Globalizing Healthcare: China's medical exports and their role in Italy’s public health system

The stability of the worldwide medical supply chain is essential for preserving public health, a fact that has been highlighted during the COVID-19 pandemic, when a drastic shortage of personal protective equipment unveiled the current system’s vulnerability. For decades, the United States and the European Union have dominated the medtech market, while China has traditionally been seen as a provider of low-cost, basic medical equipment. However, in recent years, China has increasingly become a central third pillar in both the export and import of advanced medical products. This thesis discusses the evolution of China's position in the international medical industry, focusing on its increasing medical exports to Italy. The first chapter starts with a general overview of the international medical device industry, followed by a detailed study of the key regulatory systems (the FDA, MDR, and NMPA), and finally identifies China’s strategic positioning within the global context. The second chapter analyzes the Chinese healthcare system, government policies, and the trade relationship with its Italian counterpart. In the third chapter, the focus is shifted to the pharmaceutical industry, analyzing the manufacturing of active pharmaceutical ingredients (APIs) and finished pharmaceutical products (FPPs), and the global supply chain’s complexity. Finally, two case studies of Chinese companies are presented in chapter 4: the first examines Mindray Medical, a leader in medical devices, exploring its strategy for entering the Italian market and its involvement in supporting Italian hospitals; the second presents WuXi AppTec in pharmaceuticals, analyzing its contributions to the global API supply chain and its collaboration with Italian entities.