"Sky-price ticket" limited effect of life-saving drugs cheap medicine cut off the solution

can not buy, can not afford, many patients on the shortage of medicine supply is quite helpless.In recent years, China's shortage of drug supply security has been strengthened, but drug supply and price monitoring is still not sensitive enough, drug procurement, use, reserve and price supervision policies still need to be improved, some illegal manipulation of the market to raise prices is also more prominent.In October this year, the General Office of the State Council on further do a good job in the shortage of drugs to ensure stable prices of the opinion issued. With the east wind of the policy, can the goal of completing the shortage drug supply guarantee system by 2020 be achieved on schedule? Can the shortage of medicines be fundamentally solved?Life-saving drugs play "flash"tablets, is a drug used to treat acute lymphoblastic leukemia in children, almost throughout the entire treatment process, but often face shortages and price increases.Zhou Chenyan, deputy director of pediatrics at Sichuan Provincial People's Hospital, said thatpython tablets are a necessary medicine for treating acute lymphoblastic leukemia in children, especially during the maintenance period of more than a year, if the drug is stopped, it will greatly affect the long-term survival effect of children. Because the profit is not high, the manufacturer's production enthusiasm is not big and so on, the current production oftablets of the drug enterprises are few, the hospital almost every year there will bepieces of radon supply.He Xiangling, director of the Children's Hematology Department of Children's Medical Center of Hunan Provincial People's Hospital, said that in Hunan, children's anti-cancer drugs, includingtablets, dakabazine and so on, have also been cut off several times, and the families of the children have to buy drugs everywhere, online for medicines, on the one hand, the quality of drugs is difficult to ensure, on the other hand, drug prices have also increased a lot.Reporters found that, because of the domestictablets "a drug is difficult to find", some families of children in order to use drugs, can only buy high prices of foreign imported drugs, domestictablets per bottle of dozens of yuan, and imports oftablets in the thousands of yuan, the medical burden greatly increased.Chengdu resident Ms. Li said that the domestictablets would have been cheap, but if there is a shortage, may rise to a few hundred yuan can not buy, you have to look everywhere for relationship trustees to buy, pay a lot of money, if the trustees can not buy, can only buy foreign imports of high-priced drugs. "My family started taking this medicine in early August this year, 50mg, 1/4 tablets at a time, but the hospital often out of stock and can't get the medicine. Buy it yourself, the price increase does not say, but also have to trust the relationship around. The family members of the sick child either rely on the circle of sick friends to smooth, or have to trust people to buy from abroad, no medicinal certainly not. "is not just the radon tablets that areby the cut-off. He Xiangling introduced, for children's leukemia treatment of the basic chemotherapy drug Changchun new alkali before each only about 12 yuan, the previous two years once cut off the supply, after media reports caused social concern, Changchun new alkali resumed supply, but the price rose to more than 50 yuan each;In the eyes of the industry, some niche life-saving drugs because the profit is not high, the enterprise production enthusiasm is not strong, so the supply is cut off to play "missing", and then after the price increase to resume supply. "It's like a flash in the face, making patients and doctors feel helpless." A doctor said.Parents of children with leukemia told reporters that many families of children are busy looking for medicines, and compared with price increases, they are more concerned about the stable supply of drugs and the quality of medicines. One parent said: "Children's anti-tumor drugs can be appropriately increased, as long as it can be used." I hope that the shortage of childhood leukemia drugs can arouse the attention of the relevant departments and manufacturers, do not let us worry all day long. " cheap drug price sitting "rocket"nitrate glycerosis is a quick-acting medicine for the treatment of coronary heart disease, angina, can quickly alleviate the disease for a short time, is a life-saving medicine, but also a cheap medicine.Since this year, nitrate glyceal in Jiangsu, Liaoning, Shandong, Ningxia and other places of price increases, out-of-stock frequently seen in the newspapers, causing widespread public concern.According to our reporter, in 2018, 100 pieces of domestic generic nitrate glyceal tablets sold for only 156 yuan, and then replaced with 15 pieces of independent new packaging, the retail price was adjusted to 25.7 yuan, about 10 times the price per tablet. On October 30, the reporter in JD.com to "nitrate glyceal tablets" as the key word query shows that Yimin Pharmaceuticals nitrate glyceal tablets (0.5mg x 100 tablets / bottle) price of 52 yuan.Glyceal nitrate is not an isolated case of a commonly used cheap drug to cut off price increases. The commonly used painkiller Rotontin, glutatrogen for autonantial neurofunctions, adrenal corticosteroids for infantile spasms, anti-tumor drug fissamycin, etc. are often out of stock.The director of a primary health hospital in Hunan told reporters that in recent years, West Dylan, phosphorus dephosphate, Atropine, Tigosin, isopropyl epinephrine and other drugs have seen price increases, and price increases are often out of stock, grass-roots drug use is often not guaranteed.One of the reasons for the rise in the price of cheap medicines is the severe shortage of raw materials upstream and the rise in prices. Take nitrate glycerine as an example, one of its raw materials nitric acid last year encountered a large-scale reduction or shutdown, resulting in nitrate glyceal out of stock, price increases, and the abnormal changes in the price of glyceal nitrate will naturally affect downstream pharmaceutical production enterprises, so that the price of nitrate glyceal tablets rose.Secondly, the problem of monopoly price increase of API can not be ignored. Public information shows that many of China's API only individual enterprises have production numbers, coupled with cost-effective considerations and environmental protection standards and other issues, even if some raw materials and pharmaceutical numbers more, put into production of enterprises are also very few, easy to cause the monopoly of RAW drugs price increases. In other words, many API production and supply in the hands of a small number of enterprises, these enterprises use the dominant position in the market, with price-led power, easy to form a monopoly, and for the benefit of the interests of the drug prices continue to be raised.In the case of ice acetic acid, it is mainly used in the production of hemodialysis concentrate to treat advanced kidney failure, uremia and other diseases. There are only 3 ice acetic acid production enterprises in China's market, they reached a joint agreement in February 2018 to increase the sales price of ice acetic acid API, and from March 1 of that year, the sales price of ice acetic acid API from 7 to 9 yuan / kg to 28 to 33 yuan / kg. At the end of 2018, the three enterprises also received a fine of 12.8338 million yuan issued by the State Administration of Market Supervision.“
Sky-price tickets" role is limitedinterviews, some industry insiders believe that "sky-price tickets" deterrent effect is limited.They explained that in recent years, the State Administration of Market Supervision and Administration has investigated a number of API production enterprises monopoly api prices, but compared with the huge monopoly interests, these fines and penalties are like "water", difficult to form a deterrent, some drug raw materials monopolists still adopt a "hunger marketing" strategy, hoarding waiting for the opportunity to increase prices.Chengdu, the head of a pharmaceutical company is more outspoken, glyceroic nitrate is one of the special effects of coronary heart disease, angina, there is a certain irreplaceable, such a drug has a very strong bargaining power, even if the supply of raw materials stabilized, its price increases are inevitable. Obviously, the price of the shortage of medicines is stable and involves a complex market chain, which is by no means an overnight solution. Zhang Hongbing, a professor in the Department of Physiology at the School of Basic Medicine at Concord Medical College in Beijing, said that cheap drugs usually refer to those that are safe, effective and low-cost old drugs, which have been selected through long-term clinical practice, and that their safety and ability have been fully verified, mostly falling into the category of basic drugs in the country. Some cheap life-saving drugs have outstanding efficacy and low prices, and have been welcomed by the public, hospitals, pharmaceutical companies and the government. In Zhang Hongbing's view, to ensure the stable supply of cheap life-saving drugs is an important issue of people's livelihood, related to the vital interests of the masses, the relevant departments need to strengthen law enforcement efforts to break the monopoly interests, the abnormal price of drugs trace back to the source, check the monopoly behavior of raw materials, to the monopoly of raw materials, control the market and other illegal and illegal issues. In addition, experts suggest that the efficacy of accurate, clinically necessary, irreplaceable and low-cost drugs, the establishment of long-term stable drug supply mechanism and national reserve system, the relevant government departments should develop a list of cheap and good drugs, life-saving drugs such as tablets should encourage responsible enterprises to stabilize production, to manufacturers corresponding financial subsidies, tax relief, to ensure a stable supply of drugs, so that patients in need can use life-saving drugs in a timely manner. (
44th issue of Lookout 2019
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