In early March, during China's 2021 Two Sessions (annual meetings of the National People's Congress (NPC) and the National Committee of the Chinese People's Political Consultative Conference (CPPCC)), health care was one of the hotly discussed topics. Professor Wang Ningli, a representative of the CPPCC and also an influential ophthalmologist, pointed out that eye health is an essential component of the overall health condition, and the central government should further explore options that could help improve eye health, provide high quality eye treatment for patients, and eventually decrease the number of people suffering from vision impairment or loss in China.1
In recent years, due to increasing number of allergens and certain unhealthy living habits, incidence rates of diseases like cataract and dry eye syndrome have been growing year by year for all age groups. The aging population makes it worse. Because of the complicated structure of eye, many eye diseases like cataract requires surgical intervention and cannot be effectively treated by medications alone. However, the medicine market potential for several prevalent eye diseases is still considerable, especially the treatment for myopia, dry eye syndrome, and retinal diseases.
The market size for eye medicine in China grew at a compound annual growth rate of 8% from 2015 to 2019 and is expected to reach 24.7 billion RMB in 2021.2
Eye Medicine Market Size In China (in Billion RMB)
Currently, foreign companies occupy a relatively high percentage of eye medicine market in China. A 2018 study indicates that in key public hospitals at the provincial and municipal levels, imported drugs took up around 64% of total eye medicine consumption. Novartis (25.35%), Santen (14.24%), and Ursapharm (6.32%) hold the top 3 places.3
Market Share of Eye Medicines in China (2018)
Among the various eye diseases, myopia has become the most prevalent one that affects over 600 million people in China.4 Years of clinical trials in Singapore has proved that low-concentration (0.01%) atropine eye drops are efficient in slowing down the development of myopia with very few side effects. There is no marketed product in China yet, and Sinqi Ophthalmic Medications' in-hospital preparation (produced by Sinqi's medical institutions for their patients only) is one of the very few sources that Chinese patients could access.5 Considering the huge myopia population and the relatively cheap price (comparing to wearing lenses or surgical intervention), the market of low-concentration atropine eye drops could be further expanded.
In China, around 200 million people are affected by dry eye syndrome, a disease that is treated predominantly with artificial tears.2 Sodium hyaluronate eye drops are the mainstream product within the artificial tears market. In 2019, sodium hyaluronate eye drops had a market size of almost 2 billion RMB, which accounted for over 90% of the artificial tears market in China.6 However, the situation is vastly different in the United States, with cyclosporine eye drops being the most popular treatment for dry eye syndrome. Cyclosporine is an immunosuppressant that is mainly used to prevent rejection in organ transplant, and 0.05% cyclosporine is effective for dry eyes. In 2018, its sales in the U.S. reached 2.83 billion USD, which took up 70% of all drugs for dry eye syndrome.2 While sodium hyaluronate eye drops could temporarily relieve the dryness, 0.05% cyclosporine eye drops are safe and effective in treating even very severe dry eyes. Domestic company Sinqi's product Zirun is the only approved 0.05% cyclosporine eye drops in China. The market potential is considerable.
Anti-vascular endothelial growth factor therapy is a growing field in ophthalmology. Anti-VEGF medicine can be used to effectively treat ocular fundus diseases like neovascular age-related macular degeneration (wet AMD). In Chinese hospital consumption of eye medicines, the percentage of medicines that target ocular fundus diseases grew significantly from 4.1% in 2012 to 31.4% in 2019.2 In China, Ranibizumab, Conbercept, and Aflibercept are the three main Anti-VEGF medicines, which have entered the National Medical Insurance and the cost of relevant treatment will be partially covered. More companies are starting to target this field, as the National Medical Products Administration (NMPA) statistics showed that 11 Anti-VEGF products filed application in 2020 alone.7
Marketed Anti-VEGF Medicines in China and Their Market Share in All Hospital Eye Medicine Consumption In recent years, investors have already begun to distribute capitals in this field. Before 2015, there were in total 11 financing events in the ophthalmic market and after that, there have been an average of 18 each year.7 For example in 2020, Eluminex Biosciences (Suzhou), an ophthalmic drug company that focuses on innovative therapy, received 50 million USD series A financing from Lilly Asia Ventures, Gaoling Venture Capital, and Quan Capital. Neurophth (Wuhan), first Chinese ophthalmic company dedicated to develop gene-based medicines, also received 130 million RMB series A financing and 400 million RMB series B financing. With further government support and advanced medical research, the market is expected to increase at high growth rates.
