, provide personalized health management services for long-term tracking, forecasting and early warning, accelerate the development of Internet-based medical and health services, and support innovative applications of smart health products. By analyzing massive data, including all data of medical care and chronic disease management, the qualitative values that traditional data analysis methods can't analyze are converted into quantitative values.
In addition, more and more businesses in the medical and health industry began to rely on the support of information technology, and the demand for information showed the characteristics of accelerated development. Hospitals below the third-tier cities in China have also entered a period of rapid information growth, which has generated a large demand for basic information technology products such as PCs, servers and development platforms. The informatization of large hospitals has gradually entered the integration period, and the demand for software and hardware upgrades has increased. In the informatization construction of public health management, we will focus on the development of community health management informatization, regional medical data centers, residents' health records and other systems, and information services also have great demand for information system construction.
Chronic disease management platform, such as Medical Union, was established on 20 14. 20 18 takes liver disease as the breakthrough point and focuses its business direction on the field of chronic disease management. At present, the platform has covered cardiovascular diseases, diabetes, respiratory diseases, tumors, chronic kidney diseases, liver diseases, HIV, traditional Chinese medicine, psychiatry and other diseases, and has been constructed from the aspects of patient screening, follow-up and drug administration. The advantages of the Internet chronic disease management platform are as follows.
At present, the representative Internet chronic disease management platforms are as follows:
—— The above data refer to the Analysis Report on Market Foresight and Investment Strategic Planning of Chronic Disease Management Industry in China by Forward-looking Industry Research Institute.