Text | Xiao Tian
On June 17, 1963, after 71 hours and 2 million kilometers of space flight, Soviet pilot Valentina finally opened the spacecraft door and sat in the cabin of the Vostok-6 spacecraft with a smile on her face, enjoying the joy of the outside world. People rushed to her, and soon her pictures spread all over the world.
Under the aura of "the world's first female astronaut", a large number of media reports made Valentina suddenly become a recognized representative of the brilliant achievements of women in society at that time. But what is not known is that her success was only due to this substitute opportunity that the previous winner got because of an unexpected pregnancy.
Decades later, Russia also had a woman named Valentina. At the age of 15, he married his husband Vasir Yevi, and after marriage, he began to give birth non-stop, giving birth to a total of 69 children (67 in his lifetime), becoming the first woman in the world to have the most children.
One by chance to the peak of their careers, one after another to become a "fertility machine", two women of the same name in different time and space, but in the end because of pregnancy problems to go to a completely different life.
Where there is pregnancy, there is contraception. For thousands of years, women's battle against reproductive rights has never stopped. In the book The Birth of the Contraceptive Pill, it is written: "Men and women have been avoiding having children as long as they have been making children." "For contraception, the ancient Egyptians tried crocodile dung, the ancient Greeks tried sneezing, the ancient Persians tried jumping... From ancient times to the present, all kinds of "magic" have shown great magic. It was not until the invention of the modern condom that human beings really planned the number and time of childbirth.
But from a woman's point of view, condoms only tend to let men control the number and cycle of fertility, and women really take the initiative in contraception for the first time, or from the oral contraceptive pill synthesized by Regory Pinkers and John Rosenklands 71 years ago.
In China under the transformation of the times, countless modern women have broken free from the shackles of traditional concepts and rules in different fields and pursued independence, autonomy and freedom.
According to the "Women's Health Consumption Data Report" released by Ali Health in 2021, nearly 80% of contraceptives are purchased by women, who are more eager than ever to have physical initiative.
With the advent of Women's Day on March 8, Caijing Wujie tried to review the development situation of this "small pill" in China from a financial and economic point of view.
A market segment that seems to have been forgotten
Although the contraceptive pill originated in the West, China also has an incomprehensible origin with the contraceptive pill. Even, because the threshold for the research and development of the contraceptive pill itself is not high, it was also actively developed shortly after the founding of New China.
In 1967, in just four years, Xiao Bilian's laboratory at Shanghai Renji Hospital successfully developed two low-dose oral contraceptives. Two years later, after the improvement of the experts of Union Hospital, in early 1969, the compound methylquinolone was successfully developed, which is also the first low-dose short-acting oral contraceptive in China, and also passed the qualification promoted by the State Science and Technology Commission in Beijing.
After traveling to beijing at the time, Edgar Snow, a friendly American man, described the "pomp and circumstance" in an article sent to Time that about 70 percent of women of childbearing age were using contraception and two-thirds were taking birth control pills. In the countryside around the capital, forty out of a hundred adult women are taking the pill.
However, unlike the contraceptive pill, which has accelerated the shift in the role of women in the West, the Chinese contraceptive pill has a strong undertone that inhibits rapid population growth. After the official introduction of the family planning policy, the status of contraceptives became lower and lower, and the intrauterine device, which is often called the "uterine ring", became the mainstream for a long time.
The data validated this, and in a survey by the Population Research Institute of Peking University, contraceptive use fell from 5 percent in 1990 to 2 percent in 2000, and contraceptives became increasingly unpopular in the minds of Chinese.
Policies have changed the ecology of the industry. It is also in this macro context that contraceptives have always been a forgotten market in China's pharmaceutical industry.
According to PDB statistics, the mainland contraceptive retail market in 2016 was 3.39 billion yuan, an increase of 3.8% over 2015. In 2018, according to Zhongkang CMH data, the sales market size of hormonal contraceptives used in the mainland system reached only 2.58 billion yuan, showing negative growth. In contrast, the "retrogression" of the industry in the past two years coincided with the mainland's comprehensive opening up of the two-child policy, which set off a "two-child tide", many couples have begun to prepare for the second child, and the market decline is inevitable.
According to industry forecasts, affected by the "three-child policy" implemented on May 31, 2021, the overall size of China's contraceptive market will not change much in the next five years, and the reasonable forecast range is in the range of 2.5 billion to 4 billion.
In addition to the limited growth space of the market, the composition of the domestic contraceptive market has been "dead" for many years.
According to the incomplete statistics of finance and economics, at present, the main pharmaceutical companies involved in contraceptives in China are Bayer Pharmaceutical and HealthCare Co., Ltd., China Resources Zizhu Pharmaceutical Co., Ltd., Zhejiang Xianju Pharmaceutical Co., Ltd., Jirui Pharmaceutical (China) Co., Ltd., Guangzhou Langsheng Pharmaceutical Co., Ltd., Renfu Pharmaceutical Group Co., Ltd., Shanghai Pharmaceutical (Group) Co., Ltd. Xinhualian Pharmaceutical Factory, Shanghai Xinyi Pharmaceutical Factory Co., Ltd. and so on.
From the current market share, Bayer Pharmaceutical, China Resources Zizhu, Zhejiang Xianju and Guangzhou Langsheng have long occupied 80% of the market share. Among them, the entire contraceptive market is mainly divided into long-acting contraceptives, short-acting contraceptives, and emergency contraceptives, accounting for 4%, 26. % and 69.6% of the market respectively. Therefore, each company also has its own focus on the layout of contraceptives.
Among the short-acting oral contraceptives, Bayer is "the only one", and its "Yousming", "Daying-35" and "Xinma Fulong" occupy the consumer market of women at different levels; in the emergency contraceptive pills, the domestic drugs represented by "Yuting" and "Jin Yuting" of China Resources Zizhu, L-nodroxyprogesterone enteric-coated capsules of Xianju Pharmaceutical, Bao Siting of Jirui, Danmei of Guangzhou Langsheng, and "AiWuyou" of Renfu Pharmaceutical occupy the main market; long-acting oral contraceptives only account for a very small part of the sales share.
It is worth mentioning that focusing on the specific company level, only Renfu Pharmaceutical (600079), Xianju Pharmaceutical (002332), and Shanghai Pharmaceutical (601607) have landed on the capital market, and the contraceptive business is not the main business.
From the current point of view, China is changing, policies are changing, and the status of women is changing, but why does the embarrassing situation of the contraceptive pill seem to have not changed?
What exactly is stifling the Chinese contraceptive industry?
According to the National Bureau of Statistics, as of 2019, there were 680 million women in the mainland, of which the female population aged 20-49 accounted for about 49%. With the "three mountains" of housing, education and medical care increasing, the cost of childbirth and the single economy prevail. Theoretically, the large number of women of school age means a huge market capacity for contraceptives.
But the question is also, why have contraceptives remained unpopular in China? The answer to this question can actually be answered in two ways.
First, from the perspective of the entire contraceptive track, the contraceptive pill has a "fierce enemy" - condoms.
In the past 30 years, the average age of first marriage and first childbearing among women of childbearing age in China has been significantly delayed. According to statistics, the average age of childbearing women at childbearing age increased from 23.4 years in 1990 to 26.8 years in 2017, and in less than 30 years, the average woman's first childbearing time has been delayed by more than 3 years.
The past 30 years have also been 30 years of rapid increase in the number of women in higher education. According to the relevant statistics of the Ministry of Education, since 2014, the proportion of female college students in China has exceeded that of male college students, and the growth rate of the number has been higher than that of male students for many years.
From scientists, politicians, lawyers, doctors, entrepreneurs, athletes... the role of women in the role of society is becoming more and more important. "Why is the burden of contraception all over women?" The cries are also getting louder.
The era of equal rights for men and women has arrived. Around the Tanabata festival in 2020, the Jingdong Big Data Research Institute mentioned in the adult products report released, "The higher the education of the population, the more they care about their partners' feelings, and the more they know how to protect themselves." ”
This also means that condoms are no longer exclusive to men, and women are gradually beginning to dominate the use of condoms.
According to the data released by Zhiyan Consulting, China's condom sales have been growing steadily since 2016, with a compound annual growth rate of 6.5% from 2016 to 2019, and it is expected that condom sales will reach 4.72 billion units in 2020.
More importantly, the condom industry has evolved over the years, and the industry as a whole has transitioned from a formative period to a mature stage. Due to the improvement of technology, the thickness of condoms has been greatly reduced. In addition, condom manufacturers have also begun to realize that condoms of the same size cannot meet the needs of different customers, and it is these different types of condoms of different shapes, different widths and lengths that make the condom market full of vitality and vitality.
As one of the two mainstream means of contraception, the boom in the condom industry has directly affected the contraceptive market to a certain extent, and the latter has struggled to survive in the squeeze.
Second, "it is a three-point poison of medicine", which has always been a difficult obstacle to the development of China's contraceptive industry.
Scientific data show that the reliability of conventional contraceptives is 10 to 15 times higher than condoms, and it has always been recognized internationally as the best way to achieve results. But this "best option" is often misunderstood in the Eastern context.
In Japan, up to 80% of women still choose condoms as a means of contraception, with the result that The abortion rate in Japan is as high as 8%, nearly 10 times higher than the average in developed countries. In China, this perception has a wider impact.
Fei Jia, head of the Chinese market group of women's health products at Bayer-Schering Pharmaceutical Co., Ltd., once said in an interview: "In China, many women believe that contraceptives are 'poison', try not to eat, some even think that at least 'stop the drug' for a year before getting pregnant, otherwise the 'poison' in the body cannot be cleaned." This all shows that mainland women have received a lot of wrong information in this regard. ”
However, the reason is not only due to the influence of cultural factors. If we turn the hour hand back to the 1970s, when the mainland had a policy of free distribution of contraceptives, Chinese women and contraceptives were not unheard of, nor were they shy away from wolves.
The problem actually arises in the abuse of contraceptives.
In the media, "Three minutes, easily solve your troubles of an unexpected pregnancy." Advertising slogans can be seen everywhere, and many female consumers have also supported the purchase of the product behind it - emergency contraception with practical actions, which has also become synonymous with contraceptives in people's mouths. But in fact, since the contraceptive pill appeared on the cover of TIME magazine in April 1967, the term has been used to refer directly to short-acting contraceptives, except in China.
It should be pointed out that whether it is short-acting, long-acting and urgent, it is a combination of estrogen and progesterone, but the type and dosage of estrogen and progesterone are different. But in order of side effects, emergency > long-acting > short-acting. After several iterations, short-acting oral contraceptives have developed in the direction of functionalization, normalization and safety, but under the hype of merchants, more women have chosen emergency contraceptives that are the most harmful to the body, making the entire Chinese contraceptive industry "go astray".
A paradoxical phenomenon occurs - in China, a country that has always lacked sex education, the rational use of contraceptives is neglected, the promotion is demonized, and the unusable is praised. The gap in Chinese consumers' perceptions and demand for short-acting contraceptives has ultimately brought the entire contraceptive industry to a standstill.
The liberation behind "that pill"
Over the past 60 years, oral contraceptives have become the first choice for millions of women around the world over other contraceptives.
The contraceptive pill is also considered "one of the 100 major inventions that have influenced the course of human history" and is the most valuable result left in the struggle for women to control their reproductive rights. Even 200 prominent historians agree that the impact of the pill on modern women is comparable to Einstein's theory of relativity, the atomic bomb, computers, and the Internet in the 20th century.
Dating back to the 1950s, Margaret Sanger, a pioneer of the American women's birth control movement, was 72 years old and decided to give it a final shot. She tried to improve contraceptive methods, find simple "magic pills" like aspirin, and really shift the initiative of contraception from men to women.
Before that, the woman, who was born in a poor Irish Catholic immigrant family in Corning, New York, had spent the first half of her life promoting the cause of pregnancy reduction, and it was under her impetus that condoms blossomed everywhere in Catholic countries, and she was once one of the most hated people in the country.
This time, instead of going it alone, she found wealthy wealthy Catherine McCormick, the poor and discouraged scientist Gregory Pinkers, and the gynecologist John Rosenklands who dared to challenge the church.
As a result of the efforts of these four men, in 1956, Pinkers and John Rosenklands' research formula, the isotynol-norethindrone-ethinylstradiol methyl ether tablets (Enovid), was approved by the FDA, becoming the first contraceptive pill, setting off another contraceptive revolution after the condom.
Before the invention of the contraceptive pill, although condoms could also prevent women from getting pregnant, the right to use condoms was more in the hands of men. Therefore, there are still women who still endure the results of constant pregnancy.
Since the large-scale listing of this small pill, it has not only cut off the inevitable connection between sex and fertility, but also changed women's status, work, income, appearance, figure and sexual concepts, so that women can freely control reproductive rights. As soon as it was launched, it caused a social shock.
A 2012 study from the University of Michigan showed that oral contraceptives that appeared in the 1960s once led to a 50 percent increase in women's wages, and the earlier women who took the pill, the higher their wages would later be. By 1980 and 1990, women who took the pill earned an average of 8 percent more than women who didn't.
Not only that, after women have completely controlled the "valve" of their own body fertility, they can show their charm to the fullest. Marilyn Monroe, the representative figure of the era of women's concepts in the United States, is even more charming, which has aroused the obsession of men around the world.
In the past few decades, humans have taken far more contraceptives than any other medicine in the world. To date, more than 100 million women worldwide are taking oral contraceptives every day. The proportion of use in Western countries is as high as 30% to 50%, 90% of Swedish women have used oral contraceptives in their lifetime, and 88.9% of young German women have used oral contraceptives.
However, the use of oral contraceptives in China is less than 3%.
Behind this is not only the cognitive defects of Chinese short-acting contraceptives, but also many women have "contraceptive shame" and hide the topic of "contraception" in the corner. Women's contraception relies on men to achieve, and the lack of independent contraceptive ability has also caused many accidental birth problems.
According to a report by the National Population and Family Planning Commission Research Institute, about 13 million abortions are performed in China every year, accompanied by a low age and a high proportion of repetitive abortions. The popularization of scientific contraception education for consumers to help female consumers control their lives independently, the promotion of contraceptives is imminent.
True equality between men and women is to make both men and women equal and have a choice. In this sense, the birth of the contraceptive pill is the first time in the history of women to break the inevitable link between sex and fertility, so that women can grasp the initiative of contraception and truly achieve gender equality.
From love from me to intimacy by me, from life by me to career by me, today's Chinese female user portraits are independent and brave, and they are gradually getting rid of the male gaze and showing women's unique self-expression. And in this process, there should be a place for the contraceptive pill.