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A market in motion

Dialysis patient Han Xiong doing tai chi

Regular exercise does not only strengthen the body. According to Han Xiong, it also makes people happy and gives them more energy.

Dialysis care in China

Han Xiong still remembers the day when her doctors told her that she would need regular dialysis treatment for the rest of her life. “That is certainly a dramatic moment for any patient, and I was no exception,” says the English teacher from Urumqi. “At first, it felt as if the sky above me had gone dark. But I am lucky to live in a time when China is opening up, and more and more costs are being assumed by the healthcare system.

Today, I am happy to say that I feel fine. I have gotten used to the fact that Monday, Wednesday and Friday involve trips to the clinic – and that I can live my life to the fullest.” For Han Xiong, that means starting each day with tai chi, then studying new dance choreographies and going shopping with her friends. In other words, being a person, not a patient.

Great Wall of China

Raising awareness for kidney disease in China

Han Xiong stood on the stage at the start of an endurance run along the Great Wall of China in 2018 to tell people about her experience and talk about kidney disease, the changes taking place in China and the opportunities emerging as a result. She wanted to get people’s attention. Not for herself, but for her cause.

That desire is also close to the heart of Harry de Wit, a member of the management board of Fresenius Medical Care who is responsible for the Asia-Pacific region. In his opinion, “Our vision is to ensure that people around the world have the same access to the best possible treatment. In China, a major part of this is raising awareness. Awareness is essential when it comes to big changes.”

Back to the Wall campaign China

Back to the Wall kidney care campaign: David Gier and Andrew Stuart began their journey to run the entire route of the Great Wall of China at the end of March 2018.

The number of kidney patients is on the rise

“For a highly developed company like Fresenius Medical Care, enhancements to products typically involve significant opportunities,” explains de Wit. “In China, things are a little different. Here is demand in all areas, from the local infrastructure and the question of how to provide the best possible care for patients, even in remote areas, to the scalability of products and services in the face of steadily growing demand.” After all, the number of patients with chronic kidney failure in China is rising particularly fast, even compared to other Asian countries, at over ten per cent per year. “In the last ten years, China has probably made greater progress in dialysis care than the rest of the world put together. That, combined with a steadily growing middle class, gives us good reason to look to the future with optimism. We benefit from the population’s growing demands on the healthcare system in their country and the fact that more and more people not only want access to better healthcare provision, but can also afford it.”

When David Grier and Andrew Stuart, two South African endurance athletes, were planning their 4,200-kilometre run along the Great Wall of China, Fresenius Medical Care came on board as a partner. It seemed like an ideal opportunity to draw attention to the topic of kidney health over a period of several weeks. And it paid off: the run became a nationwide event, reaching more than 300 million people, thanks above all to social media. 

During the run, the two athletes visited numerous clinics, met patients in treatment and helped to promote local running events over shorter distances to get people in different parts of the country involved. “Shortly before the end of the long-distance run, they asked me if I would like to accompany them for the last hour. It was a real honour to do so,” says de Wit. “The run is a positive story. And people in China love positive stories. That’s why we managed to reach so many of them.”

Chinese population in Shanghai

Lack of capacity outside major cities

Only a small proportion of kidney patients in China can be treated at present. “We are talking about around 45 per cent of people with chronic kidney failure. The reason is not only the current shortage of doctors and nurses, but also the fact that there is room for improvement when it comes to access to affordable products and services,” says de Wit. Outside the major cities, there is little capacity for treatment.

This is why Fresenius Medical Care is focusing on investing in tier 2 and tier 3 cities – large and medium-sized cities with a population between 150,000 and 15 million, like Kunming or Quanzhou. “The biggest cities already have good provision. That is why we can count on the authorities’ support when we invest in other regions,” explains de Wit. “This is our great advantage not only as a provider of the right products, but also one that guarantees the best treatment as well as setting up and operating clinics.”

Dialysis centre China

Fresenius Medical Care intends to open 100 renal hospitals and dialysis centres in China over the next five years.

Achieving significant milestones

China is undergoing a process of profound change. The country is also opening up in the healthcare sector to foreign companies. In the past two years, Fresenius Medical Care has achieved several milestones in China. In late 2017, the first renal hospital specialising in chronic-disease management and haemodialysis was opened as a joint venture. Shortly afterwards, Fresenius Medical Care announced the acquisition of its first independent dialysis centre in Quanzhou.

This was followed by further acquisitions in 2018, including two 70per cent stakes in hospitals in Sichuan Province and the addition of several renal hospitals and dialysis centres. The pipeline is well filled with more than 20 sites and for good reason: “We expect the Chinese government to issue further approvals for renal hospitals and dialysis centres over the coming years, and have prepared ourselves for this development,” explains de Wit.

Fresenius Medical Care is also focusing on expanding its research and development activities. In 2015, it established a proprietary China Design Center in Shanghai, which supplements the development work of the production site in Changshu that the Company acquired in 2007 and is in close contact with the product development team in Schweinfurt, Germany.

However, Fresenius Medical Care’s China strategy also includes setting up new production sites. A plant in Beijing that manufactures dialysis concentrates began operations in August 2018. In late 2018 in India, Fresenius Medical Care presented its first dialysis machine that has been developed specifically for the requirements of emerging markets. The machine, which the company also intends to roll out in China, is characterised by particularly robust materials and lower production costs. “We are focusing on reducing production costs as a way of reaching as many patients as possible who cannot currently obtain treatment,” says de Wit.

Dialysis patient during treatment

Fresenius Medical Care provided products and services to more than 4,000 dialysis centres and renal hospitals in China by 2018.

Growing expectations in China – also in terms of patient care

Reliability and high quality combined with market-specific solutions and needs-driven product innovations are key factors when it comes to successfully tapping attractive growth markets like China. For de Wit, it is only a matter of time before China accounts for more than half of all products sold by Fresenius Medical Care.

“After all, the country is home to 1.4 billion people, and its middle class is gaining in importance practically every day. As a result, expectations in terms of patient care are also rising.” China is already Fresenius Medical Care’s second-largest product market globally. “The sales figures are set to grow significantly over the coming years,” says de Wit.

For Han Xiong, the combination of dialysis products and treatment related services is already the key to a better quality of life. Part of this is having enough time to talk to medical staff like head nurse Li Yufang, who has long become an important figure in Han Xiong’s life. “I know her and every member of the team at the dialysis centre in Urumqi personally. They always have time for my questions or even just a chat, which is something I really appreciate as a patient.”

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