2026年中国银发经济：医疗与保险报告-

China

China’sBurgeoningSilverEconomyII:Healthcare&Insurance

CITI'STAKE

FollowingtheofourChinaSilverEconomyseries,whichdelvedintothepensionandlodgingsectors,wefocusonsomeofthelargest&mostcompellingopportunitiesinthissecondinstallment:thesymbioticgrowthofhealthcareandinsurance.China'srapidlyagingpopulationpresentssignificant,multi-decadegrowthopportunitiesforthetwosectors.Worthmentioning,the2026GovernmentWorkPlanspecificallymentionedcommercialhealthinsuranceforthefirsttime.Weexpectsubstantialgrowthindemandforhealthcareservicesandinnovativetherapeutics,drivenbyanexpandingelderlydemographicandawideninggapbetweenpublichealthcarefundingandactualneeds.Keyhealthcarebeneficiariesincludeserviceproviders,pharmas/biotechsfocusedonchronicdiseasetreatments,andmedtechfirmsofferingsolutionsforage-relatedconditions.Meanwhile,insurerscouldseizenewopportunitiesthroughcommerciallong-termcareinsurance(LTCI)amidanagingsociety

China'sDemographicShiftFuelsHealthcare&InsuranceGrowth—Weestimatenon-reimbursablehealthcareexpenditurewasRmb3.2tnin2025,upata7.2%CAGRtoRmb6.5tnby2035E,drivenbyolderadults'higherhealthcarespendingandasthepublicsystemcannolongerpayupfortailoredpersonalneeds.Benefitingfromthistrend,innovativedrugsalescouldgrowata15%CAGRby2035E(vs.~6%intheUSonCitiestimates.Webelievecommercialinsuranceissettocapturealargershareamidfastgrowth,potentiallycovering18%ofhealthcareexpenditure.

KeyBeneficiariesinHealthcareandInsurance—Weidentifythreecorepillarsofopportunitywithinhealthcare:1)Online/offlinechronicaldiseasemanagersforefficientelderlycaredelivery,2)InnovativePharma&Biotechforage-relateddiseasetreatments,and3)Advancedmedtechforphysiologicaldeclinemanagement.Forinsurers,weexpectcommercialinsurerstoseizenewandvastopportunitiesthroughcommercialLTCIandenhancecurrentbizthroughadd-onhealthmgmtservices.

PharmaceuticalandMedtechInnovationforGeriatricNeeds—Pharma/biotecharereorientingR&DtowardsLTchronicdiseasemanagement,focusingonenhancedconvenience,high-needareaslikeneurodegenerativediseases,andnovelmodalitiessuchassiRNA.InMedtech,innovationiscenteredonlessinvasiveprocedures,remotemonitoring,andfunctionalrestoration.

Govt-led&CommercialLTCIPresentUntappedOpportunities—CNisconcludingits9-yearpilotandcommencingnationwiderolloutofLTCIsystemwithinsocialsecurityframeworkin2026,andweexpectearlyparticipantsinthepilottogainadvantagesinestablishingserviceprovidernetworksandexpensemgmtcapabilities.ThoughcommercialLTCIisstillinnascentstage,weexpectpremiumstologa12%CAGRin2024-2030EtoRmb171bnwithpotentialtofurtheraccelerate.

BenefitedStocks–Insurance:PICCP&C,ChinaLife,CPIC;Online/AIhealthcare:AliHealth,PAGD,Fangzhou;HealthcareServices:Gushengtang,YifengPharmacy,AierEyeHospital;Pharma/Biotech:Hengrui,Innovent,Ribo;MedTech:MicroPort.

JohnYung,CFAAC

+852-2501-2790

john.yung@

MichelleMa,CFAAC

+852-2501-2723

michelle.ma@

EvaZhao,CFA

+852-2501-2701

eva.zhao@

WangbinZhou

+852-2501-2352

wangbin.zhou@

ZoeBian

+852-2501-2752

zoe.bian@

AmyJyChen

+852-2501-8156

amy.jy.chen@

SeeAppendixA-1forAnalystCertification,ImportantDisclosuresandResearchAnalystAffiliations.

NotfordistributioninthePeople'sRepublicofChina,excludingtheHongKongSpecialAdministrativeRegionandQualifiedForeignInstitutionalInvestors.

2

China

20March2026CitiResearch

Contents

China:TheFastestAgingCountryintheWorld5

China’sSiverEconomy–OpportunitiestoHealthcareand

Insurance6

CoreBeneficiariesinHealthcare&Insurance9

Healthcare:ChronicDisease,Disability,andHealthLiteracyasKey

DemandDrivers10

ChronicDiseaseManagement:AIServesas“HealthPartner”;

LeadingOnlineandOfflinePharmacy/ServiceProvidersBuildan

IntegratedEcosystem11

Pharmas/Biotechs:RidingtheWaveofGeriatricInnovation14

Medtech:AddressingPhysiologicalDeteriorationandImproving

QualityofLife18

Insurance:CommercialLTCItoSupplementSocialSecurity21

CommercialInsurancetoSupplementChina’sEvolvingLTCare

InsuranceSystemforElderly22

LTCIunderSocialSecurityFrameworkConcluded9-yearPilot

andHasEmbarkedonNationwideImplementation22

LTCIunderCommercialInsurancetoShiftFocustoProtection

FeatureandEmbraceRisingElderlyCareDemand25

ForeignExperiencesIndicateFurtherRoomforCommercialLTCI

DevelopmentinAdditiontoSocialSecurityCoverage27

Insurers’HealthManagementServicesCouldSpurBusiness

GrowthandContainClaimsfromtheElderlyGroup30

AppendixA-132

China

20March2026CitiResearch

3

TableofFigures

Figure1.ChinaHealthcareandInsurance:Comptableofbenefitedcompaniesamidsilvereconomy4

Figure2.China'spopulationagingtrendissignificantlyfasterthantheothercountries5

Figure3.China'spopulationagingtrend5

Figure4.Percapitahealthcareexpensesforindividuals60+are~5Xtimeshigher6

Figure5.China'sNon-reimbursableHealthcareExpenditure(NRHE)7

Figure6.TotalnationalhealthexpendituresbreakdownbysourceoffundsintheUSvs.Chinain20247

Figure7.Innovativedrugsalestoincrease~4x;commercialmedicalinsurancelikelytocontribute18%ofdirectHCexpenditure

in2035E8

Figure8.InnovativedrugsalesinChinatogrowat15%10yCAGRvs.6%forUS8

Figure9Overviewofbenefitedsub-sectorsinChinaHealthcare&Insurance9

Figure10.Prevalenceofchronicdiseaseamongpeopleagedover6010

Figure11.Prevalenceofdeteriorationofphysiologicalfunctionsamongpeopleagedover6010

Figure12.Chinaresidenthealthliteracylevel(2013-2025)11

Figure13.YoYgrowthofusersbyagegroupofAliHealth(forthe90daysendingAug2024)12

Figure14.FivemajorhealthproblemsfacedbytheelderlyshowedinthesurveyconductedbyAliHealth12

Figure15.PositioningofAI-assistedonline/offlineplatformsforsilvereconomy14

Figure16.Marketsizebreakdownbydiseaseandkeytargetandgrowthforecastforthenextfewyears16

Figure17.Globaloligonucleotidedrugmarketsize,2019-2034E17

Figure18.Positioningofselectedpharma/biotechsforsilvereconomy17

figure19.Keyinnovativemedtechsegmentsforaging-relatedchronicdiseases20

Figure20.Chinaisfacedwithacceleratingaging,inadditiontoadecliningbirthrateandashrinkingworking-agepopulation,

leadingtorisingdemandforlong-termcare24

Figure21.AuthoritieshavebeenpromotingtheestablishmentofaLTCIsysteminChina24

Figure22.Commercialinsurers'participationinLTCIvariedin202425

Figure23.62%CAGRincommercialLTCIpremiumsin2020-24toRmb85bn,or9%oftotalcommercialhealthinsurance

premiumsin‘24(vs.1.5%in2020)25

Figure24.WeexpecttotalcommercialhealthinsurancepremiumstoexpandtoRmb2tnin2030E26

Figure25.Assumingasimilargrowthrateforallcommercialhealthinsuranceproducts,weexpectcommercialLTCItobooka

12%CAGRin2024-2030E26

Figure26.US-the'sweetspot'forapplyingforLTCIisbetweentheagesof55and65,pertheDirectorofAmericanAssociation

ofLTCI28

Figure27.US-LTCIproductstendtobecostly,especiallyafterfactoringininflationprotection28

Figure28.Listedinsurershavebeendeployingresourcesinhealthmanagementservicestoenhanceproductattractiveness31

China

20March2026CitiResearch

4

Figure1.ChinaHealthcareandInsurance:Comptableofbenefitedcompaniesamidsilvereconomy

MktCap

CompanyTickerUS$(M)

Ccy

Close

Price

TargetPrice

P/E(x)EV/EBITDA(x)P/B(x)Divyield(%)Debt/equity(%)Rating2026202720262027202620272026202720262027

300015.SZ

AierEyeHospitalGroup

13,487

Rmb

9.980

6.500

323.0

20.8

12.8

11.5

3.7

3.4

1.8

2.0

5.7

5.1

AliHealth

0241.HK

10,056

HK$

4.87

9.00

1H33.9

31.1

29.3

26.0

3.5

3.1

NA

NA

0.0

0.0

2628.HK

ChinaLifeInsurance

101,604

HK$

28.16

40.00

15.2

5.5

NA

NA

1.0

0.8

3.4

3.4

4.8

4.2

601628.SS

ChinaLifeInsurance

101,604

Rmb

41.720

53.100

28.8

9.3

NA

NA

1.6

1.4

2.0

2.0

4.8

4.2

2601.HK

ChinaPacificInsurance

40,968

HK$

33.36

44.90

16.0

6.2

NA

NA

0.8

0.8

4.1

4.2

2.8

2.5

601601.SS

ChinaPacificInsurance

40,968

Rmb

39.160

51.500

18.0

8.3

NA

NA

1.1

1.0

3.1

3.2

2.8

2.5

6086.HK

FangzhouInc.

244

HK$

1.38

8.50

1H34.2

13.0

11.3

4.8

5.4

3.3

NA

NA

1.0

0.6

2273.HK

GushengtangHldg

777

HK$

26.50

55.00

110.8

8.7

5.8

4.2

1.7

1.4

2.7

3.5

3.1

2.6

1801.HK

Innovent

17,953

HK$

81.05

110.00

1NA

56.8

76.4

38.0

8.2

7.2

NA

NA

2.7

2.4

600276.SS

JiangsuHengrui

53,107

Rmb

55.140

123.000

141.4

35.3

32.0

26.0

5.2

3.8

0.4

0.4

0.0

0.0

1276.HK

JiangsuHengruiPharmaceuticals

53,107

HK$

64.75

134.00

142.8

36.6

32.0

26.0

5.3

3.9

0.4

0.4

0.0

0.0

Microport

2160.HK

523

HK$

3.22

8.00

1-46.6

NA

NA

37.8

1.6

1.6

NA

NA

41.8

40.0

2252.HK

MicroPortMedBot

3,165

HK$

24.04

32.00

1HNA

NA

NA

56.4

14.2

10.6

NA

NA

17.2

12.8

0853.HK

MicroPortScientific

2,345

HK$

9.58

16.00

123.5

14.5

14.5

10.3

3.9

3.1

NA

NA

127.7

109.9

PICCP&C

2328.HK

43,244

HK$

15.23

20.50

17.6

7.3

NA

NA

1.0

0.9

4.9

5.1

3.9

3.6

PingANHealthcareandTechnology1833.HK

3,228

HK$

11.70

18.00

148.0

33.4

63.5

38.7

2.2

2.0

NA

NA

0.0

0.0

SZRibo6938.HK

1,242

HK$

57.05

102.00

1HNA

-21.8

NA

-23.1

7.9

13.1

NA

NA

36.7

60.6

YifengPharmacyChain603939.SS

4,296

Rmb

24.450

33.000

115.7

14.2

9.4

8.2

2.3

2.1

3.3

3.7

23.5

22.5

Source:CitiResearch,anddataCentral.Financialsandratiosarecalendaryearbasis.

China

20March2026CitiResearch

5

China:TheFastestAgingCountryintheWorld

Chinaisundergoingaprofounddemographictransformation,withitspopulationagingatapaceandscalethatisunprecedentedglobally.AsshowninFigure2,thecountry's21-yeartransitionfroman"agingsociety,"toa"deeplyagingsociety"

(from7%to14%ofthepopulationaged65orabove)in2021.Thisvelocitystandsinstarkcontrasttosignificantlyslowertransitionstookplaceinothermajor

developedeconomies:France(126years),theUnitedKingdom(46years),Germany(40years),andJapan(24years).Themomentumofthisdemographicshiftissettocontinueduetobirthratejusthithistoricallowin2025.Chinaisprojectedtoreach"super-aged"status,with20%ofthepopulationaged65andabove,by

approximately2032,accordingtoUNestimate.

AsillustratedinFigure3,thepopulationaged65andaboveisexpectedtoexceed224mnby2025,accountingfornearly16%ofthetotalpopulation—afigurefar

surpassingtheglobalaverage.Thismassiveandrapidlyexpandingelderly

populationshouldbeamajorconsumerofhealthcareservicesandtherapeutics;

thehealthcaredemandsarerigid,long-term,anddiverse.BothChinahealthcare

andinsuranceindustriesneedtobefundamentallyrestructuredtoentertainneedsoftheagedpopulation,soastobenefititself,long-termandstructurally,inthe

silvereconomy.

Figure2.China'spopulationagingtrendissignificantlyFigure3.China'spopulationagingtrend

fasterthantheothercountries

No.yearsfromagingtodeeplyagingsociety

fromagingsociety

126

46

40

2421

FranceUnitedKingdomGermanyJapanChina

mn

300

250

200

150

100

50

-

10%

145

2015

11%

150

2016

11%

160

2017

12%

167

2018

13%

178

2019

14%

191

2020

14%

201

2021

15%

15%16%16%

210

217220224

2022202320242025

Chinapopulationages65andabove(mn)%oftotal

18%

16%

14%

12%

10%

8%

6%

4%

2%

0%

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.Source:CitiResearch,WorldBank

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.Source:CitiResearch,Nationalbureauofstatistics

China

20March2026CitiResearch

6

China’sSiverEconomy–Opportunitiesto

HealthcareandInsurance

China'srapidaginghasbecomeamulti-decadetailwindforboththehealthcare

andinsuranceindustries.AccordingtoresearchconductedbyTsinghuaUniversity(Mar2017),thepercapitahealthcareexpensesforindividualsover60are~5timeshigherthanforthoseunder60.Thisspendinggaphighlightsthedirectand

powerfulimpactofdemographicsonhealthcaredemand.BasedonNational

BureauofStatisticsdata,weestimatethepercapitahealthcareexpenditureforChineseindividualsabove65wasRmb7,050,~5XofRmb1,410ofthosebelow65.

Figure4.Percapitahealthcareexpensesforindividuals60+are~5Xtimeshigher

Rmb7,050

1,410

Agesbelow65Ages65andabove

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.

Note:Thepercapitahealthcareexpenditurebyagegroupiscalculatedbasedonthepercapitahealthcareexpensesfor

individualsannouncedbyNationalBureauofStatistics.Theexpenditureisadjustedbyexcludingindividualpremiumpaymentoncommercialhealthinsurance.

Source:CitiResearchEstimate,NationalBureauofStatistics,TsinghuaUniversity

Thedemographicmultipliereffectispoisedtofuelasignificantexpansionofthehealthcaremarket.However,thisrisingdemandisrunningintoasignificant

constraint:publicfundingisfailingtokeeppace.ThisisclearlyevidencedbythesharpdecelerationintheexpendituregrowthoftheNationalBasicMedical

Insurancefund,whichslowedtojust0.8%yoyin2025from5.6%in2024.This

slowdowncreatesasubstantialandwideningfundinggapbetweentotal

healthcaredemandandwhatthepublicsystemcancover.Thisgaprepresentstheprimarymarketopportunityforbothcommercialinsurersandtheprovidersof

aging-relatedhealthcaretherapiesandservices.

Toquantifythetotalmarketopportunitycreatedbythisfundinggap,wehave

calculatedthescaleofChina'snon-reimbursablehealthcareexpenditure(NRHE).Thisfigurerepresentsthetotaldemandthatmustbefundedprivately,either

throughout-of-pocketpaymentsorcommercialinsurance.Asillustratedinthe

figurebelow,weestimatethismarketwillreachRmb3,242bnin2025andis

projectedtogrowata10-yearCAGRof7.2%toreachRMB6,521bnby2035.Therobustgrowthofthismarketisfundamentallyunderpinnedbytherapidexpansionofthe65+populationitself,whichisforecasttogrowataCAGRof9.5%overthenextdecade.

China

20March2026CitiResearch

7

Figure5.China'sNon-reimbursableHealthcareExpenditure(NRHE)

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.

Note:ThehealthcareexpenditureiscalculatedbasedonthepercapitahealthcareexpensesforindividualsannouncedbyNationalBureauofStatistics.Theexpenditureisadjustedbyexcludingindividualpremiumpaymentoncommercialhealthinsurance.

Source:CitiResearchEstimates,NationalBureauofStatistics,NAFR

Crucially,thisfundinggapisnotexpectedtobebornebyout-of-pocketpaymentsalone.AsChina'shealthcaresystemmatures,weanticipateitspaymentstructurewillevolvetomoreresemblethatofdevelopedmarketsliketheUS,where

commercialinsurancecoversasignificantportion(~31%)oftotalhealth

expenditures.Therefore,thismulti-trillionRMBgaprepresentstheshared

addressablemarketforbothcommercialinsurers,whichwillfinanceagrowingportionofthisspending,andtheprovidersofaging-relatedtherapeuticsandservices,whichwilldeliverthecare.

Figure6.TotalnationalhealthexpendituresbreakdownbysourceoffundsintheUSvs.Chinain2024

16%

51%

43%

7%

31%

43%

11%

USChina

uOut-of-pocketuPrivatehealthinsuranceuPublichealthinsuranceuOther

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.

Source:CitiResearchEstimates,CMS,NAFR,NHSA

Weestimatethatcommercialinsurancepayoutscouldgrowtocover~18%of

nationalhealthcareexpenditure(from~7%in2024),addingRMB2.0tninfundingtothehealthcaresystemandfuelingdemandfortheinnovativetherapiesand

servicesdiscussedinthisreport.Inparticular,weexpectthisnewdynamicto

China

20March2026CitiResearch

8

significantlyexpandthemarketforinnovativedrugsby~4x.Thisindicatea10-yearCAGRof~15%,muchfastervs.the6%CAGRoftheUSinnovativedrugsales

market,onCitiestimates.

Figure7.Innovativedrugsalestoincrease~4x;commercialmedicalinsurancelikelytocontribute18%ofdirectHC

expenditurein2035E

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.Source:CitiResearchEstimates,Menet,IQVIA,NHC,NAFR

Figure8.InnovativedrugsalesinChinatogrowat15%10yCAGRvs.6%forUS

US$bn

10yCAGR:

-China:15%

-US:6%221

53

20252035EChina

934

535

20252035EUS

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.

Note:Weassumeinnovativedrugmarketsizeaccountfor80%ofthepharmaceuticalmarketintheUS.ForChina,weassumedrugsalesaccountfor~30%ofChina’sdirectmedicalexpenditure(i.e.sameasthe%in2025),andinnovativedrugsales

accountfor45%ofoverallChinadrugmarket.

Source:CitiResearchEstimates,Menet,IQVIA,AnnualReportofAlembicPharmaceuticals

China

20March2026CitiResearch

9

CoreBeneficiariesinHealthcare&Insurance

WebelieveChina'sagingpopulationcreatescompellinginvestmentopportunities.ForHealthcare,weseethekeybeneficiariesfallingintothreemainpillars:

nHealthcareServices&DigitalHealth,whichbuildstheplatformstodelivercareefficientlytotheelderly.BenefitedStocks:AliHealth,PAGD,Fangzhou,

Gushengtang,YifengPharmacy,AierEyeHospital

nInnovativePharma&Biotech,whichdevelopstreatmentsforage-relateddiseases.BenefitedStocks:Hengrui,Innovent,Ribo

n

AdvancedMedtech,whichprovidesthetoolsanddevicestomanage

physiologicaldecline.BenefitedStocks:MicroPortanditssubsidiarieslikeMicroPortMedbot,MicroPortCardioFlow

Forinsurance,thisboominghealthcaredemandcreatesasubstantialgrowth

opportunityforthecommercialinsurancesector,whichstrategicallyshiftstoanintegrated“payer+provider”modelfromasimple“payer.Specifically,thesurgingdemandforlong-termcareprovidesavastrunwayforcommercialinsurersto

evolvebeyondtheircurrentroleasthird-partyadministrators(TPAs)for

governmentprograms.Theyarepositionedtooffersupplementaryandmore

comprehensivesolutions,directlyfinancingandmanagingthehigh-qualitycarethesilvereconomyrequires.BenefitedStocks:PICCP&C,ChinaLife,CPIC.

Figure9summarizesourinvestmentframeworkandhighlightsrepresentativecompaniesthatarewell-positionedtocapitalizeonthesestructuraltrends.

Figure9Overviewofbenefitedsub-sectorsinChinaHealthcare&Insurance

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.Source:CitiResearch

China

20March2026CitiResearch

10

Healthcare:ChronicDisease,Disability,andHealthLiteracyasKeyDemandDrivers

Asthepopulationages,weidentifykeychallengesashighprevalenceofnon-

communicablechronicdiseasesandtheinevitabledeteriorationofphysiologicalfunctions.Asthepopulation'soverallhealthliteracycontinuestorise,thedemandforhealthcaretreatment/therapeuticsshouldkeepincreasing.

First,theburdenofchronicdiseaseisimmense.AsshowninFigure10,

approximately75%ofindividualsaged60andabovesufferfromatleastonechroniccondition,withastaggering43%managingtwoormore.Second,asdetailedinFigure11,about14%ofthisdemographicexperiencessignificantdeteriorationofphysiologicalfunctions,creatingabaselineneedforcareandassistance.

Crucially,thisdemandisbeingamplifiedbyathirdfactor:arapidincreaseinhealthawareness.AsshowninFigure12,theproportionofChineseresidentspossessingbasichealthliteracyhasmorethantripledoverthepastdecade,risingfrom9%in2013to34%in2025.Thisshiftfrompassivepatienttoproactivehealthconsumermeanstheelderlyarenotonlyexperiencingmorehealthneedsbutarealsomore

informedandwillingtoseekoutandpayforhigher-qualitymanagementservicesandadvancedtherapies.Thisconfluenceofhighdiseaseprevalence,functionaldecline,andrisinghealthliteracyunderpinstherigid,long-term,andincreasinglysophisticateddemandforinnovativehealthcaresolutions.

Figure10.Prevalenceofchronicdiseaseamongpeopleagedover60

Figure11.Prevalenceofdeteriorationofphysiologicalfunctionsamongpeopleagedover60

25%

14%

32%

43%

86%

Withatleasttwochronicdiseases

Withonechronicdisease

Withoutchronicdiseases

Withdeteriorationofphysiologicalfunctions

Withoutdeteriorationofphysiologicalfunctions

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.Source:CitiResearch,CDC

©2026CitigroupInc.NoredistributionwithoutCitigroup’swrittenpermission.Source:CitiResearch,CRCA

China

20March2026CitiResearch

11

Figure12.Chinaresidenthealthliteracylevel(2013-2025)

34%

32%

30%28%

25%23%

19%17%

9%10%10%

14%12%

201320142015201620172018201920202