Myth: China’s usage of immunosuppressants accounts for only 10,000 transplants per year

As transplant patients rely on immunosuppressants after operation to avoid organ rejection, the international community has expressed doubt over the surge in organ transplants in China and why there hasn’t been significant growth in the international immunosuppressant market.

The Chinese regime has manipulated the apparent size of the domestic immunosuppressant market to match its claim of the country performing around 10,000 transplants per year. On August 22, 2016, Huang Jiefu, chairman of the China Human Organ Donation and Transplant Committee, said at the 26th International Congress of The Transplantation Society in Hong Kong that China accounted for 10,057 transplants (8.38%) of the total of 120,000 performed worldwide in 2015. Since China’s usage of immunosuppressants was about 8% of the total, he asserted, the two figures corroborate each other.¹

The Chinese government lists the research and development of immunosuppressants as national key scientific research projects. The High Technology Research and Development Program (863 Program), National Program on Key Basic Research Projects (973 Program), “985 Project” of the State Key Universities, and China National Natural Science Fund all invested heavily in promoting immunosuppressant research and development. Many domestic transplant-related institutions engaged in R&D early on. Transplant hospitals in China mostly use domestic products instead of imported ones. China’s immunosuppressant market has dozens of brands, including products made by foreign investment companies, joint ventures, and imitation and domestic products; they even include brands of traditional Chinese medicine.²

By 2004, domestic drugs began to catch up and shared almost half of the market with imported and joint-stock drugs. This development greatly lowered the cost of immunosuppressants, lifted a barrier for many patients who otherwise could not afford to receive organ transplants, and greatly contributed to a rapid growth in transplant volume in China.³

In a 2004 Guangming Daily report, Professor Zhang Yuhai, director of urologic surgery at Beijing Friendship Hospital, said that kidney transplant patients in the past [before 2004] mainly used imported or joint venture immunosuppressive products, and that more than half of patients are now using domestic immunosuppressants, including self-financed patients and many covered by free public health services or medical insurance.⁴

In 2006, Health Times (owned by People’s Daily) interviewed Yan Lvnan, the director of the liver transplantation center at West China Hospital of Sichuan University. Dr. Yan said that West China Hospital was able to keep the cost of maintenance at 30,000 yuan in the first year and an average of 10,000 yuan per year thereafter; this was achieved by using immunosuppressants reasonably, which greatly reduced the cost.

In March 2006, just before the exposure of forced organ harvesting, the Southern Medicine Economic Institute under the China Food and Drug Administration published a report in its own publication–Medicine Economic Reporter–which said the domestic immunosuppressant market at the time was nearly 10 billion yuan, and that there were more than 100 manufacturers and nearly 30 varieties.⁵

If each patient pays an average of 30,000 RMB per year for immunosuppressants, the 10-billion-RMB market in 2006 would have supported 333,000 patients. Organ transplantation grew significantly only after 2000 and would have averaged 50,000 to 60,000 per year, not the 10,000 per year claimed by the government.

According to the 2011 “China Science and Technology Development Report,” China has established a series of new demonstration bases for piloting the production of raw materials and preparations of immunosuppressants. China has also improved its research capacity and development and manufacturing of domestic immunosuppressants, achieved the localization of new immunosuppressive products, reduced medical costs for transplant patients, realized earnings from exports, and strengthened the international competitiveness of the Chinese organ transplant immunosuppressant industry.⁶

International drug sales data, such as those from IMS indicating a 2.3-billion RMB market in 2009,⁷ reflect only part of the actual size of the Chinese immunosuppressant market.

As the Chinese government, transplant hospitals, and pharmaceutical companies have widely deflated public transplant data for tax evasion and inability to explain organ sources, it is difficult to determine accurate statistics for domestic immunosuppressant usage. Nevertheless, our research indicates that China’s organ transplant industry has undergone momentous development; China’s actual immunosuppressant market should be far more than the 10 billion figure in 2006 and the scale reflected by current IMS data.

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