China's pharmaceutical market currently ranks in the top 10 markets and is estimated to reach number one by the middle of the century, according to a report by PWC, titled: "Top eight health industry issues in 2008." Similarly, India's pharmaceutical market is 13th in the world but is anticipated to grow 80 per cent by 2009. Asia's substantial ageing population, along with an increasing prevalence of chronic "western" diseases are expected to fuel this region's drug market demand. Meanwhile, it is well documented that over the past few years the pharma industry has been shovelling out work that it considers "non-core" to Asia by the bucket load. The region has already become established as a major drug product and ingredients manufacturing hub as well as a popular destination for pharma firms to offshore other functions such as IT and data management. More recently though, Asia has been moving up the pharma food chain, busily trying to carve out a place for itself in conducting services in the more traditionally "core" clinical trials and research and development (R&D) phases, and the pharma industry is responding, lured by the promise of faster turn around times and lower costs. The average cost of running a US-based clinical trial per patient is $5,404 for Phase I, $6,538 for Phase II and $7,635 for Phase III. According to an analysis in 2006 by Rabo India Finance, conducting a clinical trial in a lower-cost destination such as India, for example, can cost significantly less, sometimes up to 60 per cent less, than in the US. Similarly, according to a recent report published by the UK Trade and Investment (UKTI) department, the local Chinese industry estimates that Phase I trials can be conducted in China for around 15 per cent of the equivalent cost in a Western country, while Phase II studies cost 20 per cent of the price in the west. However, intellectual property is still a looming concern where preclinical work is concerned, with seventy-six percent of executives from multinational corporations admitting that they were "extremely concerned" about intellectual property rights and legal risk, according to the report. Despite this, a comparable number of those interviewed by PWC also conceded that they have noted an improvement in intellectual property protection over the past five years, and as a result, "many are turning their attention to R&D in Asia", the report said. Meanwhile, many US-based pharmaceutical companies also have increased their own presences in Asia to carry out R&D and be positioned and ready to tap into a potentially vast market potential due to its sheer population size, increasing wealth, and heightening awareness of health-related issues. For the time being though until the region really takes off, these Asian investments are still only small when compared with what is currently being spent on R&D in the West.