Background
2021 turned out to become a positive year for China's healthcare industry, where the gigantic demand stems from the aging population, growing individual wealth, and – more importantly – the COVID-19 crisis' aftermath. The market has grown consistently; in 2020, the growth rate slumped to 7.2% due to the massive lockdowns, although it is expected to rise back to 17.6% in 2021 with total market size of CNY 8.7 trillion. Despite this, the market remains relatively undeveloped – since 2016, the Chinese authorities have been working on creating a CNY 16 trillion healthcare ecosystem by 2030.
Online healthcare is in the limelight
The pandemic challenged people's sense of well-being and facilitated their desire and determination to become more active and engaged in managing their health, which also boosted the need for remote medical consultations and online medicine sales. According to Deloitte, the portion of consumers who have used virtual visits rose from 15% to 19% from 2019 to early 2020, then jumped to 28% in April 2020. In fact, consumers plan to continue using them – 80% of the Deloitte survey respondents are likely to keep using other online services even post COVID-19.
Jessica Tan, co-CEO of Ping An Group, once said that around 20% to 25% of healthcare services in China could be moved to the online space. This will present new opportunities to the most competitive businesses in this field. Among these, JD Health (6618:HK) and Alibaba Health (0241:HK) are two tech giant-backed companies that have ridden this surging wave quite well.
Alibaba (BABA:NASDAQ) is deemed to be the first explorer among Chinese tech giants, having joined the game as early as 1998 by founding Alibaba Health (0241:HK). In fact, it is the first Chinese Internet-healthcare company to go public on the Hong Kong Stock Exchange. Alibaba Health is primarily engaged in the pharmaceutical direct sales business, the pharmaceutical e-commerce platform business, medical and healthcare services platforms and digital infrastructure business and related services, though it wants to take off the 'e-pharmacy' tag for long.
And the latecomer, JD Health, is moving really fast – only four months' independent operation since May 2019 before it filed a public offering. In August 2020, JD Health ranked 35th on Hurun Global Unicorn Index 2020 with a valuation at CNY 50 billion, which crowned it as the world's youngest unicorn. Different from traditional platforms, JD Health has established various online and offline integrated businesses, including JD Pharmacy, JD Health Internet Hospital and Pharmacy Alliance.
Check out our previous article about Alibaba Health and JD Health:
Alibaba Health Aims Higher with Rebranding and New Strategies
JD Health: A Low-profile Unicorn Challenging BAT's Healthcare Arms
How do Alibaba and JD.com compare in their healthcare endeavors?
In September 2021, JD Health released its interim financial report with relatively strong results. Its total revenue increased by over half (55.4%), from CNY 8.8 billion in H1 2020 to CNY 13.6 billion in H1 2021, which was primarily due to the increase in revenue from sales of pharmaceutical and healthcare products within the reporting period. In fact, this continuous upward trend also shows in its gross profit for the past four fiscal years, although the loss enlarged even further in 2020 when compared with the previous years. Another catalyst for the growth could be the increase in JD Health's number of Annual Active User (AAU) accounts. As of June 30, 2021, the AAUs in the past 12 months reached 109 million, representing a net addition of over 18.8 million as compared with that of 2020. The growing number also shows that the stickiness of users has been well improved as well as its brand awareness. In other words, JD Health's constant investment in marketing activities – its selling and marketing expenses almost doubled for two consecutive fiscal years – finally began to work.
Alibaba Health finally became fully profitable in its fiscal 2021, when the revenue reached CNY 15.52 billion Among four major businesses, medicine remains the main contributor to its revenue, amounting to CNY 13.21 billion, or about 85% of the total revenue. The rest is contributed by pharmaceutical e-commerce platform business, the medical health service business and digital infrastructure business, with revenues of CNY 1.96 billion, CNY 284 million and CNY 53 million respectively. Benefiting from the improving cost control ability and the emerging economies of scale, the overall expenses of Alibaba Health are far less than that of JD Health for every comparable fiscal year.
As the healthcare business arm of Alibaba Group, the natural traffic comes with related brand benefits; Alibaba Health's core pharmaceutical direct sales and e-commerce platform businesses are thus boosted to a great extent. Three specific edges are worth mentioning.
First, brand power drives growth. In 2021, Alibaba has grown its brand value by 32% year-on-year to USD 201.86 billion, with a 2nd ranking domestically and 7th ranking globally. As one of the most valuable brands, consumers are more likely to pay a value premium for the products with this recognizable name, or for the creditability it owns. This is indeed what is going on with Alibaba Health. For the 12 months ended March 31, 2021, the revenue from drugs generated from the pharmaceutical direct sales business under the brand of 'Alibaba Health' increased by 86.1% year-on-year, accounting for 64.8% of the revenue of the business. And the number of annual active users of the direct online stores in the reporting period reached a record high of 81 million.
Second, synergistic benefits of Alibaba's ecosystem. The synergy effect is most difficult or even impossible to be imitated by competitors. When looking back at Alibaba's business scope, we could see it has already laid out a lot – Alipay's insurance services and 'Future Hospital' plan, O2O medicine delivery service on takeaway platform and hospital-specialized modules on DingTalk – most major businesses owned by Alibaba have medical-related s. With continuous investment in these business-to-consumer marketplace made by the Group, Alibaba Health is able to enhance health awareness and acquire new customers at relatively low acquisition costs, which lays a strong foundation for future growth. As of March 31, 2021, the number of annual active users had exceeded 280 million on Tmall's Pharmaceutical Platform while Alipay's healthcare channel as a whole reached over 520 million annual active users for the fiscal year.
Third, empowerment of big data. As a wholly-owned subsidiary of Alibaba with deep roots in the Internet, Alibaba Health's capabilities and resources are naturally geared towards leveraging the prowess of the Internet, big data and Cloud computing. To further boost its digital infrastructure business, for example, tracking platform 'Ma Shang Fang Xin' (Chinese: 码上放心) and digital health business, Alibaba Health has been working closely with Alibaba Cloud to lead the healthcare area. In addition, it also focuses on digital infrastructure. Based on the Group's internal AI, big data, payment and IT capabilities, Alibaba Health is working on exploring the construction of intelligent medical systems, such as AI-assisted diagnostic decision-making, remote imaging platforms and blockchain data security solutions in major hospitals and regions.
Although JD Health is relatively inferior to its competitor in terms of annual active users – 109 million as of June 30, 2021 – JD Health's revenue is all the way higher than that of its closest competitor, Alibaba Health, more specifically, the revenue as nearly two times higher. One booster is its complete business structure. Integrating B2B/B2C/O2O businesses, JD Health can have more wings – for example, along with the retail pharmacy, JD Health also offers its own family doctor services, online hospital services as well as smart healthcare solutions. Through the integration of pharmaceutical retail businesses and online healthcare services, the medical products users also become target customers for other consumption healthcare units, and vice versa; a closed cycle hence is developed and can also be seen in its ever-growing operating income at a CAGR of 11%.
JD Logistics is another catalyst supporting the healthcare unit's strong performance, being one of the leading supply chain players in the field of medicine now. Through JD Logistics, JD Health is able to connect with upstream, midstream and downstream enterprises: from industrial enterprises and healthcare institutions to offline pharmacies and dental clinics. This absolute advantage over comparable companies enables JD Health to further cut its fulfillment costs to around 10% of total revenue, which is related to warehousing, logistics and customer service expenditures incurred by the self-operated pharmaceutical business.
Future in the mist
The future won't be easy for both Alibaba Health and JD Health, as the competition is intensifying. Except for the 'peer pressure,' some inherent problems exist in the essence of most healthcare services – those are mainly related to professionalism, trust and quality.
It is partly because of the particularity of healthcare services and pharmaceutical drugs along with the recent market chaos, the government has tightened supervision increasingly, more than ever before. Rory Green, a China economist at TS Lombard, said that the healthcare sector is the only one not hit by regulatory scrutiny yet but is particularly vulnerable, which may possibly make it the next target.