China is the world’s second largest market for pharmaceuticals, worth an estimated $169.4 billion in 2020 and larger than the third and fourth largest markets, Japan ($86.96 billion) and Germany ($71.3 billion) combined. Despite its commercial importance, global teams in Pharma companies often have a limited understanding of the country’s political, cultural, demographic and linguistic idiosyncrasies which play a critical role in the success of their assets. Collaboration with local teams can be difficult, and when market research also doesn’t take into account these nuances, global teams are left operating in the dark or, to borrow a Chinese expression, ‘making a cart behind closed doors’.

What’s more, China is changing – since 2009, the country’s healthcare system has undergone massive reform, not least introducing near-universal social health insurance for the country’s 1.4 billion inhabitants. The ‘barefoot doctors’ of a bygone socialist healthcare system have been replaced by a highly marketized industry that coexists with and incorporates traditional Chinese medicine.

Yet, factors including an aging population, COVID-19 restrictions, overcrowded hospitals, urban/rural divide and poorly perceived primary healthcare, make medical services hard to access for many. To help redress this, more change is planned under the “Healthy China 2030” roadmap first announced in 2016.

In this article, we’ll explore how social media listening (SML) offers the perfect opportunity for Pharma to lift the lid on China’s nuances by exploring the country’s burgeoning digital health ecosystem and vibrant social media landscape.

The doctor will see you 24/7

China’s hospitals were already under pressure pre-Covid, with consultation times averaging only 6-8 minutes and 10-15 in the top-ranking Tertiary Grade A (sanjia) hospitals. Accelerated by the pandemic, a plethora of digital health applications – unparalleled in the west – have sprung up to plug the gaps in healthcare exacerbated by the crisis.

Doctor Q&A platforms are levelling the field, crossing socio-economic and interregional divides by offering on-demand access to highly qualified HCPs. Matching patients with Sanjia doctors in minutes, these offer ready access to consultations, telediagnosis, counselling and prescriptions – without lengthy waits or a need to travel. Ping An Good Doctor, Dingxiang Doctor, Ali Health and Tencent Trusted Doctor are some of the platforms transforming healthcare in China, leapfrogging challenges and alleviating patient frustration, with demand increasing at an exponential rate since the start of the pandemic.

These private sector platforms are not only tolerated but actively condoned and promoted by China’s central government. As part of ongoing healthcare reforms, online appointments and consultations will become reimbursable through social health insurance, further revolutionizing healthcare access; currently expenses are reimbursed for hospital treatment within a patients’ household registration (hukou) area.

Given that doctor-patient interactions on many of these platforms are public, they can provide a unique source of insight into the questions, concerns and needs of patients and carers, as well as a view on the doctor-patient dynamic, in a way which is unparalleled in other markets.

Healthcare on social  

Social media take-up in China soared 12.9% to 930.8 million active users between 2020-21, providing a unique environment and ever-changing suite of tools that facilitates different forms of engagement between patients, carers, HCPs and Pharma.

The leading platform in China, WeChat is a social media ‘Swiss army knife’, a ubiquitous and indispensable part of life for its 1.2 billion users. A vehicle to communicate, socialize and even pay for goods and services, with millions of ‘mini programmes’, the platform is also a vital resource for those seeking medical advice. A search for ‘lung cancer’ in WeChat generates countless articles, HCP-led research, and integrated Doctor Q&A sites covering everything from symptoms to prognosis.

Short video-sharing app, Douyin (TikTok in China), has amassed 600+ million active daily users. Second only to WeChat, Douyin influencers include HCPs with thousands of followers who use the app to educate and engage with patients seeking information and advice.

The app is also a valuable tool for nascent patient advocacy groups (PAGs) such as CORD, the Chinese Organisation for Rare Disorders. The organization has 36,000 followers on Douyin and 31,000 on micro-blogging site Weibo, providing crucial avenues for them and similar groups to increase their social influence and reach more stakeholders. Meanwhile, Pharma is getting in on the act, posting informational content on Douyin and other social channels about how to manage conditions such as diabetes and available therapies.

Social media listening enables Pharma to step into the shoes of patients and their loved ones, see the questions asked, what’s being discussed, which content adds value and how people interact with information in China.

Breaking down barriers

For diseases where stigma may prove a barrier to open conversation in an interview setting, social media can provide a lens through which Pharma can sensitively view the impact of these medical conditions.

Lumanity’s recent SML study into a genetic bleeding disorder in children in China explored and unpicked the role of stigma – by looking at safe, anonymous online communities, we revealed parents’ innermost fears about their children’s futures, whether the disorder might impact university applications, job prospects and how others thought of them. By utilizing social media, we were able to come face to face with the wide range of difficulties faced by parents of children with the condition – by exploring the impact of China’s highly competitive society, the role of reputation, and a fraught patient-HCP relationship exacerbated by overburdened hospitals, we could unpack the complex interplay between society and disease, and provide our client with far more meaningful insights into the real-world situation faced by parents of children with the condition in China.

China is an increasingly crucial market for Pharma, but understanding of the country’s healthcare and digital landscape and the potential it holds often lags sorely behind among global teams. SML provides the perfect window for Pharma to delve into the lived experiences of patients and carers via these online platforms at the forefront of China’s healthcare revolution.

Thomas Markham is a former Beijing resident, Mandarin speaker, and leads Lumanity’s social media insight and analytics within the Chinese market. For any questions or inquiries, please contact