At present, there are 35,600 dialysis centers in whole world. And the gaps of market concentration ratio are large due to the different regional operating entities: Expect for Japan, dialysis centers in other Asian countries are operated by state-owned medical institutions. The rankings of countries in terms of market concentration ratio are as follows: North America, Europe, Latin America and Asia-Pacific. North America is the region has the most advanced dialysis services and highest market concentration ratio.
According to the 2013 annual report of Fresenius, the market share of the two Giants in hemodialysis services– Fresenius and DaVita was only 10.7% and 6.6%. The global market concentration was low in that year. The reasons accounted for that are the influence of the government policies and market openness of each country, so the expansion barrier of hemodialysis services is high. For example, Fresenius has completely failed to enter into Japanese market by far. However, on the other hand, regional market of hemodialysis services is under the monopoly of a specific brand. For example, the total market shares of Fresenius and DaVita in America have exceeded 60% in 2013.
Excerpt? 2.3.2 Market Situations in America, Japan, and China In 2013, the latest research report of IBIS World states that the market scale of American hemodialysis center has reached USD 19 billion, with CAGR (compound annual growth rate) up to 4.9% in 2008-2013. And it is estimated to reach USD 24.5 billion by 2018. In America, the number of the patients who have received the dialysis services from giants-Davita and Fresenius has accounted for 62.7% of the total in 2013, and that of the 9 medium and small chain dialysis institutions has accounted for 15%, nearly 800 non-chain dialysis centers has accounted for 13.6%, and the dialysis centers in hospital has accounted for 8.7%. In general, the average number of patients in each dialysis center is 60-70 people. However, the patients in hospital dialysis centers are no more than 50 people. Obviously, the service ability of independent hemodialysis centers is much greater than those in hospitals.
A typical dialysis center in America is equipped with 18 dialysis machines, and each one of them can give dialysis treatment three times a day, six days a week. Personnel allocation includes five nurses, nine technicians and four supporters (administrative staff, nutritionist and clerk), eighteen members in total. In terms of the distribution of the direct operation cost of American hemodialysis center, manpower cost is a quite important part which covers nearly 40% of the total cost.
Since 1980s, the development scale and level of human resource service industry have been improved constantly in global, especially in Asia. Service fields and contents diversify increasingly, from the original recruitment service and personnel agency to training service, labor services dispatching, employment guidance, talented personnel assessment, management consulting and HR outsourcing etc services and relatively complete service industry chain has been formed.
As one of the most important markets of HR services, Japanese market has unique speciality: special labor force and special profitability model of HR service industry.
Fig.9 Market Share of American Dialysis Services in 2014
Source: Huidian Research
Dialysis cost covers 4-5% of Japanese medical treatment expenses, 8% of Taiwanese medical treatment expenses, 6% of American Medicare and only 0.5% of Chinese medical treatment expenses. Currently, American Medicare has covered about 90% of dialysis patients. In 2012, dialysis cost of this country reaches USD 35 billion. It is estimated that by the end of 2020, Compound Average Growth Rate (CAGR) will be 4.9% with USD 54 billion. Although the absolute cost of dialysis in Medicare is rising, the proportion of dialysis cost is dropping because the overall Medicare cost is rising at a greater speed.
In Taiwan, dialysis cost reaches USD 1.5 billion annually, making it the biggest cost in Taiwan medical insurance cost. Dialysis cost in Japan reaches USD 15-20 billion every year. At present, dialysis cost in Chinese mainland is less than CNY 15 billion every year. However, if the dialysis demands of Chinese ESRD patients were to be covered completely, the annual cost is expected to reach CNY 100 billion, which is about 5% of the total medical treatment cost.
Due to the fact that our life-style has become increasingly westernized, our spectrum of disease is also approaching developed countries. Along with the expansion of governmental medical insurance and income growth, dialysis cost in developing countries will continue to rise. In such developing countries as China, India and Pakistan, 90% end-stage renal failure patients died because they couldn’t receive dialysis treatment.
The cost of dialysis treatment in developed countries and regions far surpasses that in developing countries. However, thanks to the sound medical insurance coverage, the proportion of dialysis patients in developed countries and regions is much higher than that in developing countries.
Table Of Contents
Research and Future Development Trend Forecast of China Dialysis Market, 2015-2020 1. Overview of Dialysis Industry 1.1 Definition 1.2 Classification 1.3 Development History
2. Global Dialysis Market 2.1 Morbidity of Chronic Renal Failure 2.2 Dialysis Product Market 2.2.1 General Situation of Global Dialysis Product Market 2.2.2 Products Made in Europe, America, and Japan Take up the Lion's Share in Global Market 2.2.3 Fresenius Becomes the Giant in Manufacturing Hemodialysis Products 2.2.4 Baxter Becomes the Giant in Manufacturing Peritoneal Dialysis Products 2.3 Dialysis Treatment Market 2.3.1 Overview of Global Market 2.3.2 Market Situations in America, Japan, and China
3. Current Status of China's Dialysis Market 3.1 Development Status 3.2 Competition Landscape of Product Segmentations 3.3 Policy Environment 3.3.1 Gradual Implementation of Critical Illness Insurance Program 3.3.2 Dialysis treatment has the priority to enjoy more benefits in the current short term, while the situation in the long run is determined by Medical Insurance Policy 3.3.3 Exposure Draft Regarding the Independence of the Management Regulations and Basic Standards of Hemodialysis Center issued by NHFPC (National Health and Family Planning Commission of China): with obvious intention to ease the industry access and the openness is appealing 3.3.4 Key Tasks for Deepening the Reform of Health System in 2014: actively promote social capital to invest in and set up medical institutions
4. Overview of Industry Segmentations 4.1 Dialysis Machines 4.1.1 Booming Market Demand and the Soaring Import 4.1.2 China's Dialysis Machine Market is under Foreign Monopoly 4.1.3 Anti-dumping Investigation Helps China Get out of Trade Deficit 4.2 Dialyzers 4.2.1 Market Demand 4.2.2 Distribution Channel Expansion 4.2.3 Competition Landscape 4.2.4 Major Technical Breakthroughs of Domestic Manufacturers 4.3 Hemodialysis Solutions 37 4.3.1 Current Market Scale is About CNY 800 Million and Keeps Growing 4.3.2 Chinese Manufactures Take the Upper Hand but with Low Market Concentration Ratio 4.3.3 Layout of Factory Address is Essential 4.3.4 Low Added Value 4.4 Hemodialysis Tube 4.4.1 High Barriers to Entry and Market Scale is about CNY 1.2 Billion 4.4.2 Chinese Manufacturers Take Half of the Market and the Substitution for Imported Ones is Accelerating 4.5 Peritoneal Dialysis Solution (PDS) 4.5.1 PDS has been Listed in National Essential Medicine New Version and the Market Scale is about CNY 3 Billion 4.5.2 Baxter (Guangzhou) Possesses a Predominant Market Share
5. Development of China's Private Dialysis Industry 5.1 Current Status of Development 5.1.1 Inadequate Supply of Dialysis Services 5.1.2 Insufficient Momentum for State-owned Hospital Developing PDS to Bridge the Supply Gaps 5.1.3 Limited Expansion for State-owned Hospital and Development Opportunity unleashed for Social Capital 5.2 Independent Dialysis Service Center is in Early Development Stage 5.3 Three Major Operation Models for Private Dialysis Industry 5.3.1 Independent Dialysis Center -Customs are the Biggest Barrier 5.3.2 Quick Expansion Model but Low Profits 5.3.3 Hospital Cooperation Model 5.3.4 Privatization and Economies of Scale are Future Development Directions 5.4 Porter Five Forces Analysis
6. Import and Export of Dialysis Equipment 6.1 Import 6.2 Export
7. Key Foreign Manufacturers 7.1 Fresenius (Germany) 7.1.1 Company Profile 7.1.2 Medical Department Development 7.1.3 Business in China 7.1.4 Outlook 7.2 DaVita (America) 7.2.1 Company Profile 7.2.2 Profitability 7.3 Nikkiso (Japan) 7.3.1 Company Profile 7.3.2 Main Products 7.3.3 Business Performance 7.3.4 Development Plan in Next Five Years 7.4 Baxter (the United States) 7.4.1 Company Profile 7.4.2 Business Performance 7.4.3 Renal Dialysis Business 7.4.4 Business in China 7.5 Asahi Kasei (Japan) 7.5.1 Company Profile 7.5.2 Operation Status of Health Care Department 7.5.3 Main Products 7.5.4 Business in China 7.5.5 Future Development Strategy 7.6 B.Braun (Germany) 7.6.1 Company Profile 7.6.2 Operation Conditions 7.6.3 Dialysis Department 7.6.4 Import Business in China 7.7 NxStage (America) 7.7.1Company Profile 7.7.2 Operation Conditions 7.7.3 Portable Hemodialysis Machine Business 7.7.4 Hemodialysis Machine Consumptive Materials Business
8. Key Domestic Production Enterprises 8.1 Shandong Weigao Group Medical Polymer Company Limited 8.1.1 Company Profile 8.1.2 Operation Conditions 8.1.3 Distribution Channel Expansion 8.1.4 Hemodialysis Business 8.1.5 PDS Business 8.2 Huaren Pharmaceutical Co., Ltd. 8.2.1 Company Profile 8.2.2 Operation Conditions 8.2.3 PDS Business Development and Distribution Channel Construction 8.2.4 Development Planning in Next 5 Years 8.3 Boxlight 8.3.1 Company Profile 8.3.2 Operation Conditions 8.3.3 Hemodialysis Business Development 8.4 Kelun Pharmaceutical 8.4.1 Company Profile 8.4.2 Main Products 8.4.3 Operation Conditions 8.4.4 Peritoneal Dialysis Business 8.4.5 Development Strategy 8.5 Jihua Medical Apparatus and Instruments Co., Ltd. 8.5.1 Company Profile 8.5.2 Product Research and Development 8.5.3 Hemodialysis Business 8.5.4 SWOT Analysis 8.5.5 Future Development Strategy 8.6 Chongqing Shanwaishan Science and Technology Co., Ltd (SWS) 8.6.1Company Profile 8.6.2 Operation Conditions 8.6.3 Main Customs 8.6.4 Future Development Goal 8.7 Shandong Xinhua Medical Instrument Co., Ltd (SHINVA? 8.7.1 Company Profile 8.7.2 Operation Conditions 8.7.3 Dialysis Business Promotion Strategy 8.7.4 Dialysis Business Development 8.8 Bain Medical Equipment Co., Ltd. 8.8.1 Company Profile 8.8.2 Competitive Advantages 8.8.3 Development Planning 8.9 Jiangsu Lengthen Life Science and Technology Co., Ltd. 8.9.1 Company Profile 8.9.2 Business Performance 8.9.3 Main Products 8.9.4 Future Development Strategy 22.214.171.124 Make Enterprise Larger 126.96.36.199 Make Enterprise More Excellent 188.8.131.52 Make Enterprise Stronger 8.10 Guangzhou Koncen Biotechnology Co., Ltd. 8.10.1 Company Profile 8.10.2 Business Performance 8.10.3 Future Development Planning 8.11 Shandong Blue Sail Plastic and Rubber Co., Ltd. (Blue Sail) 8.11.1 Company Profile 8.11.2 Build Dialysis Industry Chain and Actively Pursue Industrial Transformation 8.12 Hebei Changshan Biochemical Pharmaceutical Co., Ltd. 8.12.1 Company Profile 8.12.2. Dialysis Business Development
9 Analysis and Suggestions of the Investment in China's Dialysis Industry 9.1 Future Development Forecast 9.2 Investment Opportunity 9.3 Experts' Suggestions 9.3.1 Vigorously Develop Small-scale Portable Equipment 9.3.2 Ensure the Medical Safety through Strict Standardized Training 9.3.3 Complete Family Hemodialysis Related Reimbursement Policies 9.3.4 Open the Market Access; Allow Private Capital to Establish Hemodialysis Center; Standardize Related Detailed Rules 9.3.5 Make Use of Price and Geographical Advantages; Actively Explore the Southeast Asian Markets