The development and Reform Commission launched a cost investigation on some pharmaceutical enterprises involving 60 famous enterprises

Originally, everything was perfect: the emotional patients talked about the endless pain brought by the disease, and the glory of life was dim However, the emergence of new drugs changed everything, and life was back on track The enterprise Manifesto of vows and pledges -- take patients as the center, and strive to be conscience medicine No trace of expert help cavity - this disease needs early detection and early treatment, early use of this medicine, the effect is very different   Until someone asked, "how much is this medicine?"   The expert didn't seem to be alert and replied, "7900 yuan a piece..." Before he finished, the person in charge of the enterprise stopped and said, "it's very difficult for us to measure the social value of a product from its price, and we should see the changes it brings to patients' lives..." However, someone is already muttering: "the price is too high! How many people can afford it? "   This is the scene of a press conference held by the international pharmaceutical giant, Aberdeen, to promote its product Sumeria Recently, xiumeile was approved by China food and Drug Administration for the treatment of ankylosing spondylitis For this reason, Aberdeen carried out a typical round of pharmaceutical marketing activities Including the establishment of "holding tomorrow" public welfare projects However, in these activities, price is always a sensitive topic, which is carefully ignored They are more willing to talk about dreams, hopes and responsibilities   In fact, not only Albright, but almost all foreign pharmaceutical companies deliberately avoid the price issue when they release new drugs At a launch conference for its product, refumex, a new drug for multiple myeloma, the US based company chose to turn a deaf ear to reporters' questions about prices When reporters asked again in the form of e-mail how much financial burden the drug caused to patients, they still ignored it However, they also acknowledge that "the cost of innovative cancer therapies today is very high."   It's too expensive, which is why these pharmaceutical companies are reluctant to mention it publicly Forbes once made the list The single drug with the highest price in the world is soliris, which is used to treat paroxysmal nocturnal hemoglobinuria The annual treatment cost is as high as 410000 US dollars However, the record was later refreshed At the end of last year, the European drug regulatory agency EMA officially approved a gene therapy drug, glybera, for the treatment of an extremely rare genetic disease, lipoprotein lipase deficiency (lpld), which cost an unprecedented $1.6 million Although ordinary new drugs are not so exaggerated, the price of tens of thousands of Yuan such as Sumeria is still common   It is with high prices that the pharmaceutical giant has made a huge profit Therefore, they are always frequent customers of the world's top 500 enterprises, and their stable growth is envy of other industries Marcia angel, former editor of the New England Journal of medicine, was surprised to find that in 2002, the total profits of 10 pharmaceutical companies on the top 500 list could exceed the total profits of 490 other companies   "The pharmaceutical industry is really profitable It's hard to imagine how much money pharmaceutical companies have." She could not help feeling   Reasons for high profits   Why can the pharmaceutical industry set such a high price for life-saving drugs and make staggering profits? Their answer is usually a beautiful story of an industry The story usually includes two parts: a string of R & D cost figures and the social value of drugs   In the United States, the number of cancer survivors rescued by the pharmaceutical industry has doubled in the past 20 years, from 7 million to 14 million "Through our approach, we have helped many cancer patients enter a long-term manageable disease state and get cured"; "in the case of multiple myeloma, the survival rate of patients has increased by 73% in the past 10 years Previously, because of the limited medical level, patients with multiple myeloma could not get treatment even if they spent more money, could not survive longer and live a higher quality life "   As a result, the company said that all this was not in vain, and the pharmaceutical industry has made arduous efforts to explore it - a long time and a lot of money "It will take 15 years for an innovative treatment to develop and ultimately benefit patients Only one out of 10000 compounds can pass clinical trials, and only one out of 10 treatments is profitable "   Weisile, former chairman of Novartis group, once wrote a book called "magic anti-cancer pill" In the book, he lists how Novartis, taking patients as the first consideration in the development of Gleevec, which is a targeted drug for leukemia, has given birth to new drugs despite the risks of poor prospects However, he is aware of the criticism caused by Gleevec's pricing that the cost of 400 mg / day for chronic myeloid leukemia patients is $2000-2400 / month, and $3500 / month for patients with 600 mg / day for acceleration or acute transformation   "We do agree with those who think that the price of greavelli is quite high, but after measuring all factors and conditions, we are sure that the price is fair and reasonable." After comparing the cost of patients choosing other treatment options - allogeneic bone marrow transplantation of 193000 yuan and high probability of complications, chemotherapy and interferon treatment costs the same as that of Gleevec and the side effects are great - he said   Weishile also argued that if the various stages of the new drug pre marketing were taken into account, it would cost an estimated 600 million dollars for each new drug program Before the new drugs are put on the shelves, the average time required is 10-14 years "Since the patent protection period is only 20 years, there is only a profit period of 6-10 years left In this profit period, we must earn enough profits to pay for the previous capital and risk investment, as well as the expenses required for the reinvestment of the enterprise If the patent protection is lost, the product price will not gain the advantage of profit Without the expected profit, we can no longer invest in the follow-up research and development It has nothing to do with morality or right or wrong It's just a matter of logic for the survival of an enterprise "   He expects the public to recognize that the pharmaceutical industry "is also a business in some ways, no different from Microsoft, ge or Pepsi." We also want to make a profit by selling our products Without profit, there will be no capital, no research and development, no investment, and in the end, no new products Many people tend to ignore this fact and prefer to stand in the short-sighted position, just want to buy medicine with less money "   His successor, Jiang Muzhong, took a similar view in an interview with reporters "We have to get enough revenue to reinvest in R & D in order to develop a new generation of innovative drugs," Jiang said   In this way, high prices and huge profits seem to be justified   Take what you shouldn't   However, is the expensive pricing of new drugs really just to cover R & D costs and reward risky innovation? Existing evidence suggests - not quite   Recently, another multinational pharmaceutical giant, GlaxoSmithKline, has been in trouble in China During its operation in China, the public security organ said that in order to open up drug sales channels and increase drug prices, it bribed individual government officials, a small number of pharmaceutical industry associations and foundations, hospitals and doctors "The case involves a large number of people, lasts for a long time, involves a large amount of money and has a bad criminal circumstances."   According to Liang Hong, vice president of GlaxoSmithKline China, who was taken away by the police for investigation, the proportion of drug enterprise operation in drug price is as high as 20% - 30% In the chain of bribery, it goes up to the functional departments of industry and commerce, price, human resources and society, and down to the basic hospitals and doctors in China Some sold a batch of drugs to settle a sum of money, each of the cooperative doctors issued a credit card, and the kickback was credited the next day after the prescription Of course, all the expenses are ultimately paid by the patient   After that, AstraZeneca employees were also taken away by the police   This opened the eyes of the Chinese public Although the major pharmaceutical companies in the United States have been repeatedly punished for "improper payment" and the crime location is mostly in China, they are always exempt from prosecution in China It's like nothing happened GlaxoSmithKline's bribe door finally tore through his golden body   In fact, the media in Europe and America have systematically exposed and criticized pharmaceutical companies Marcia angel wrote a book called the truth of the pharmaceutical industry In the book, she points out: "the price of a drug is not determined by its R & D cost On the contrary, it is determined by their value in the prevention and treatment of diseases I heard that he admitted that the industry would spare no effort to set the price as high as possible, and the price has little to do with the R & D cost "   Angel also analyzed the so-called "820 million dollars to create a new drug" lies of pharmaceutical companies at that time (2001), and believed that the results of a series of fallacies of Taft drug development research center had little factual basis "I estimate that the real cost of each drug is on average under $100 million If it's really close to $820 million, the pharmaceutical industry won't be too secretive about the data "   She found that many of the costs of pharmaceutical companies are spent on questionable marketing As GlaxoSmithKline did, it was not really spent on developing and innovating drugs   In addition, angel believes that pharmaceutical companies exaggerate the role of Companies in the pharmaceutical innovation process Many new drugs are first discovered by universities and other research institutions, then the patent is licensed to pharmaceutical companies, and then clinical trials are launched to the market   Mark Crowell, vice president of research and executive director of innovation at the University of Virginia, also confirmed angel's statement when answering questions from reporters recently "In terms of new drug research and development, universities are engines, or even fuels," Crowell said   "In 2006, more than 500 start-ups were founded in American universities, two-thirds of them in biomedical industry In addition, two thirds of biomedical start-ups in the United States are created by universities Without universities, the ecosystem or industrial chain of pharmaceutical research and development is incomplete Now many new drugs of those big pharmaceutical companies come from cooperation with other institutions, such as purchasing from university start-ups " He said   If angel and Crowell are telling the truth, the public has twice buried a single drug   Open the black box   Recently, the national development and Reform Commission launched a cost survey on some pharmaceutical enterprises, involving 60 well-known enterprises, including multinational companies such as Astaire and GlaxoSmithKline According to the national development and Reform Commission, the purpose of this investigation is to understand and grasp the cost, price and relevant information in the process of drug production and circulation, and to formulate and adjust drug prices in a timely manner   In fact, not only policy makers, but all sectors of society feel that pharmaceutical companies urgently need some transparency People need to know that pharmaceutical companies are