Introduction to China healthcare and pharmaceutical market healthcare... · pharmaceutical market ... R&D and others Consumer health Financial investors. CONFIDENTIAL ... Asia Pacific

DRAFT – subject to revision

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Introduction to China healthcare and pharmaceutical market

The materials contained in this document are intended to supplement a discussion between with L.E.K. Consulting. These perspectives are confidential and will only be meaningful to those in attendance.

L.E.K. Consulting Limited, Floor 34, CITIC Square, 1168 Nanjing Road West, Shanghai 200041, China

T: 86.21.6122.3900 F: 86.21.6122.3988 www.lek.com

October 26, 2012

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Today’s discussion objectives

Introduction

� Introduce L.E.K. Consulting

� Share the opportunities and challenges of China healthcare and Rx market

� Provide a snapshot of the venture capital activities to-date

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Global Capability

Life Sciences Experience & Expertise

� 20 offices worldwide, including 2 in China

� Founded in 1983 in London

� 900+ consulting professionals; 100+ partners

� Advised 25% of largest 200 companies globally

� Highly differentiated from peer consultancies in analytically driven decision-making

� Leading advisor to life sciences companies around the world with over 2,800 engagements ; advised 9 of the top 10 pharmas, 4 of the 5 top global biotechs and more than 150 biotechnology companies

� More than US$115B in transactions in life sciences

� Awarded Healthcare Sector Adviser of the Year 2010 by Acquisitions Monthly and Consultant of the Year at the 2011 Health Investor Awards

� On the ground capabilities and experiences in China; over 50 projects in 2011 in China life sciences and healthcare

L.E.K. Consulting is a leading global strategy firm with a strong focus on life sciences

Introduction to L.E.K. Consulting

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Industry awards recognise the value we bring to cli ent organisations

Consultants of the Year at the 2011 Health Investor Awards

� The judges recognized L.E.K. for its outstanding contribution to the industry and selected the firm as the winner from a shortlist

Healthcare Sector Adviser of the Year 2011

� “L.E.K. has demonstrated its position as one of the foremost transactional advisers to the healthcare sector and has continued to prove its value as a commercial adviser to a variety of corporate and private equity clients”Henry Gibbon, Editor, Acquisitions Monthly

Commercial Due Diligence Provider of the Year 2009

� Voted by industry peers as joint Commercial Due Diligence Provider of the Year at the ACQ Global Awards 2009

Specialist Due Diligence Provider of the Year 2008

� “Sophisticated, discreet and professional, L.E.K. Consulting has delivered good growth in the past year, supporting over 90 transactions with a combined value of £23 billion.” Patrizia Rossi, Editor, M&A Magazine

The Queen’s Award for Enterprise: International Tra de 2007

� L.E.K. Consulting is the first strategic management consulting firm to receive the UK's most prestigious award for business performance

� The International Trade category recognises companies that have demonstrated substantial growth in overseas earnings and commercial success


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Life Sciences and Healthcare

Industrial Products & Construction

Transport & Logistics Financial Services

Media & Entertainment Retail & Consumer Goods

Energy & Environment Industrial Support Services

Examples of L.E.K.’s client relationships across se lected sectors


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The China life sciences practice supports a wide ra nge of healthcare clients

L.E.K. China life sciences practice

Medical devices and diagnostics

Sample Client List - Confidential

Biopharmaceuticals

R&D and others Consumer health Financial investors

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Agenda

Agenda

� Introduction to L.E.K. Consulting

� Overview of the China healthcare and pharmaceutical market

� Venture investment in China healthcare

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China, already the third largest pharmaceutical mar ket in the world, is expected to be a major value driver of the global pharma market, accounting for a quarter of global value growth to 2015

Overview of China healthcare and pharma market

China

Russia

Japan

Canada

U.S.

UK

Asia Pacific

Spain

Germany

ItalyFrance

15-20%

10-15%

5-10%

0-5%

CAGR*2010-15F

Pharmaceutical market growth rate* by major market (2010-15F)

The worldwide contribution of the Chinese pharmaceutical market is expected to continue growing through 2015, eclipsing the growth contribution of the U.S., EU5, and Japan combined

Latin America

Africa

Note: * Constant USD exchange rate Source: IMS Health, L.E.K. analysis

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8Source: United Nations, EIU, Credit Suisse, L.E.K. case experience


185208284

366438

393

14464

0

100

200

300

400

500

Millions of people

2050F2035F20051975

Aged 65 & older

Aged 0-14

20102005

20001995

Percent

100

80

60

40

20

02025F

2020F2015F

China population by age(1975-2050F)

UrbanRural

China urbanization trend(1995-2025F)

0

200

400

600

800

1,000c.4%

25F

c.980

2010

c.560

Thousands of people

Perceived new lung cancer

incidences per year in China

(2010,25F)

Perceived Type II

diabetes prevalence

among China adult

population(2010,25F)

Perceived hypertension

prevalence among China

adult population (2011,21F)

0

50

100

150

200

Millions of people

c.4%

25F

c.165

2010

c.90

0

100

200

300

2011

c.230

Millions of people c.3%

21F

c.300

Factors, such as a rapidly aging population with in creasingly urban lifestyles, contribute to a growing patient population / market among major diseases

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However, per capita healthcare spend in China remai ns relatively low when compared to other nations, limited primarily by pat ient affordability due to low disposable income levels and high out-of-pocket pay ments

Disposable income and out-of-pocket payment as a % of healthcare expenditure (2010)

China healthcare context

Source: WHO, China Healthcare Yearbook, China Statistic Yearbook, U.S. Office of the Actuary, CIA Factbook, L.E.K. case experience

0

10

20

30

40

50

0 10 20 30 40 50

Percent of healthcare expenditure

Per capita disposable income (US$K per year)

US

UKGermany

Japan

China

Out

-of-

pock

et

paym

ent

National healthcare expenditureUS$ 200bn

0

5

10

15

20

Thousands of USD

10

8

6

4

% of GDP

China

3.3

0.2

USUK

8.6

2

0Germany

4.3

Japan

3.4

Healthcare expenditure per capita

Health care expenditure as % of GDP

Healthcare expenditure per capita and healthcare expenditure as a % of GDP (2010)

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10Source: L.E.K. research and analysis

� Outlines an overall objective by 2020 to set up a safe, effective, convenient and affordable healthcare system that covers all urban and rural residents

� 5 key initiatives are laid out

- increase medical insurance coverage

- build a basic medicine system

- upgrade grassroots medical institutions

- equalize services in rural and urban areas

- public hospital reform programs


2009-11 healthcare reform 12th 5-year plan (2011-15)

� Focuses on “inclusive growth”, with initiatives targeting 7% GDP growth, consumption over investments and exports, closing income gap, increasing social safety nets and energy efficiency

� There’s continued focus on public health and improving the healthcare of the rural population

- broader basic healthcare coverage

- improve rural reimbursement

- expand grassroot healthcare infrastructure

- improve disease prevention; increase China’s average life expectancy by 1 year to 74.5

- improve healthcare infrastructure, increase capacity and upgrade smaller facilities

- creation of national standards and benchmarks

- invest in healthcare information technology

Continued improvement and expansion of the healthcare spend, infrastructure and access

China’s 2009 health reform initiatives and the new ‘12th Five-Year Plan’ are designed to dramatically improve healthcare across regions

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China public health insurance coverage by type, (2004-11)

CAGR%(2004-11)

0

200

400

600

800

1,000

1,200

1,400

Urban residentbasic medical insurance(URBMI)

New rural cooperative medical system(NCRMS)

Urban employeebasic medical insurance(UEBMI)

11100908

Uninsured

06052004

Millions of people

07

(36)

40

50*

10

In China, over 95% of citizens are now covered by me dical insurance, though ~40% of the payments remain to be out-of-pocket

Note: * 2007-11CAGRSource: China Health Yearbook, Credit Suisse, EIU, United Nations, U.S. Census Bureau, L.E.K. analysis


China healthcare expenditure by payer type(2010)

10%

37%

~US$ 316 billion

Public

0

54%

Private

Out-of-pocket

10

Payer Type

60

30

20

80

90

50

100

Percent

70

40

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Hospital role in the China healthcare system(2010)

Hospitals have and continue to play an overwhelming ly vital role in China’s healthcare infrastructure system

Note: *Others includes small healthcare institutes with limited medical capacity and capability; ^Others includes nursing homes, research centers, and clinical laboratory centers; ^^Includes patients in emergency care; ^^Few CHCs have inpatient facilities and beds, some rural and L1 hospitals have been re-categorized as CHCs by the governmentSource: China Ministry of Health; China Resources Sanjiu Medical & Pharmaceutical Presentation

Medical institutions by type(2010)Percent

100

80

60

40

20

0% of hospitals

20,918

Public

Private

% of total medical institutions

288,503

Hospitals

Othermedical

institutions*

0

20

40

60

80

100

Percent

% of Rx (value)

Hospital

CHC

Retail pharmacy

% of outpatient visits^^

Hospital

CHC

Others^

% of inpatient visits

Hospital

CHC

Others^

% of healthcare staff

Hospital

CHC

Others^

% of total beds

Hospital

CHC

Others^


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Note: * Assumes USD1 = RMB6.3 exchange rate, ** BMI cap information is the most recent informationSource: China City Statistical Yearbook, local medical insurance bureaus, L.E.K. interviews analysis

Beijing(Tier 1)

Tianjin(Tier 2)

Qinhuangdao, Hebei(Tier 3)

City landscape

Population (M) 19.6 12.9 3.0GDP per capita* RMB75,943

(USD12,054)RMB72,994(USD11,586)

RMB31,120(USD4,939)

# of hospitals (all levels) & healthcare institutions

9,411 4,542 670

# of beds in hospitals (all levels) & healthcare institutions

92,764 48,828 5,544

# of certified physicians & physician assistants in hospitals (all levels) & healthcare institutions

66,163 28,892 3,358

BMI reimbursement cap for severe diseases (per yr)*, **

RMB300,000(USD47,619)

RMB300,000(USD47,619)

RMB250,00(USD39,682)

2010

sta

tistic

sAs a geographically large developing country, gover nment support, patient preferences and hence company strategies are impact ed by the economic and health infrastructure differences


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The vast majority of prescriptions in China are for chemical generics, with a falling but still significant share of antibiotics being pr escribed

Note: * Based on prescription data from 22 sample major cities in China; ^ Biologics excluding non-pharmaceuticals such as vaccines and diagnostic reagentsSource: Citi, National Bureau of Statistics, China Pharmaceutical Association, IMS, State Administration of TCM, L.E.K. analysis

Biologics^

Therapeutic area

TCM Rx

Chemical Rx

40

20

0Drug product category

Antibiotics

Caridovascular

Blood system

Anti-cancer

Digestive system

Others

Product type

Generics

Innovative /originators

Percent

100

80

60

China prescription drugs landscape*(2010)


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Amongst the 5 thousand generic companies, there are Chinese companies aspiring to develop innovative drugs and outreach t o the world

Growth strategy � Business upgrade

� Strong R&D investment

� Strong marketing capabilities

� Business upgrade

� Strong R&D investment

� Strong manufacturing capabilities

� Strong capital operation capabilities

� Aggressive joint ventures, mergers and acquisitions

� Leading branded generic manufacturer

� China’s innovative drug pioneer

� Leading CMO for MNC pharmas

� Leading branded generic manufacturer

� Healthcare conglomerate with diversified businesses

Positioning & business model

Areas of improvement

� M&A and partnership capabilities

� Advanced marketing capabilities

� Capabilities to efficiently integrate and optimize portfolio companies


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16Source: L.E.K. research and analysis


Increase coverage and quality of

services

� Increase insurance coverage � Improve public hospital services� Improve services for family planning, women, children, elderly and disabled

populations� Guarantee drug safety

Innovation

Industry restructuring and

upgrade

� Reach 40 new biopharmaceutical drugs with domestic intellectual property rights� Establish R&D hubs � Innovate education model to create ideas and foster innovation abilities� Accelerate use of new technologies, materials, techniques and equipment to

improve traditional industry

� Build large scale businesses with globally-known brands and core competitiveness

� Build 5 global top 100 biotech companies by 2020� Create 1-3 major national pharmaceutical distributors with over RMB100bn in

revenues� Open up to foreign investment

Three key themes in healthcare initiatives in the T welfth Five Year Plan

A number of initiatives within the 12th Five Year P lan will impact the pharmaceutical sector

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To support its biopharma and medical innovation goal s, China has started and plans to continue funding research and development

Note: * All RMB / USD conversions assume USD1 = RMB6.3 exchange rate, ** “重大新药创制”Source: BioChina, L.E.K. analysis

� c.RMB20billion (USD3.2billion)* invested to spur the biopharma innovation

- investments were done via various special initiatives, e.g. “Major new drug innovation and creation**”

- in addition, more than 50 corporation-led national level technology centers [in the biomedical field] were established via industry-academic collaborations

� RMB40billion (USD6.3billion) targeted in the current period

- China is expected to establish 30-50 clinical / translational medicine research centers and 8-10 specialty medicine research centers

� RMB75billion (USD11.9 billion) planned to increase biopharma innovation

- the news was delivered by Chen Zhu, China’s Minister of Health, who spoke recently at the BioChina Convention

- with the 13th FYP spending, it would bring China total spending to over USD20billion in 15 years, 2006-20

� In addition to the FYPs, numerous plans are implemented and funding are provided for innovation

- their emphasis are on basic research

- 2 plans, The 973 Plan and National Major Scientific Research Plan , have been estimated to provided RMB11.5billion (USD1.8billion) and supported c.500 research projects during the 2006-10 time period


11th FYP (2006-10)

12th FYP(2011-15)

13th FYP(2016-20)

Other programs

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Chinese companies have stepped up their innovative activities and have been increasingly in-licensing, and even and out-licensi ng, early stage compounds

Source: Company websites, L.E.K. analysis


Source: Company websites, L.E.K. analysis

From To DatePartnership type / Geo. direction

Clinical stage

Comments

AlnylamPharma

Ascletis Pharma(Sino-U.S. JV)

Jul-2012Co-development / into China

Phase IIAscletis to receive the rights for the development and commercialization of a liver cancer RNAi treatment in the Greater China region

AscepionPharma

Debiopharm(Switzerland)

Jun-2012Out-licensing / from China (global rights)

Pre-clinicalAscepion out-licensed the worldwide rights of its kinase inhibitor cancer treatment molecule to Debiopharm

Kinex Pharma(U.S.)

Xiangxue Pharma May-2012In-licensing / into China

Pre-clinical (U.S. INDplanned)

Xiangxue to acquire the Greater China rights to a cancer drug potentially for brain tumor

Evotec AG (Germany)

Conba Pharma May-2011In-licensing / into China

Phase IConba Pharma to develop and commercialize Evotec’s early stage anti-inflammatory drug in China

Hutchison MediPharma

AstraZeneca Dec-2011

Co-development / from China

Phase IMediPharma to lead the development, registration, and commercialization of Volitnib, a lung cancer drug, in China. The two companies will share the development costs

Roche Hua Medicine Dec-2011In-licensing / into China(global rights)

Pre-clinical(U.S. IND ready)

Hua Medicine in-licensed from Roche the worldwide rights to Roche’s diabetes compound

Bristol-Myers Squibb

Simcere Pharma Dec-2011Co-development / into China

Phase IIA second collaboration between Simcere and BMS; in this deal, the two companies co-developed a cardiovascular drug. Simcere has the China rights to the drug

Shanghai Institutes for Biological Sciences (SIBS)

Sanofi-Aventis Dec-2010In-licensing (global rights)

Pre-clinical

In Dec, 2010 Sanofi-Aventis in-licensed global rights from SIBS for a molecule that inhibits the slit-robo signaling path that controls tumor vasculature and growth; In May, 2012 Sanofi-Aventis announced that it will begin Phase I trials in China in 2013 for a novel drug for liver cancer stemming from this molecule

Recent transactions involving early stage compounds

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Agenda

Agenda

� Introduction to L.E.K. Consulting

� Overview of the China healthcare and pharmaceutical market

� Venture investment in China healthcare

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Note: * Based on ChinaVenture definition, including pharmaceutical, medical device, biotech, healthcare services, and health management Source: ChinaVenture, L.E.K. analysis

0

20

40

60

80

100

120

140

160

Number of investment

11

101

10

156

09

85

08

94

07

80

2006

47

VC

PE

Angel

N/A

0

200

400

600

800

1,000

1,200

1,400

1,600

644

1,174

102006

Millions of USD

11

829

07

1,469

09

614

08

922

Angel

VC

PE

Financial investment deal numbers in China’s healthcare sector*

CAGR%(2006-11)

17

CAGR%(2006-11)

13

Financial investment valuein China’s healthcare sector*

VC/PEs have invested over US$6b since 2006 in the C hina healthcare space, with both deal numbers and size of deals growing

Private equity and venture capital healthcare inves tment in China

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21

In addition to the financial investors, corporate M &A activities in healthcare have been increasing active, worth over USD13.3bn in the last six years

Note: * Excludes deals that only involves PE/ VC investmentSource: China Ventures, L.E.K. analysis

1 2

64

4

2

0

5

10

15

Number of deals

11

12

8

10

14

8

0908

4

2

072006

3

2

11

21

21

0

5

10

15

1009

5

4

08

Number of deals

11

4

3

072006

Outbound* M&A:Corporate healthcare

Inbound* M&A:Corporate healthcare

New dealsAdd’l investmentto existing entities

192

227216

207

183

117

0

50

100

150

200

250

Number of deals

11100908072006

In-China* M&A:Corporate healthcare

USD2.9bn value from 2006-11

USD550.6mn value from 2006-11

USD9.9bn value from 2006-11

All deals


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22

Two thirds of the financial investments are less th an US$10 million in size

Note: * Including deals where value s were not reportedSource: China Venture, L.E.K. analysis


72

119

656968

41

0

20

40

60

80

100

120


11100908072006

129

365

156144

213

99

0

100

200

300

400

Millions of USD

11100908072006

<=US$10M

29

37

2025

126

0

10

20

30

40


11100908072006

>US$10M

1,0441,112

458

778615546

0

200

400

600

800

1,000

1,200

111009

Millions of USD

08072006

>US$10M

Number of financial investments <=US$10M(2006-11)*

Financial investment value for deals < US$10M(2006-11)*

Number of financial investments >US$10M(2006-11)

Financial investment value for deals > US$10M(2006-11)

<=10M US$

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23

Leading U.S. ventures firms, such as KPCB, Sequoia, and Vivo, have invested and successfully exited their China investments

Source: ChinaVenture, company websites, L.E.K. analysis


Key investors Portfolio company

Exit information Comments

Date Type Value (USD)

GGV Capital GrandhopeBiotech

Jul-2011

IPO –ChiNext

44 million raised at IPO

Grandhope Biotech is a regenerative medical devices company. GGV Capital invested USD1.53m series A for 18.92% of Grandhope in 2009

Fidelity AsiaVentures, and Atlas Venture

NovaMed Apr-2011

Acquisition 105million

NovaMed was a pharmaoutsourcing commercialization company was acquired by SciClone Pharma. Fidelity Asia Ventures and Atlas Venture invested in the B round

KPCB China, IDG Capital, and Vivo Ventures

KanghuiMedical

Aug-2010

IPO –NYSE

68 million raised at IPO

Kanghui Medical is a orthopedic medical devices company. KPCB China and IDG Capital invested USD8 in the series A. Other key investors include Vivo Ventures

Sequoia Capital China

NuokangBiopharma

Dec-2009

IPO -NASDAQ

45 millionraised at IPO

Nuokang is a biopharmaceutical company in the hematology and cardiovascular treatment areas. Sequoia Capital China and syndicates invested USD17m in 2007

Select exits of U.S. VC / PE portfolio companies

6

5

4

4

0

5

10

15

20

25

M&A

11

17

11

13

9

102008

22

18

6

1

09

Number of deals

IPO

Number of VC /PE related exits in China’s healthcare sector(2009-11)

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24

Examples of the healthcare funds in China and inves tments (1/2)

Source: ChinaVenture, L.E.K. analysis


Investor

# of funds Recent investment in healthcare sector

Total2010raised

2011raised

Company Date Sub-sector Invest value Comment

OrbiMed 1 0 0 Crown Bioscience 2011-05-04 Pharmaceutical N/A � OrbiMed exited its investment in ForteBio- ForteBio was acquired by

Pall Corporation- Pall is listed on NYSE and a

fluid filtration, separation and purification solutions provider

Bonovo Orthopedics 2010-12-24 Medical device N/A

Eddingpharm 2010-09-17 Pharmaceutical N/A

Response Biomedical 2010-06-28 Medical device USD7.52m

Zhonghe Pharmaceutical 2010-04-30 Pharmaceutical USD8m

Realton Laser 2010-04-15 Medical device USD5.1m

Angelalign System 2010-03-08 Medical device USD6.6m

ForteBio 2009-12-01 Biotech N/A

Lilly Asian Ventures礼来亚洲礼来亚洲礼来亚洲礼来亚洲

2 0 1 Lianya Medicine 2012-06-13 Pharmaceutical USD20m � In 2011, LAV raised c.USD160m Lilly Healthcare Industrial Equity Fund in 2011 to focus on China investments

� Lianya, BrightGene, and Novastare the most recent investments of a series of investments by Lilly Asian Ventures- Lilly Asian Ventures

participated in the B, C, D rounds of Lianya

BrightGene 2011-01-31 Pharmaceutical c.USD30m

Beta Pharma 2010-06-11 Pharmaceutical N/A

Chipscreen Biosciences 2009-11-01 Biotech USD5m

Novast Pharmaceuticals 2009-07-02 Pharmaceutical USD10m

HDB Bioscience 2008-08-01 Pharmaceutical N/A

Exited investment

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25

Examples of the healthcare funds in China and inves tments (2/2)

Source: ChinaVenture, L.E.K. analysis


Investor

# of funds Recent investment in healthcare sector

Total2010raised

2011raised

Company Date Sub-sector Invest value Comment

KPCB China 3 1 1 Kindstar Global 2012-03-06 Healthcare service

N/A � In 2011, KPCB China raised its KCPB China Fund II at USD250m

� In 2010, KPCB China raised a RMB600m RMB Fund

Arrail Dental 2011-08-29 Healthcare service

N/A

Genscript 2009-10-01 Biotech USD3m

Chiral Quest 2009-01-14 Biotech N/A

Tianren 2008-06-11 Biotech N/A

Sequoia Capital China

9 4 0 Kaifeng Pharma 2011-04-01 Pharmaceutical N/A � In 2010, Sequoia Capital raised 4 funds- USD1b Sequoia Capital

China III- Other three are fund

associated incubator / accelerator centers in China cities, Wuxi and Zhuhai

� Sequoia exited Nuokang in 2009- Nuokang went public on

NASDAQ

Guokang 2010-11-07 Healthcare service

N/A

Eddingpharm 2010-09-17 Pharmaceutical N/A

Beijing Yicheng 210-04-12 Medical device N/A

Bicon Pharma 2009-11-01 Pharmaceutical USD4m

Nuokang Biopharma 2007-12-15 Pharmaceutical USD1.325m

Exited investment

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2626

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Documents

Introduction to China healthcare and pharmaceutical market healthcare... · pharmaceutical market ... R&D and others Consumer health Financial investors. CONFIDENTIAL ... Asia Pacific