Chinese medical tourism is a growing trend. The trend is both an encouraging sign of the ever-increasing ability of Chinese citizens to travel and purchase goods and services abroad, but undeniably also a sobering reminder of the lacking quality of medical offerings on the Chinese mainland. Chances are, if it’s not available in China, it’s probably purchasable in Hong Kongat a premium of course. Recently, a shortage of pharmaceuticals giant Merck & Co’s human papillomavirus (HPV) vaccine Gardasil 9 has led to protests by Chinese medical tourists in Hong Kong and the lodging of accusations of exploitative business practices by Hong Kong clinics and Chinese travel agents and demands that Merck & Co. step up production.

The scandal illustrates how tenuous and exploitative the medical tourism industry can be for Chinese citizens, and how it can lead to substantial financial losses and even medical danger

Gardasil 9 is still unavailable in most of China, with only limited availability in Hainan Province. However, it is considered one of the most effective HPV vaccines. HPV is linked to various kinds of cancer, including cervical cancer. The vaccine is another example of how Chinese medical policies, or lack thereof, drives medical tourism abroad. While profitable for destinations around the world, it’s frustrating, and potentially dangerous, for Chinese patients, especially those without means.

Hong Kong has served as a popular destination for Chinese women looking to get the Merck & Co. vaccine, which must be administered three times over the course of six months. For a medical treatment that requires repeat visits like the administration of Gardasil 9, Hong Kong is the closest and most affordable destination for most Chinese medical tourists. The vaccine itself, however, is not cheap. Each administration reportedly used to cost between $153 (1,200 HKD) and $510, that price has shot up considerably now due to lack of supply.

Clinics have ran out of the vaccine, causing medical tourists to go without critical final doses

Despite the cost, the vaccine has been a popular treatment for Chinese residents in Hong Kong. So popular in fact, that clinics have run out of the vaccine. For women who had only received the first and second doses, that means that the treatment will not be effective in protecting them against HPV and the potential development of cervical cancer.

Many of the Chinese women who had traveled to Hong Kong and paid for the treatment are, quite understandably, angry, and some 1,600 complaints have been lodged with Hong Kong’s consumer watchdog bureau. That figure is more than triple last year’s total complaints.

Some protests against the manufacturer were revealed to be organized by a medical tourism agency

There have even been protests by some mainlanders demanding that Merck & Co. produce more of the vaccine and accusing the company of cheating Chinese consumers. However, a South China Morning Post investigation has revealed that at least some of the protests have been organized by the medical tourism agency Shenzhen Gangan Medical Consultant Limited, which profited from referrals to Hong Kong clinics that administered the dosages.

Merck & Co. has said that it is unable to expand production in the short-term. In fact, the company reportedly informed clinics eight months ago that because of a cyber attack last year, supply may be threatened and they should plan accordingly. However, it’s not clear whether it was clinics or the medical agents (or both) who oversold vaccine dosages.

How this scandal will be resolved is hard to say and whether the patients involved will be able to receive a new round of vaccinations, damages, or at least a refund from the referral medical agency or the clinics involved is somewhat complicated due to the cross-border nature of the situation. Regardless, it underlines how challenging it can be for Chinese citizens to get life-saving medical treatment that Chinese regulators haven’t gotten around to approving, and how shady businesses can profit off of this need. On the other hand, it is opportunity for reputable hospitals and clinics to benefit from the quality and transparency of their care and business practices to attract Chinese medical tourists. Of course, for many Chinese citizens, these options are simply too costly to be feasible and will likely have to go without.

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