News / Asia

Health Care Bribery in China: Why it Worries Global Drug Makers

A Chinese national flag flutters in front of a GlaxoSmithKline (GSK) office building in Shanghai, July 12, 2013.
A Chinese national flag flutters in front of a GlaxoSmithKline (GSK) office building in Shanghai, July 12, 2013.
A high-profile Chinese investigation of alleged bribery at Britain-based drug giant GlaxoSmithKline is drawing attention to the growing presence of foreign pharmaceutical companies in China's booming health care market.

The recent arrest of four Chinese GSK executives implicated in the scandal also highlights the challenges facing the foreign drug makers as they deal with deep-rooted corruption in Chinese health care and Beijing's new efforts to crack down on it.

Chinese authorities announced the arrests on Monday, saying the executives are suspected of bribing doctors, hospitals and government officials to boost sales and prices of GSK products in China.

China also has placed a travel ban on the British finance director of GSK's China division, Steve Nechelput, preventing him from leaving the country.

GSK confirmed the ban on Thursday, but said Nechelput has not been questioned or detained. It also has pledged to cooperate with Chinese authorities in combating corruption.

GSK is one of 38 multinational drug companies with research and development capabilities operating in China. An organization representing those firms, the R&D-Based Pharmaceutical Association Committee (RDPAC)), said they invested $3 billion in China from 2006 to 2010.

Growth potential

Victoria Lai, a New York-based China analyst at the Economist Intelligence Unit, told VOA that foreign drug companies see China as a crucial market to grow their business as sales slow elsewhere.

"The pharmaceutical market in China is still relatively undeveloped," she said. "The size of the market is only around 17 percent of the size of the U.S. market (by value), even though the [Chinese] population is much bigger."

The EIU says pharmaceutical sales in China reached $69 billion in 2012. It predicts those sales will more than double to $166 billion in 2017.

"By then [China] will have surpassed Japan to be the world's second biggest pharmaceutical market," Lai said. "So that is something that foreign drug makers really do not want to miss out on."

Several factors have contributed to surging purchases of pharmaceuticals in China.

"Health care coverage in the country has been expanding rapidly and incomes are rising rapidly as well," Lai said. "As China grows richer, they are experiencing more lifestyle changes leading to different diseases. For example, with changing diets, more people are getting what we would call rich world diseases, like diabetes."

Besides selling drugs in China, multinational companies also have increased research and manufacturing operations there.

Deepening investment

RDPAC says its members spent about $1 billion to build 22 R&D facilities in China from 2006 to 2010. It says 70 percent of member companies also have established Chinese manufacturing plants.

Lai said foreign companies need the R&D facilities to run clinical trials of their medications before Chinese regulators will approve them. She said Chinese officials also have been encouraging the companies to manufacture the drugs inside China.

"Part of this is because they want to boost various sectors of their economy, and biotech and pharmaceuticals manufacturing is very attractive, because it counts as higher value and can generate quite a bit of output and tax income in the future," she said.

The expansion of foreign drug makers in China also has increased their risk of involvement in corrupt practices that have plagued Chinese hospitals and clinics for decades.

Bribery risks

American firms Pfizer and Eli Lilly paid tens of millions of dollars to the U.S. government last year to settle charges of corruption in foreign markets, including China.

Wang Fangqing, a Shanghai-based health reporter for SCRIP Intelligence, told VOA it is common for drug makers, foreign and local, to pay bribes to ensure that drugs are distributed in hospitals and prescribed to patients. "GSK is definitely not alone," she said.

Many Chinese medical workers accept bribes and sell drugs at artificially high prices to supplement low incomes and weak state funding for health care. Such practices are so typical that Chinese people often refer to them by the phrase Yi Yao Yang Yi, or "feeding hospitals by selling drugs."

Wang said China launched health care reform almost a decade ago to change that system. "But little has changed," she said.

EIU analyst Lai blamed the lack of progress on poor enforcement of rules against corrupt behaviors.

"Those [drug companies] that do not adopt these practices find it really hard to compete with those that do," Lai said. "They see themselves as being left behind in terms of being prescribed to patients. This is the case not just for foreign drug makers but for local drug makers as well."

The Chinese government's investigation of GSK and other recent measures indicate that Beijing is getting tougher.

Crackdown intensifies

The State Food and Drug Administration said Wednesday it will stage a six-month operation against drug industry misconduct.

China's National Development and Reform Commission also recently launched an investigation of prices charged by 60 local and international drug makers, including units of GSK, U.S.-based Merck and Japan's Astellas Pharma.

Belgium-based company UCB said Thursday Chinese regulators have visited its offices and those of other drug makers in recent days.

Beijing is under pressure to act in response to long-running public anger about the high prices of medications not covered by state health insurance plans.

But Lai said it is too early to tell if China is serious about including domestic companies in the crackdown.

"It could be another example of Chinese investigators targeting a high profile Western company just to make a point. There is a risk that it is only targeting foreign companies to give local drug makers a bit of a leg up [boost]."

In a commentary published Thursday, Chinese state news agency Xinhua denied any attempt to "sacrifice international firms to give domestic companies unfair advantages."

Xinhua said Beijing is "firmly opposed to commercial bribery in all forms." It vowed that malpractice by "any enterprise -- Chinese, foreign or jointly-funded -- shall be punished."

Michael Lipin

Michael covers international news for VOA on the web, radio and TV, specializing in the Middle East and East Asia Pacific. Follow him on Twitter @Michael_Lipin

You May Like

Video Protests Continue in Ferguson, Spread to Other US Cities

Missouri officials say deployment of more than 2,000 National Guard soldiers helps curb second night of rampant arson and looting in Midwestern town More

Video Ebola, Crackdown on Illegals Hit Business in Guangzhou

Chinese city has largest community of Africans in Asia More

Video Legendary Lebanese Actress, Singer Sabah Dies at 87

Music and film diva, affectionately called 'Sabbouha' by millions of her fans, performed at Carnegie Hall in New York, Royal Albert Hall in London, Olympia in Paris, Sydney Opera House in Sydney More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Aung San Suu Kyi: Myanmar Opposition to Keep Pushing for Constitutional Changei
X
November 24, 2014 10:09 PM
Myanmar opposition leader Aung San Suu Kyi says she and her supporters will continue pushing to amend a constitutional clause that bars her from running for president next year. VOA's Than Lwin Htun reports from the capital Naypyitaw in this report narrated by Colin Lovett.
Video

Video Aung San Suu Kyi: Myanmar Opposition to Keep Pushing for Constitutional Change

Myanmar opposition leader Aung San Suu Kyi says she and her supporters will continue pushing to amend a constitutional clause that bars her from running for president next year. VOA's Than Lwin Htun reports from the capital Naypyitaw in this report narrated by Colin Lovett.
Video

Video Mali Attempts to Shut Down Ebola Transmission Chain

Senegal and Nigeria were able to stop small Ebola outbreaks by closely monitoring those who had contact with the sick person and quickly isolating anyone with symptoms. Mali is now scrambling to do the same. VOA’s Anne Look reports from Mali on what the country is doing to shut down the chain of transmission.
Video

Video Ukraine Marks Anniversary of Deadly 1930s Famine

During a commemoration for millions who died of starvation in Ukraine in the early 1930s, President Petro Poroshenko lashed out at Soviet-era totalitarianism for causing the deaths and accused today’s Russian-backed rebels in the east of using similar tactics. VOA’s Daniel Shearf reports from Kyiv.
Video

Video Hong Kong Protests at a Crossroads

New public opinion polls in Hong Kong indicate declining support for pro-democracy demonstrations after weeks of street protests. VOA’s Bill Ide in Guangzhou and Pros Laput in Hong Kong spoke with protesters and observers about whether demonstrators have been too aggressive in pushing for change.
Video

Video US Immigration Relief Imminent for Mixed-Status Families

Tens of thousands of undocumented immigrants in the Washington, D.C., area may benefit from a controversial presidential order announced this week. It's not a path to citizenship, as some activists hoped. But it will allow more immigrants who arrived as children or who have citizen children, to avoid deportation and work legally. VOA's Victoria Macchi talks with one young man who benefited from an earlier presidential order, and whose parents may now benefit after years of living in fear.
Video

Video New Skateboard Defies Gravity

A futuristic dream only a couple of decades ago, the hoverboard – a skateboard that floats above the ground - has finally been made possible. While still not ready for mass production, it promises to become a cool mode of transport... at least over some surfaces. VOA’s George Putic reports.
Video

Video Falling Gas Prices Impact US Oil Extraction

With the price of oil now less than $80 a barrel, motorists throughout the United States are benefiting from gas prices below $3 a gallon. But as VOA’s Kane Farabaugh reports, the decreasing price of petroleum has a downside for the hydraulic fracturing industry in the United States.
Video

Video Tensions Build on Korean Peninsula Amid Military Drills

It has been another tense week on the Korean peninsula as Pyongyang threatened to again test nuclear weapons while the U.S. and South Korean forces held joint military exercises in a show of force. VOA’s Brian Padden reports from the Kunsan Air Base in South Korea.
Video

Video Mama Sarah Obama Honored at UN Women’s Entrepreneurship Day

President Barack Obama's step-grandmother is in the United States to raise money to build a $12 million school and hospital center in Kogelo, Kenya, the birthplace of the president's father, Barack Obama, Sr. She was honored for her decades of work to aid poor Kenyans at a Women's Entrepreneurship Day at the United Nations.
Video

Video Ebola Economic Toll Stirs W. Africa Food Security Concerns

The World Bank said Wednesday that it expects the economic impact of the Ebola outbreak on the sub-Saharan economy to cost somewhere betweenf $3 billion to $4 billion - well below a previously-outlined worst-case scenario of $32 billion. Some economists, however, paint a gloomier picture - warning that the disruption to regional markets and trading is considerable. Henry Ridgwell reports from London.
Video

Video Chaos, Abuse Defy Solution in Libya

The political and security crisis in Libya is deepening, with competing governments and, according to Amnesty International, widespread human rights violations committed with impunity. VOA’s Al Pessin reports from London.
Video

Video US Hosts Record 866,000 Foreign Students

Close to 900,000 international students are studying at American universities and colleges, more than ever before. About half of them come from Asia, mostly China. The United States hosts more foreign students than any other country in the world, and its foreign student population is steadily growing. Zlatica Hoke reports.

All About America

AppleAndroid