Recruiting in China

Based on information gathered from several sources, it appears that clinical trial subjects in China are recruited in a limited number of ways, starting with heavy reliance on the investigator to tell appropriate patients about the study, followed by the use of posters and fliers in waiting rooms at accredited clinical trial sites.

Hospitals in the major cities, such as Beijing, Shanghai, Ghangzhou, Chongqing, and Nanjing, tend to be very large by Western standards, many with more than 1,000 beds, reflecting the centralized nature of healthcare delivery in China. As a result, doctors in those institutions are extremely busy, seeing as many as 50 patients most mornings.

Yet, while working at that harried pace, some doctors, especially those seeking to increase their clinical trial workload, remember to discuss clinical trials with patients. Yue Wei, vice president and medical director of Beijing MedSept Consulting Co., a CRO, says, “Doctors generally discuss the opportunity to participate with patients. That is the common way.”

Stefan Astrom, Ph.D., CEO of Astrom Research International, adds, “[Doctors] recruit patients from their regular patient pool. There is an abundance of patients and it's very attractive for them to participate in trials as they may receive new treatment, extra patient care and free medication.” In addition, patients generally do not see the same physician each time they visit a clinic, so the promise of seeing the same physician over the course of a clinical trial may spur interest...

Posters in the waiting rooms may make patients aware of ongoing trials but, according to Shanghai Pharma Engine, a Chinese CRO, patients rarely initiate discussions about them and generally look to the doctor to start this type of conversation.

Notification by physicians and posters may be the key modalities used to recruit subjects, but evidence suggests that other tools are used, as well, but to a lesser degree. A recent article referred to the use of newspapers to advertise about clinical trials.

Representatives of Union Clinical Research Services, Ltd., a Beijing-based company handling clinical trial management at Peking Union Medical College Hospital, explained to a 2005 U.S. delegation (see next section) that various types of electronic media, namely television and radio, are used. The general sense, however, is that electronic media is rarely used.

Sandy Matzek-Cole, one of the delegates, explains, “It’s not clear how frequently these modalities are used, and their use seems to be random rather than as part of an organized recruitment campaign.” Dr. Wei of Beijing MedSept adds, “A few use websites, but ads hardly ever appeared in the media. It’s mostly print-style posters.”

The limited advertising in China seems to be done in accordance with GCP Guidelines, whereby written approval for subject recruitment material is required by an independent ethics committee (IEC). Lisa Sun, clinical process manager for AstraZeneca Pharmaceutical Co. in Shanghai, says IEC approval for patient recruitment advertisements is routine in China. Furthermore, she explains that the names of the sponsor and the product cannot appear in the ads, “only the indication and/or target group as well as the contact name of the hospital or institute.”

Is compensation to study volunteers allowed in China?

GCP Guidelines allow for compensation of study volunteers, provided this information appears in the informed consent document, which has the written approval of the appropriate institutional review board (IRB) or ethics committee (ICH-GCP Sec. 4.8 and Guideline 7 of CIOMS). So, technically speaking, compensation is permitted in China.

In practice, however, there appears to be conflicting opinion on whether compensation is permitted. Some believe that compensation is provided to subjects participating in Phase I studies, but not in subsequent phases. Dr. Astrom says, “Healthy volunteers in Phase I studies are compensated according to international practices. Patients in Phase II, III and IV studies are never compensated, except occasionally for travel costs.”

Similarly, representatives of the Peking Union Medical College mentioned to the People-to-People delegation that generally, patients are not compensated for participation.

By contrast, James Fan, M.D., of Protech Pharmaservices Corp., a CRO, says, “According to No. 43 items of GCP issued by SFDA on 2003-09-01, the sponsor must pay compensation and insurance to patients or volunteers.”

In addition, guidance for medical device studies found in “Provisions for Clinical Trials of Medical Devices,” Chapter 2, specifically states that compensation for study volunteers is permitted, encouraged even, and that information about compensation is to be presented during the informed consent process.

Excerpted from Anderson's book International Patient Recruitment Regulatory Guidelines, Customs and Practices.

By Paul Wiseman, USA TODAY

HONG KONG — Americans and other Westerners have been leaving Hong Kong by the thousands, raising questions about the city's future as the commercial gateway to China and Southeast Asia.
Since the end of 1997 — the year the former British colony returned to Chinese rule — the number of Americans living here has dropped by 7,680, or 21%, to 28,320. Other nationalities have departed in even greater numbers, although a change in the way the statistics are calculated may explain some of the decline.

For almost two centuries, Western firms have used Hong Kong as a base for doing business in China, taking advantage of first-rate infrastructure, world-class banks and even-handed, transparent courts. But China's booming economy is drawing firms directly to the mainland.

"China is sucking in a lot of expatriate talent," says Mike Bekins, managing director for executive recruiter Korn/Ferry International in Hong Kong. Multinational companies "are moving to Shanghai lock, stock and barrel."

"The benefits of being directly in the China market are overriding the benefits of Hong Kong's history," says Laurie Underwood, who interviewed foreign executives in China for her book China CEO.

Other factors:

•Multinational firms are hiring locals for top jobs. "The local talent has improved greatly," Bekins says. "All companies would rather put a local person in a key role. The locals are here for the long term."

They also bring Chinese-language skills and don't require compensation packages that include housing allowances and tuition for kids at expensive international schools, Bekins says.

•Hong Kong's smoggy skies are making it tougher for the city to attract foreign executives. Thirty-five percent of Hong Kong businesses reported having trouble getting employees to move to Hong Kong "as a direct result of the city's air pollution," according to a 2006 survey by recruiting firm Hudson.

The American Chamber of Commerce in Hong Kong has warned that "a deteriorating environment will erode Hong Kong's edge over competing Asian cities." Super-clean Singapore, in particular, has been gaining from Hong Kong's reputation for pollution, says Brenda Wilson, business leader of human capital for Mercer, Hong Kong.

•Dual citizenships might make the exodus look bigger than it is. Under a Chinese law in effect here since 1997, ethnic Chinese born in Hong Kong or the mainland are officially counted as "Chinese," even if they hold passports from other countries and were once counted as foreigners.

Other evidence suggests that the drop in Westerners might not be so big. International schools are packed — though that partly reflects rising demand among locals for English-language education, says Peter Craughwell, spokesman for the English Schools Foundation.

InvestHK, a government agency that promotes foreign investment in Hong Kong, says the number of U.S. companies with regional headquarters in Hong Kong has risen steadily — from 256 in 2004 to 262 in 2005 and 295 in 2006.

Still, the perception remains among some foreigners that the city's fortunes have peaked. When Underwood finished her Chinese-language studies five years ago, she didn't even consider looking for work in Hong Kong. "I just wanted to skip it," she says.

Underwood moved to Shanghai and works as director of external communications at the China Europe International Business School there. "It seemed like (Hong Kong) was over," she says. "I wanted to work in the China market, not the Hong Kong market."

A reader's toolbox:

Attempting156-215 as well as 640-863 do not require much experience. However for 642-382 or even 642-901, every credit matters. That means those 70-528 and N10-003 under your belt do matter after all.

China Automotive Systems Promotes Co-Founder and COO Wu to CEO; Promotes Li to CFO
September 25, 2007: 11:55 AM EST

NEW YORK (Associated Press) - China Automotive Systems Inc., a supplier of power steering components and systems, said Tuesday it promoted co-founder and Chief Operating Officer Qizhou Wu to chief executive.

Wu, 42, succeeds Hanlin Chen, who will continue to serve as chairman.

The company also promoted Jie Li from corporate secretary to chief financial officer. Li, 38, takes over as CFO from Daming Hu, who is now chief accounting officer.

Both positions are effective immediately.

Shares of China Automotive Systems gained 35 cents, or 4.3 percent, to $8.50 in midday trading. The stock has traded in a range of $5.72 to $13.39 over the past 52 weeks.

October 11, 2007
Microsoft (MSFT) has, for the first time, set a chief operating officer position for the Microsoft Greater China region and appointed Eugenio Beaufrand as its first COO.

Eugenio Beaufrand is responsible for sales, marketing and service and focuses on improving clients' and partners' satisfaction. As a top manager of the company, he is also responsible for providing support to the main clients of Microsoft in the region.

As COO, Beaufrand will be responsible for overseeing sales, marketing, and services operations in the market. His responsibilities will include a strong focus on driving customer and partner satisfaction as well as providing support to Microsoft's major clients in the region.

Eugenio Beaufrand will report to Zhang Yaqin, chief executive officer of Microsoft Greater China region.

A seasoned, 23-year veteran of Microsoft, Beaufrand most recently held the position of vice president, Microsoft Latin America, where he led the region to four highly successful years of unprecedented growth. Beaufrand is a native of Maracaibo, Venezuela and has a Bachelor of Science in Business Administration and Economics from the Lewis and Clark College in the United States.

Sino Fibre Communications Corp. (SFBE.OB) revealed that it named Ben Yan as Chief Operating Officer.
Yan has been working on developing the Company's North American business development and is now prepared to take a more active role in its overall achievement particularly as it relates to the build out of our service offering in China.

In addition, Sino Fibre Chairman, President & CEO, Matthew Mecke has announced his intent to focus on his role as Chairman of the company and relinquish his titles of President & CEO as soon as a new CEO can assume this roll. Mecke would continue to focus on U.S. Investments, Shareholders, and related Company activity.

One of China's leading producers of organic rice China Organic Agriculture has appointed Zhidong Li as its CEO.

In a statement, the company said that Li has held positions as CEO, COO and marketing director, as well as investment banker, fund manager and asset manager. At age 27, he was the youngest fund manager for Alliance e-Finance in Australia, managing hundreds of millions of dollars in investments, the company said.

"We are very excited about welcoming Mr. Li to China Organic and we believe his unique mix of experience and expertise will assist us during this high-growth period of our company's development," said Huizhi Xiao, chairman of China Organic Agriculture. "I believe that his insightful leadership will serve every member of the China Organic team and ultimately enable us to reach ever higher levels of shareholder value. His decision-making and business tactics will benefit the Company greatly by allowing us to explore new business opportunities to expand our operations."