The intensity of China's transformation over the past decades has unleashed unparalleled momentum while also presenting profound challenges to its socioeconomic ambitions, impacting how multinationals navigate this new environment. Nowhere is this tension more critical than in its health system, where building a more prosperous society hinges on reducing stark health disparities that have constrained China for decades. The Healthy China 2030 initiative, launched in 2016, was designed to resolve this tension, and in the process has opened massive market opportunities across the healthcare, pharmaceutical, and technology sectors. But, with the 2030 deadline rapidly approaching, progress toward its goals remains uneven and complex, necessitating careful planning and foresight by companies pursuing success in China’s health economy. In the below piece, Alfredo Montufar-Helu and Patrick Beyrer of Ankura China Advisors forecast the policy’s trajectory over its final phase and assess the policy’s impact on the healthcare business landscape.
Healthy China 2030: An Ambitious Call to Action
With the core goal of achieving health equity by 2030 — meaning the elimination of health disparities to give all Chinese citizens a fair opportunity to be healthy — Healthy China 2030 stands as one of China’s most ambitious initiatives. With its introduction, China’s top leadership signaled their aspiration to upgrade the national healthcare and medical systems to world-leading standards, itself a requirement for China to achieve prosperity as envisioned under current policy directives.
The initiative was reinforced by implementation guidelines in 2019, as well as 18 action plans and several health promotion programs. These directives set out a vast scope of cross-sectoral tasks and targets, designed to enhance the quality, accessibility, and affordability of health services; improve commercial conditions; reduce major health risk factors; and ultimately elevate national living standards. Progress has been noteworthy:
- China’s life expectancy had reached its 79-year goal age in 2024, rising from 76 in 2015.
- By 2022, China’s five-year cancer survival rate climbed to 43.7%, from 40.5% at the initiative’s outset.
- In terms of drug development, experts now estimate that China accounts for over 30% of innovative therapies in global pipelines, with drugs originating in China estimated to reach an annual revenue of $34 billion by 2030.
These benchmarks are a bellwether of China’s continued progress on critical health goals and provide a window into the changing conditions for participants in the Chinese health economy.
Progress and Challenges in the New Chinese Health Economy
Under Healthy China 2030's guideposts and other national health-focused initiatives, new opportunities, as well as obstacles, have rapidly emerged for multinationals seeking to succeed in the Chinese health economy:
Healthcare: A major focus of Healthy China 2030 is completing China’s healthcare system transition from a disease treatment to preventative healthcare model, thus shifting emphasis from chronic condition management to community and individual well-being. This governance shift will especially benefit companies producing next-generation, user-friendly healthcare technologies, including those making advanced diagnostic tools as well as those providing digital health solutions — a market anticipated to grow 30% annually over the next decade. Yet, companies seeking to capitalize on this dynamic will be forced to navigate high payoffs against high risks, as volatile competition, especially with domestic champions, is expected to persist. Further, multinationals have struggled to comply with onerous privacy and data localization requirements, in which health data collection and transfer is deemed as especially sensitive.
Eldercare: China is experiencing one of the fastest shifts to an aged society the world has ever seen. With a gross domestic product (GDP) per capita that is below the global average, greater concerns have surfaced regarding increasing healthcare costs, the sustainability of pension systems, and the availability of care services for the elderly. This demographic acceleration — with the population aged 65 or older is projected to climb from 15% in 2025 to over 22% by 2035 and over 30% by 2050, according to the United Nation’s (UN’s) latest demographic projections — simultaneously unlocks an enormous economic opportunity: estimates forecast the silver economy to reach between RMB 19.1-21.7 trillion (USD 2.7-3.1 trillion) by 2035, and between RMB 49.9-63.5 (USD 7.0-9.0 trillion) by 2050. The Healthy China 2030 initiative directly addresses this duality, mandating comprehensive reforms across strategic areas, including improving the institutional capacity and quality of long-term care; integrating advanced technologies like artificial intelligence (AI) and robotics for enhanced risk prevention; and developing specific market solutions in financial/insurance services, nutrition, and recreational services.
Pharmaceuticals and Biotechnology: Since Healthy China 2030’s announcement, the government focus on improving innovative pharmaceutical and biotechnology research and manufacturing has been steadily elevated from a policy standpoint. This policy support has helped deliver impressive financial returns — China’s pharmaceutical sector attracted more than RMB 418.4 billion ($58.6 billion) in primary market financing over the last 10 years and publicly-listed biotechnology companies have grown over 100 times in value since 2016. Multinationals have since leveraged China’s biotechnology growth through record-breaking out-licensing deals this year, obtaining commercialization rights to Chinese drug pipelines and harnessing new sources of innovation.
Despite such positive developments, obstacles for multinational pharmaceutical and biotechnology companies in the Chinese market are well-documented and deep-seated, with such firms facing market access barriers through artificial price reductions and regulatory negotiations for their products to be included on China’s National Reimbursement Drug List. These negotiations result in average drug price reductions of over 60%, hampering foreign multinationals while thereby favoring domestic firms that can absorb thinner margins. Additionally, multinationals in the pharmaceutical sector continue to grapple with intellectual property (IP) protection and technology transfer challenges, areas in which progress has been limited and slow-moving.
Medical Devices: Much like pharmaceutical products, China has prioritized enhanced research and investment into high-end medical devices — including from overseas players — with foreign firms occupying approximately 12% of the medical device market and striking numerous partnerships with local manufacturers. However, multinational medtech companies also have faced research and development (R&D) asymmetries through government indigenous innovation initiatives like “Made in China 2025” and market access obstacles such as large-scale government procurement tenders. For example, since its introduction in 2018, the Volume-Based Procurement (VBP) mechanism has been known to heavily favor domestically made medtech products while deflating foreign product prices by 60-90%.
Financial Services: Achieving equitable access to quality healthcare necessitates ensuring both fiscal sustainability and user affordability, making the expansion of commercial insurance and private pension systems imperative. While this is recognized by Healthy China 2030, the reality is that both systems are under severe strain. The pension system faces a deepening funding shortfall driven by China’s rapid demographic aging, which reduces per capita contributions to the national fund. This challenge is compounded by an unsustainable dependence on public financing, which constitutes nearly 70% of total pension assets, compared to roughly 30% for employer annuities and less than 1% for private commercial pensions. This overreliance strains government fiscal resources, especially at the local level, and leaves retiree proceeds insufficient to cover rising living and healthcare costs. Concurrently, the insurance market confronts its own systemic hurdles: public medical insurance funds face insufficient balances, escalating expenditure pressure on local governments due to rising subsidies. Significant inequities also persist in coverage and affordability across regions and schemes, with rural residents facing heavy economic burdens from low reimbursement rates, which threatens their participation.
The Healthy China Homestretch: What Companies Can Expect
Despite achieving several goals well ahead of schedule, it is uncertain how many of Healthy China 2030’s remaining objectives may be achieved in the next five years, as Chinese officials face both structural and emergent challenges. To take on these obstacles, Healthy China 2030 has been complemented by several new reform efforts within the industry, including the 15th Five-Year Plan (FYP) (2026-2030), whose timeline synchronizes with Healthy China 2030’s culmination. Recently published recommendations on the 15th FYP from top leadership have emphasized new practical cooperation initiatives in the healthcare sector, increased support for private sector scientific development, and direct advancement of the Healthy China 2030 initiative under the “health-first strategy,” a new vision proposed last year that aims to expand preventative health efforts, ease regulatory hurdles for product approvals, and expand application of innovative medicines.
Although these efforts have provided limited details about what the next five years will entail in China’s health economy, three major trends can be reasonably forecasted — and each of them will entail opportunities for multinationals.
1. Biotechnology R&D will remain at the top of the government agenda because of the sector’s strategic status as a “New Quality Productive Force.” Even as Chinese officials seek to shore up indigenous innovation and self-sufficiency within biotechnology and pharmaceutical manufacturing, multinationals will still encounter a vibrant business landscape ripe for research partnerships, joint ventures, local acquisitions, and direct investment. Additionally, as maturing Chinese biotechnology firms develop international ambitions, multinationals that can facilitate cross-border financing and knowledge-sharing may have a critical function in enabling these companies to reach global markets. Close partnership with Chinese biotechnology ventures, however, may bring its share of geopolitical and reputational risks, as the sector has become enveloped within technology competition between China and developed economies.
2. The silver economy will play a heightened role in China’s economic growth, driven by the country’s rapidly aging society and the corresponding rise in non-communicable diseases. This will generate immense, sustained demand for long-term care services and innovative therapies, including those developed through biotechnology. This will also create a vast spectrum of strategic business opportunities extending beyond core products, including in food and beverage products, healthy foods and complements designed for elderly diets; best practices for the operation and administration of eldercare facilities; caregiver training; digital and advanced tech solutions, such as the Internet of Things (IoT) wearable devices with SOS alarms, remote care, and “smart” homes; and design, construction, and retrofitting of facilities to make them “elderly-friendly.”
3. Increasing the affordability of healthcare services while reducing fiscal pressures will rise in importance as a policy priority given the challenges brought by China’s changing demographic structure; and the government’s ongoing efforts to reduce financial risks against the backdrop of a slowing economy. As China moves to address the structural weaknesses in its pension and insurance systems, conditions may arise for multinationals to provide specialized supplemental health and long-term care products, invest in high-quality healthcare facilities and solutions, and bolster the third pension pillar through global asset management expertise.
Finally, across each aspect of the health economy, the influence of Chinese firms will continue to rise. State subsidies, improved private investment, and home market advantages such as preferential regulatory treatment have enabled domestic firms to emerge as viable challengers to foreign brands, heightening the overall competitive landscape. Each of these trends stands to markedly reshape China’s health economy, even in the near-term.
As Healthy China 2030 reaches its closing stages, these policy waypoints create significant motivation for multinationals to formulate company goals and long-term strategy coordinated around healthcare sector development in China. With China’s health economy reaching a groundbreaking stage by transitioning from a manufacturing hub to an innovative pacesetter, stakeholders ranging from patients, health professionals, and multinationals are entering a pivotal moment to mitigate risks, define new areas of policy progress, and realize comprehensive and improved health outcomes across the country.
© Copyright 2025. The views expressed herein are those of the author(s) and not necessarily the views of Ankura Consulting Group, LLC., its management, its subsidiaries, its affiliates, or its other professionals. Ankura is not a law firm and cannot provide legal advice.
