Annex 1: China Assistive Product Supplier Landscape

ATscale
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Annex 1: China Assistive Product Supplier Landscape

Logo of CLINTON HEALTH ACCESS INITIATIVE Logo with icons of eyeglasses, hearing aid, prosthetic limb, and smartphone. Text reads: ATscale GLOBAL PARTNERSHIP FOR ASSISTIVE TECHNOLOGY Hosted by UNOPS.
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Table of Contents

Introduction 3
Research methodology 6
Scope and limitations 7
Overview of Chinese assistive products export to LMICs 8
Overview of China’s supplier landscape for assistive products 18
1. Hearing aids 18
2. Wheelchairs 22
3. Prostheses 30
4. Spectacles 35
5. Digital assistive products (screen readers, smartphones, and AACs) 40
Competitive advantage for LMIC exports 46
Challenges for LMIC exports 47
Recommendations 50
References 52
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Introduction

China is the world’s largest domestic market and a key global manufacturing hub for assistive products. According to recent estimates, a significant proportion of assistive products available globally are manufactured in China. For instance, over 50 per cent of global spectacles exports and over 60 per cent of global hearing aids are made in China [1] [2]. Furthermore, China’s overall rehabilitation assistive products market has been growing 9.4 per cent year-on-year since 2015, which is estimated to be higher than global average [3]. The AT market growth in China is driven by two critical factors:

  1. Large and growing domestic demand: As of 2023, China has 86 million persons with disabilities and 297 million people over 60 years old [4] [5]. The population over 60 years old has grown to 21.1 per cent of the total population in 2023 and is projected to exceed 33.3 per cent by 2050 [6]. As one of the key AT used among elderly population, research shows that from 2016 to 2022, the market size of manual wheelchairs in China grew from US$590 million to US$1 billion [7].
  2. Strong policy support: In 2016, the State Council launched the first national guideline “Several Opinions of the State Council on Accelerating the Development of the Rehabilitation Assistive Devices Industry, State Issue [2016] No. 60” to accelerate the growth of the assistive technology industry, aiming for a market size of RMB700 billion (~US$97 billion) by 2020 [8]. This guideline positioned the AT industry as a national priority and has led to the development of many relevant policies and regulatory changes on both the demand and supply sides for persons with disabilities in China. With this support, the industry has shown robust expansion over the past decade.
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Figure 1: Market size of China’s rehabilitation assistive product 1 industry from 2015 to 2020 (Unit: 1 bn RMB, equivalent to US$140 mn) [3] [9]

Bar chart showing data from 2015 to 2020. Each year is represented by a vertical blue bar, with the value written above each bar. The values increase steadily each year: 2015: 461; 2016: 503; 2017: 550; 2018: 596; 2019: 650; 2020: 721. A dotted trend line runs above the bars, indicating a consistent upward trend over the years.

China is home to thousands of manufacturers producing across 10,000 different types of assistive products [9]. According to the China Association of Assistive Products, from 2016 to 2020, the number of Chinese wheelchair companies grew by 51.3 per cent, those producing or selling hearing aids by 142.5 per cent and those producing or selling prostheses by 85.8 per cent [10]. By 2020 the total number of companies in these three segments exceeded 25,000 — a fivefold increase from 2010. Several global leading companies have manufacturing plants in China such as EssilorLuxottica (spectacles), Ottobock (prostheses) and GN (hearing aids).

China’s assistive products supply is characterized by competitive pricing and diverse product range. Key drivers are strong manufacturing capability, supply chain advantage, and policy support. However, China's manufacturing capability still focuses more on low to mid-end products compared to countries with longer manufacturing experience, such as Europe, the US and Japan. The overall supplier landscape is fragmented, consisting of small- to medium-sized suppliers (< 100 staff) with limited publicly available information on their product quality and pricing. This makes it challenging for global buyers to find suitable suppliers offering affordable, high-quality products.

1. Definition of “Rehabilitation assistive product” in China can be found at “China Catalogue of Rehabilitation Assistive Products (2023 Edition)”. It includes both rehabilitation devices and assistive products. ↩︎

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This report provides an overview of China’s supplier landscape for five assistive products (Digital AT, spectacles, hearing aids, prostheses and wheelchairs). It examines the manufacturing landscape for these products in China, identifies suppliers capable of and interested in supporting low- and middle-income countries (LMICs) assistive product sales. The report also explores growth trends, challenges and opportunities for China's exports to LMICs and provides recommendations for global stakeholders to better leverage China's AT manufacturing capability to benefit persons with disabilities worldwide.

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Research methodology

The report is informed by primary and secondary research. It includes a literature review of China’s supplier landscape, focusing on suppliers with export experiences to LMICs. A survey was also conducted through the China Assistive Devices and Technology Center for Persons with Disabilities (CADTC) to gather information on suppliers interested in expanding into LMIC markets. Additionally, over 20 suppliers were interviewed and 10 site visits were conducted. Suppliers selected for interviews and site visits were chosen based on their manufacturing capabilities, previous experience in LMICs and interest in expanding into these markets.

In total, 90 suppliers responded to the survey, 66 of whom supply the five priority assistive products (9 supply digital AT, 12 for vision aids (including spectacles), 16 for hearing aids, 20 for prostheses, 31 for wheelchairs and the rest mainly for walking aids and sickbeds). 2

Please note that only a small set of spectacles, such as low-vision products, are classified as assistive products in China; spectacles for myopia and presbyopia do not fall into the AT category. Therefore the survey is not designed to target spectacles suppliers, the data for the spectacles section are mainly derived from desktop research and expert interviews.

2. Note: some manufacturers supply more than one priority assistive product. ↩︎

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Scope and limitations

This report focuses on five priority assistive products. Moreover, the report focuses on assistive products that meet WHO assistive product specifications [11]. This excludes low- quality products, which are prevalent in LMICs.

The suppliers in this report are mainly those currently exporting to or interested in LMIC markets. Suppliers primarily focus on domestic or high-income markets are not captured as they do not prioritize products tailored to LMIC needs.

Most data are based on self-reports from suppliers who participated in the survey and interviews. These data have not been independently verified, so readers are advised to carefully interpret the information.

Given that spectacles are not classified as assistive products in China, the spectacles suppliers participating in the survey are limited compared to the large supplier base in the country. The team has tried to identify those interested in and capable of LMIC sales through desktop research and interviews, but readers are advised to interpret the findings with this context in mind.

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Overview of Chinese assistive products export to LMICs

Company size and sales pattern

Most Chinese suppliers are small to mid-sized enterprises (< 100 staff). Around 80 per cent of the respondents reported annual revenue under US$5 mn. Correspondingly, most respondents' export revenue to LMICs is below US$2 mn per year.

Chinese suppliers export to LMICs through three main channels: 1. as Original Equipment Manufacturer (OEM)/Original Design Manufacturer (ODM) for global brands or NGOs; 2. via exporters and distributors (mainly connected via participating in-person EXPOs); and 3. through direct sales, either by responding to tenders or via e-commerce. Branded sales remain limited, with only 9 respondents (17 per cent) registering their own products in LMICs, primarily in Asia. Some larger suppliers have dedicated sales representatives for LMICs, but very few have local offices. Given this, Chinese manufacturers mainly deliver after-sales services either via local LMIC partners or remotely.

Overseas manufacturing in LMICs is also very limited. Out of all manufacturers who participated in the survey or interviews across 5 product categories, only two spectacles manufacturers have set up manufacturing plants in LMICs.

Survey respondents expressed strong interest in increasing their engagement in global public sector sales, and many have attempted to do so. For government tenders, most respondents indicated that they participate through local distributors or partners due to the need for local registration and government relationships. Regarding NGO procurements, suppliers tend to reactively wait for opportunities rather than proactively seek them out, given the fragmented and limited volume of NGO procurement.

For tenders like those from UNICEF Supply Division, while most suppliers are interested in responding, they face several challenges: 1. lack of awareness of such tenders; 2. limited understanding of the global market, leading to uncompetitive pricing; 3. lack of international standards required by UNICEF, such as ISO 7176 wheelchair standards or medical equipment certificates for hearing aids; and 4. inexperience in responding to public tenders directly, including unfamiliarity with the procedure, the level of detail required, the timeline, and the communication methods.

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Companies exporting to LMICs

Among the 90 survey respondents, 51 (or 56 per cent) have already sold to LMICs (see Figure 2). Nearly all companies confirmed their interest in future sales to LMICs and 7 in 10 have shown interest in joining international initiatives, including product donations.

Figure 2: Number of LMICs exported to by survey respondents

Pie chart showing experience across countries. The chart is divided into four segments, each labeled with a percentage and description: 43%: No experience (largest segment, dark blue); 40%: Under 20 countries (second largest, teal blue); 13%: 20-50 countries (smaller segment, light blue); 3%: Over 100 countries (smallest segment, green). Each segment has a dotted line pointing to its label and percentage.

Asia is the top export destination for Chinese suppliers. The table below shows the top 10 LMIC sales destinations. LMICs geographically close to China, such as the Philippines, Viet Nam and India, are the most common sales destinations. However, more distant countries like Bolivia, Egypt and Kenya also show significant interest in Chinese products.

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Table 1: Top 10 LMIC sales destinations for the survey respondents

# Country # of suppliers Region
1 The Philippines 31 Asia
Viet Nam 31 Asia
3 India 29 Asia
4 Cambodia 20 Asia
Ukraine 20 Europe
6 Pakistan 17 Asia
Myanmar 17 Asia
8 Bangladesh 14 Asia
9 Uzbekistan 13 Asia
10 Mongolia 12 Asia
Laos 12 Asia
Bolivia 12 Latin America
Egypt 12 Africa
Iran 12 Asia
Kenya 12 Africa

This growing interest in LMIC markets is driven not only by rising demand but also by intense competition in the domestic market. Several suppliers have highlighted the fierce domestic competition and the associated price wars that erode their margins. According to one of China’s largest wheelchair suppliers, they have observed an approximate 40 per cent decrease in their domestic market sales and are therefore actively strengthening their exports.

Quality

Most assistive products are regulated and inspected by the State Administration for Market Regulation (SAMR), the national government agency responsible for overseeing market regulation, product quality and fair competition. Some assistive products, such as manual wheelchairs and hearing aids, are also classified as medical equipment and therefore receive additional regulations and inspections by the National Medical

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Products Administration (NMPA), China's regulatory authority responsible for the supervision and administration of drugs, medical devices and cosmetics.

National quality standards have been developed for all key assistive products. Many assistive product standards in China are primarily developed based on ISO standards with equivalent application. Core parameters, such as fatigue testing criteria, generally maintain consistency with ISO standards, incorporating only minor adaptations for Chinese conditions and needs. For example, some products may require slight modifications to account for anthropometric differences between Asian and Western populations or local usage environments.

Table 2: Quality management of different assistive products in China 3

Product category Classified as assistive product? Classified as medical equipment? Illustrative national quality standards
Spectacles Yes for low vision No for myopia and presbyopia No for myopia and presbyopia
Hearing aids Yes Yes, Class II medical device
Wheelchairs Yes Yes, manual wheelchair is Class II medical device
Prostheses Yes No
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Regarding international certifications, approximately 70 per cent of survey respondents report having attained one or more international certifications. The table below summarizes the key certifications obtained. Over half of the respondents have Europe CE, ISO 9001, or ISO 13485 certification, and around one-fourth have obtained US FDA approval.

Table 3: The international certifications held by survey respondents

Bar chart showing the number and percentage of organizations with different types of international certifications. There are six categories: ISO 9001 (Quality Management Systems): 51 organizations, 57%; Europe CE: 48 organizations, 53%; ISO 13485 (Quality Management Systems): 47 organizations, 52%; US FDA: 23 organizations, 26%; Other ISO: 5 organizations, 6%; No International Certification: 29 organizations, 32%. Each bar is labeled at the top with the number of organizations and inside the bar with the corresponding percentage.

Competitiveness

China’s competitiveness lies in its high production capacity, low prices, extensive product categories and efficient delivery. These advantages stem from several factors. For example, each assistive product has multiple dedicated manufacturing hubs in China, supported by local government initiatives such as subsidies, tax incentives, accelerated product approval and specialized industrial parks that centralize resources for production, warehousing, logistics, quality inspection and R&D. Other factors include productive labour, low-cost logistics, a comprehensive supply chain and rich OEM/ODM experience in AT manufacturing.

In addition, China is strategically upgrading its AT innovation capabilities, transitioning from its historical concentration on low-to-mid product models. A study in 2023 shows that most Chinese AT suppliers used to have few patents, with many copying products they previously manufactured for global brands [12]. This resulted in low product differentiation, intense price competition, and low brand awareness in the global market.

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The industry recognizes the need for innovation and industrial upgrading, evidenced by growing AT exhibitions, contests and innovation hubs. Many research institutions and manufacturers are also launching related innovation projects. However, commercializing these products and achieving large scale industrial transformation will require a longer time.

Table 4: Examples of assistive technology innovation events in China

Name Main organizer Description
Exchange Event for Promoting Innovative AT for PWDs China Association of Rehabilitation of Disabled Persons and CADTC
Shenzhen AT Design Innovation Competition Shenzhen Municipal Disabled Persons' Federation
Hubei Province Assistive Device Innovation Design and Entrepreneurship Competition for People with Disabilities [17] Hu Bei Disabled Persons’ Federation
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Yangtze River Delta Region “Technology for Disability” Assistive Product Innovation Competition [18] Zhejiang Provincial Disabled Persons’ Federation
Jiangsu Province “Technology for Disability” Assistive Product Innovation Competition [19] Jiangsu Disabled Persons’ Federation

Table 5: Examples of assistive product innovation hubs in China

Name Description
China Assistive Devices and Technology Center for Persons with Disabilities
National Research Centre for Rehabilitation Technical Aids
Greater Bay Area Assistive Device Innovation Centre [21]
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Institute for Accessibility Development, Tsinghua University
Zhejiang University
University of Science and Technology of China

Challenges in entering LMIC markets

Several challenges also exist for exports to LMICs. For example, Chinese suppliers, in general, still lack information on LMIC demand, needs and opportunities given the language barrier and the lack of available information. Chinese assistive product manufacturers are relatively small, so few have a dedicated sales team specifically targeting the LMIC markets. Also, the suppliers face fierce domestic and international competition with homogeneous products.

The expansion of assistive product exports faces several technical and procedural challenges related to standards, certification, and verification processes. In China, some assistive products are subject to compulsory national standards (GB), while others follow voluntary standards (GB/T), allowing for broader market access but resulting in varying degrees of adherence [27]. Product inspection mechanisms, such as spot checks, are in place but may not always reflect the full scale of production. Internationally, while certifications like CE and ISO are widely used, the credibility of certification bodies can vary, and there may be gaps between certified distributors and their upstream manufacturers. Differences in technical standards, classification systems, and certification expectations between China and other countries—particularly regarding medical device designation—can also create complexities for export, often requiring

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suppliers to obtain additional documentation such as ““Certificate of Free Sale 4 ” or certification tailored to each market.

Suggestions from buyers and suppliers on how to increase Chinese manufacturers’ participation in LMIC markets

Chinese suppliers have suggested the following on how policymakers and industry organizations can better support them expand business to LMIC markets:

And several LMIC buyers have also suggested what Chinese suppliers can focus on more to better serve LMIC markets.

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Overview of China’s supplier landscape for assistive products

1. Hearing aids

China’s annual export for hearing aids was around 14 million units in 2022, with a total export value of approximately US$350 mn [28]. From 2018 to 2022, the market size increased 7 per cent year-on-year [29]. The top 5 global hearing aid suppliers (Demant A/S, GN Group, Sonova, Starkey and WS Audiology), which totally account for over 90 per cent of the global market share, all have China as one of their key manufacturing hubs.

Supplier landscape

Hearing aids are classified as Class II medical devices in China. 6 To obtain a license, producers must submit their quality inspection reports and other required documents. The manufacturers with medical-certified hearing aids will be listed on the National Medical Products Administration (NMPA) official website. For a range of products, including hearing aids, the clinical trial procedure is waived to accelerate their market availability [30]. According to the China NMPA website in October 2024 a total of 96 Behind-the-ear (BTE) hearing aids 7 are certified as medical devices in China 8 , produced by 60 manufacturers [31]. Of these 60 manufacturers, 51 are local Chinese companies that registered 70 BTE products. The remaining manufacturers are local production facilities established by foreign brands.

Manufacturing is concentrated in Guangdong (50 per cent of the suppliers with certified BTE products), Fujian (16 per cent) and Jiangsu (9 per cent). Fujian and Jiangsu are where global hearing aids suppliers initially established their manufacturing bases, stimulating the local hearing aid industry growth. Today these regions host the most experienced hearing aids suppliers in the country. Guangdong, as a major hub for electronic components and precision equipment, has a strong supply chain for hearing aid production. A number of existing assistive listening devices (ALDs) suppliers in the region have recently transitioned into manufacturing medical-grade hearing aids.

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Table 6: Top 5 cities with the highest number of certified medical-grade BTE hearing aid suppliers

City Province Percentage
Shenzhen Guangdong 26%
Xiamen Fujian 16%
Zhongshan Guangdong 11%
Suzhou Jiangsu 7%
Hangzhou Zhejiang 5%
Total: 65%

Three hearing aid manufacturers are publicly listed in China: Jinghao, Minami Medical, and Cofoe Medical. Jinghao is the most focused on the hearing aid business, with 93.1 per cent of its sales in 2022 attributed to hearing aids, amounting to RMB 179 mn (approximately US$24.3 mn). No specific sales data are available for Minami and Cofoe’s hearing aids, but both companies have broader medical equipment product categories and hearing aids are not their primary products.

Based on interviews, Jinghao is one of the largest exporters to LMICs, but the hearing products it exports are not only medical-grade hearing aids but also assistive listening devices (ALDs). While detailed sales data are not available, Jinghao sells to 90 countries and international revenues amounted to US$22.5 mn in 2022 representing over 90 per cent of its total hearing products revenues.

Other Chinese manufacturers with medically certified BTE products and a reported presence in LMICs include Austar, New Sound and Acosound. Austar and Acosound have stated the interest and priority of LMIC in their strategies and would like to promote their own brands while New Sound prioritizes the US market in their current strategy.

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Table 7: Survey respondents with medical-certified BTE products and presence in LMICs

Company Introduction LMIC presence Quality
Acosound (Hangzhou)
Austar (Xiamen)
Newsound (Xiamen)
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Beyond certified medical suppliers, sound amplifier or assistive listening device manufacturers also sell their products as low-end hearing aids both domestically and internationally, generally at lower prices than medical-grade hearing aids. However, these products are classified only as electronic products rather than medical devices, and are therefore unregulated by medical authorities. Medical-certified hearing aids are not allowed to be sold online in many LMICs, therefore most products available for purchase online are ALDs. Buyers should be aware of this distinction and choose products accordingly.

2. Wheelchairs

China’s 2022 export volume of manual wheelchairs reached 9.2 million units, with an export value of approximately US$736 mn [32]. From 2017 to 2022, export volume grew 6 per cent year-on-year, while export value grew at 8 per cent.

Supplier landscape

Known for price competitiveness, China serves as a contract manufacturer for international NGOs and social enterprises such as Motivation, UCP Wheelchairs and LDS Charities. Global brands such as Rehasense and Ottobock have manufacturing plants in China. The average export price for manual wheelchairs (including transport wheelchairs) in 2022 was around US$80 per unit, a figure that has remained steady since 2017 [32].

The Chinese wheelchair industry is fragmented with low market concentration, with the majority being small-scale businesses. According to the survey, a significant number of manufacturers report low sales volumes, with around 80 per cent of suppliers having annual sales of less than US$5 million. This high level of market fragmentation creates pressure on suppliers to remain cost-competitive, which may lead to varied approaches in product design, materials, and production processes as companies seek to differentiate themselves and expand their market share [33].

In China, manual wheelchairs are classified as Class II medical devices. To obtain a license, producers must submit their quality inspection reports and receive approval from NMPA. Clinical trials are not required for manual wheelchairs, as they are exempted along with a list of other medical products, to speed up market availability. According to the China NMPA website in October 2024, 223 certified manual wheelchair products are held by 194 different companies across China.

Wheelchair manufacturing is concentrated in Beijing-Tianjin-Hebei Region, Guangdong, and the Jiangsu province.

The Hebei region focuses on low-end products, the Guangdong region on low-to-mid end products (between US$35-US$100), and the Jiangsu region on high-end products (above US$100).

Table 8: Top 5 cities with the highest number of medical-grade manual wheelchair suppliers.

City Province Percentage
Foshan Guangdong 19%
Tianjin Beijing-Tianjin-Hebei Region 12%
Hengshui Beijing-Tianjin-Hebei Region 8%
Danyang Jiangsu 4%
Langfang Beijing-Tianjin-Hebei Region 4%
Total: 47%

Seven manufacturers in the survey reported having medically certified manual wheelchairs and presence in LMICs. Among these, both Dongfang and Kaiyang have an annual production capacity of over 600,000 manual wheelchairs and have shown strong interest in expanding into LMICs. However, few suppliers have registered their products in LMICs. Among the 20 respondents that sell to LMICs, only one has products registered in at least one country. They primarily sell through distributors and exporters at ex- factory prices and do not handle in-country product registration.

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Table 9: Survey respondents with medical-certified manual wheelchairs and footprints in LMICs

Company Introduction LMIC footprint Quality
Dongfang (Foshan)
Hongguan (Hengshui)
Kaiyang (Foshan)
25
Kangyijian (Hengshui)
New Century (Hengshui)
Xiangrun (Hengshui)
Zhongjin (Changzhou)
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Four publicly listed medical equipment companies also have medical-certified manual wheelchairs.

Table 10: Public listed companies with medical-certified manual wheelchair business segments

Company Annual revenue and exports percentage Wheelchair segment introduction Flagship products outside wheelchairs Global presence
Cofoe (Hunan, Changsha) [34]
HL Corp (Shenzhen, Guangdong) [33]
27
Intco (Zhenjiang, Jiangsu) [35]
28
Yuwell (Danyang, Jiangsu) [36]

A few other manufacturers also have all commonly used international certifications (all CE, FDA, and ISO), domestically certified licenses for manual wheelchairs and international sales experience. However, since they did not participate in the survey, detailed information on their capacity and sales is not available. For reference, the company list is provided here for readers wishing for more information and to make contact.

Table 11: Other wheelchair manufacturers identified with all three CE, FDA and ISO certifications

Company Global footprint Official website
Caremax (Foshan, Guangdong) Over 50 countries https://www.caremax-med.com/
Dayang (Foshan, Guangdong) Across Asia, Europe, North America, South America and Oceania. https://www.dayangyiliao.com/
Feiyang (Foshan, Guangdong) Around 15% of the sales goes to South America and 15% in Southeast Asia https://feiyangmed.en.alibaba.com/
First Medical (Zhongshan, Guangdong) Information not available http://en.fstmed.com/
JBH (Nanjing, Jiangsu) Countries include US, Canada, Germany, Spain https://www.jbhwheelchair.com/
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3. Prostheses

According to the most recent estimates, there are currently over 600 various types of prostheses and orthoses manufacturing, assembly and fitting institutions in China [37]. In 2023, China’s prostheses sales market size in China is RMB787 million (~US$110 mn), with an annual production volume of approximately 130,000 units and around 70 per cent are lower limb products [38].

China’s prostheses are known for their price competitiveness and responsiveness. For example, according to a supplier, the price of their comparable hydraulic knee joints can be 20 to 60 per cent of those from global brands. This is primarily due to China’s advanced supply chain and high production efficiency. Required materials can be sourced locally at low cost, resulting in shorter lead times for global procurement.

In China prostheses used to be classified as medical devices. However, certain below- knee (BK) prostheses were removed from the national medical device list in 2015, and certain above-knee (AK) prostheses were removed in 2020 [39] [40]. As a result, relevant products are no longer regulated or monitored by NMPA. Quality control for prostheses is now regulated only by the SAMR.

The National Rehabilitation Technical Aids Quality Supervision and Test Centre, under the Ministry of Civil Affairs, is assigned by SAMR to issue quality certifications and to conduct mandatory spot inspections [41]. For lower limb prostheses, the centre has established the national standard GB/T 18375, which leverages global prostheses standards, such as ISO 10328, and is used as the gold standard certification in domestic sales.

Supplier landscape

Prostheses manufacturers are smaller compared to other categories of assistive products. 67 per cent of respondents have an annual sales value of less than US$1 mn. Altogether, 25 per cent reported sales between US$1 mn and US$5 mn.

Around 67 per cent of the respondents have previously sold to LMICs, but none of them have registered their prostheses products in those markets. One of the manufacturers shared that prostheses could be sold in many LMICs without local registration. However, without local registration, they cannot participate in local government tenders, impacting their long-term brand establishment in that market.

China’s lower limb prostheses manufacturers are more fragmented, but are primarily located in Beijing and Shijiazhuang, both of which have implemented policies to support

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prostheses manufacturing. For example, Beijing offers tax benefits for R&D expenses, accelerated depreciation and corporate income tax reductions. Shijiazhuang has similar government support policies, including a priority product approval process, financial subsidies and investment in industrial parks. In the Jiangsu and Shanghai region, few manufacturers focus exclusively on upper limb prostheses, such as Danyang Prosthetic Factory and Shanghai Kesheng. Below is a list of prostheses suppliers that participated in the survey.

Table 12: Survey respondents for prostheses

Company Introduction LMIC footprint Type Quality
Chonglang (Beijing)
Fuyutiancheng (Beijing)
32
Fengxing (Beijing)
Beijing rehabilitation hospital (Beijing)
Linkang (Bazhou, Hebei)
Grootre (Jinan, Shandong)
33
JBK (Beijing)
Dongfang Resun (Beijing)
Reborn (Danyang, Jiangsu)
Jingbo (Beijing)
34
Ruipu (Hebei)
Shenghe (Changsha, Hunan)

4. Spectacles

China has over 3,000 manufacturers of spectacles and associated products. Of these, 400 have annual sales exceeding RMB20 million (approximately US$2.8 mn), and at least 600 manufacturers export their products. China is the largest exporter of eyewear to LMICs; for instance, 78 per cent of India’s eyewear imports come from China. Nigeria also relies significantly on imports, with over 90 per cent sourced from China [1]. Chinese manufacturers also produce products for several global brands such as EssilorLuxottica and Safilo and social enterprises such as Vision Spring.

The China Optometric and Optical Association publishes China’s export volume and value every year [42]. The data show a general growing trend of spectacles and its accessories from 2016 to 2023, reaching over US$7.4 bn in 2023 [43]. The export value to “BRI” 9 countries is US$2.7 bn in 2022 (37 per cent of the total), a 20 per cent increase from 2021. And the export value to ASEAN countries is US$639 mn in 2022 (9 per cent of the total), a 52 per cent increase from 2021 [44] [45].

Figure 3: China spectacles export value (Unit: US$100,000)

Bar chart showing yearly values from 2016 to 2023. Each year is represented by a vertical dark blue bar. The values above each bar are as follows: 2016: 4,996; 2017: 5,360; 2018: 5,452; 2019: 5,606; 2020: 5,376; 2021: 6,666; 2022: 7,415; 2023: 7,415. The bars gradually increase from 2016 to 2019, dip slightly in 2020, then rise sharply in 2021, and reach their highest and equal value in 2022 and 2023.

Spectacles are not classified as medical devices in China [46]. Therefore, no compulsory clinical trials are required. In addition, spectacles for myopia and presbyopia are also not classified as assistive products in China and not included in the national rehabilitation and assistive products list.

Spectacles are only classified as an industrial product in China. The quality control is regulated by SAMR. There is a National Inspection and Testing Centre for Ophthalmic Optics Products located in Danyang, established in 2006 as the leading quality inspection centres in China. China has published a series of national compulsory quality standards for spectacles products, which are widely used in the Chinese domestic market,

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specifically GB10,810 for lenses, GB13,511 for near-vision spectacles, and GB14,214 for frames [47].

Supplier landscape

The four key spectacles manufacturing hubs are Wenzhou and Danyang (known for producing low- to mid-range products), Xiamen (prominent for sunglasses), and Shenzhen (recognized for high-end brands). Combined, Wenzhou and Danyang host over 1,000 manufacturers. Wenzhou mainly produces frames and near-vision spectacles, whereas Danyang is known for lenses and near-vision spectacles.

Danyang is recognized as the world’s largest spectacles production base, which has 600 manufacturers producing over 400 million spectacles in 2022, representing about 45 per cent of global production. Both cities benefit from supportive government policies that foster industry growth and boost export sales.

For lenses, there is a lack of publicly available data on the exact number of manufacturers in China; however, it is predicted to be at least hundreds. Among these, Conant and Wanxin stand out due to their production volume, with Conant particularly focused on international sales. According to Conant's 2023 annual report, its resin lens sales exceeded 150 million units, and Wanxin's sales were around 100 million units, ranking them second and third in the world, just behind EssilorLuxottica with over 300 million units. EssilorLuxottica has also established a series of joint ventures in China for lens manufacturing, such as SeeSee Optical and Yoli Optical, where they serve as OEMs for EssilorLuxottica but also manufacture for other brands.

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For frames, there is also a lack of publicly available data on the exact number of manufacturers in China, although experts note there are at least hundreds of them. As the production technology required is less complex, the market is more fragmented than for lenses. Among the suppliers, Ouhai Glasses, Pilot Optical and Matt (Weilan) Optical stand out for their production volume. The frame manufacturers also normally produce near-vision spectacles and sell these as ready-made products to LMICs.

Table 13: Survey or interview respondents for spectacles

Company Introduction LMIC footprint Type Quality
Conant (Shanghai)
Pilot (Wenzhou)
Weilan (Matt optical) (Wenzhou)
38
Ouhai Glasses (Wenzhou)
Readsun (Wenzhou)
Select Optical (Jiangsu)
Zhantai (Wenzhou)
Mike Optical

5. Digital assistive products (screen readers, smartphones, and AACs)

Supplier landscape

Compared to the other four assistive products (spectacles, hearing aids, prostheses and wheelchairs), the publicly available research on the Chinese digital assistive product market is limited. Overall, 9 digital assistive product suppliers responded to the survey. Among them, 6 offer screen readers, 5 provide AACs, 2 produce phones and 4 supply alternate input devices as well as navigation and wayfinding tools. The data indicate that most manufacturers operate on a smaller scale with fewer than 50 staff and have limited exposure to LMICs. These manufacturers do not focus on producing a single type of digital AT but typically offer a diverse range of products.

There are no significant geographical clusters or regional initiatives for digital assistive product production. Limited available data indicate that these products are mainly manufactured in tier-1 cities such as Beijing, Shenzhen and Hangzhou.

Digital assistive products manufacturers that participated in the survey are listed below:

Table 14: Survey respondents for digital AT

Company Introduction LMIC footprint Type Quality
Huibang (Shenzhen)
LL Vision (Beijing)
41
KeAn (Guangzhou)
Qiming (Shenzhen)
Yuanfangboai (Beijing)

Another 7 digital AT suppliers participated in the 2023 China International Care and Rehabilitation EXPO, where interested buyers could explore their product offerings.

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Table 15: Additional digital AT suppliers that participated 2024 China International Care and Rehabilitation EXPO

Company Digital product Website
Huawei (Shenzhen) Phones https://consumer.huawei.com/en/sustainability/information- accessibility/
iflytek (Anhui) Speech- text and text- speech https://www.iflytek.com/en/about-us/csr.html
Jumaoyuan (Beijing) Screen readers http://jumaoyuanbj.com/col.jsp?id=111
Nanhe Technology (Shenzhen) Phones http://www.nanhotech.com/
Rejoin Technology (Hangzhou) Screen readers https://www.rejointech.com.cn/
Shunde F.L.K (Foshan) Screen readers Phones https://www.cnflk.com/?lang=en
Sightcare (Hangzhou) Screen readers https://www.crexpo.cn/exhibition/483?cboofs_je=96

According to the WHO, digital assistive technology refers to devices or software that provide practical solutions to individuals with disabilities, enabling improved communication, time management and monitoring [52]. In alignment with this broader definition, smartphones have gained prominence due to their portability, multifunctionality, and integration of advanced accessibility features [53]. In recent years, many leading Chinese smartphone suppliers have already been making efforts to develop smartphones tailored for assistive purposes. Given the significant market penetration of made-in-China smartphones in LMICs, it would be beneficial if more persons with disabilities in these countries could access the products.

Among the Chinese smartphone suppliers available in LMICs, Huawei and Honor are leading the way in accessibility feature development. Since 2017, Huawei has introduced features such as screen readers, voice-to-text capabilities, and AI-powered tools [54].

The company announced in 2024 that its accessibility features have reached almost 8

43

million users globally [55]. Honor developed several features such as “screen reading”, “AI subtitle” and “Hearing aids as earphones” and announced in their ESG report that monthly almost 1 million users access these functions. Other suppliers, such as Xiaomi, Oppo, Vivo and Transsion, are launching models or systems with accessibility features but detailed user numbers are not publicly available.

All the features work specifically with each phone's proprietary operating system, and any phone model equipped with the system can access them. For example, across different suppliers, phone models ranging from US$80- US$130 could already have these features.

Table 16: Accessibility features introduced by Chinese smartphone suppliers

Supplier Year Key accessibility features
Honor [56] [57] 2022
2023
Huawei [58] 2017
2019
2020 [59]
44
2022 [60]
2023 [61]
2024
OPPO 2017 [62]
2021
2024 [63]
Transsion [64] 2023
Planning
Vivo 2019 [65]
2021
45
2023 [66]
2024
Xiaomi 2018
2020 [69]
2021
2022 [70]
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Competitive advantage for LMIC exports

Chinese suppliers are recognized for their competitive pricing, high production capacity, diverse product range and short lead times. While some other countries have recently expanded manufacturing of low-cost assistive products like spectacles, China's extensive production experience allows it to maintain richer, more affordable product variety with greater functional diversity, solidifying its position as the key global manufacturing hub for assistive products.

Several key factors driving these competitive advantages are listed below:

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Challenges for LMIC exports

Most respondents expressed interest in strengthening sales in LMICs. However, based on the interviews, they face several common challenges:

Several challenges are identified for specific product category, for example in the following fields:

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Digital assistive technology:

Spectacles:

50

Recommendations

Chinese suppliers recommend the following to the relevant Chinese industry association and parties to better support them to serve LMIC markets.

52

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