China’s patient assistance industry to gain traction with key role in medical insurance system

The 3rd Chinese Physicians Assembly for Humanity was held online today. At the meeting, Deloitte China and the China Patient Assistance Alliance (CPAA) released the Yearbook of patient assistance in China 2021 (the Report), which includes an overview of China’s national policies, major players, and programs of patient assistance. The Report also analyzes the industry drivers and pain points in patient assistance, and predicts four future trends.

The protection and assistance of patients with major diseases is a critical issue for every country. In recent years, China has issued a host of policies on patient assistance, providing a stable development environment for the operation of related programs. In 2020, the State Council’s Opinions on Deepening Reform of the Medical Security System stressed that, “by 2030, a medical security system will be established, in which basic medical insurance plays a dominant role, medical aid provides supporting financial cover for medical expenses, and supplementary medical insurance, commercial health insurance, charitable donations, and medical mutual aid activities co-exist”. This highlights the prominent role charitable donations have to play in medical security.           

The Report points out that charitable organizations are leveraging enterprise donations to help more patients. Patient Assistance Projects (PAPs) are a typical form of medical charitable donation program. Currently, drug assistance programs are mainstream and the number of financial assistance programs is edging upwards. The approval process for the inclusion of drugs in China’s catalogue of medicines covered by medical insurance has been shortened, which has reduced the cycle of some PAPs and led to a surge in the number of post-inclusion assistance programs. The population base of assistance recipients has been expanding to cover diverse regions and disease types. In 2020, donations from charitable organizations’ PAPs reached RMB12.3 billion, accounting for 45% of all medical charitable donations in China.          

“Following years of development and innovation, this boom in the charity sector has been a shot in the arm for PAPs in China. The definition of patient assistance has evolved from traditional PAPs to diverse models, including early screening, patient education, patient care, and post-illness care. Numerous representative cases have emerged with breakthroughs in the type of medication used, population covered, and project mechanism,” says Deloitte China Financial Advisory Partner Chris Lin.

The number of active patient assistance programs in China almost doubled from 72 in 2016 to 135 in 2020, with a cumulative value of around RMB96.6 billion. Continuous support from national policies, enhanced patient reach, and the publicity and promotion of medical philanthropists, are the major drivers of the industry’s rapid development. However, PAPs continue to face obstacles, mainly around patients' misunderstanding of drug assistance programs and the absence of a unified program management system among charitable organizations.        

“Expanding scientific publicity for pre-illness education enhances the public’s understanding of diseases, which is conducive to the progress and advancement of programs. Besides, establishing a unified patient assistance and program management system for charitable organizations would help patients discern project information and heighten the effect and impact of patient assistance,” adds Beijing Health Alliance Charitable Foundation Chairperson Liu Ying.

The Report predicts four development trends in China’s patient assistance sector as industry standards and norms become clearer: the emergence of comprehensive platforms that promote the development of patient assistance; the evolution of assistance programs into patient-centric, full-lifecycle assistance services in which patients’ status is improved; breakthroughs in donations to PAPs making the launch of drugs for rare diseases possible; and PAPs addressing patients’ “last mile” payment issues through multiple channels.         

“With the government vigorously promoting and supporting the establishment of a multi-tiered medical insurance system, there is a vast scope for the development and improvement of China’s patient assistance industry. PAPs, which once assumed a prepositive role in medical insurance, will become important supplements to the medical insurance system, leading to the continuous development of post-inclusion assistance programs,” Lin concludes.