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| The shortage of life-saving medicine goes back to the beginning: tens of thousands of dollars in costs |
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| Author：中國銘鉉 企劃部 Release Time：2017-8-18 11:21:36 Number Browse：2095 |
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On August 18, the medical website said: "when the medicine is scarce, it can be fired up to tens of thousands of dollars. However, the cost of fish protein is only a dozen yuan, and the market cannot be regulated by supply and demand."
The "lifesaving" shortage came again and again.
On August 16, the sichuan provincial department of pharmacy centralized purchasing service announced "a notice concerning the reasons for the shortage of medicines", referring to 212 medicines. There are "regular" shortages of fish protein, digoxin and human blood albumin, as well as common medicines such as qingkai, norfloxacin, and gynaecology.
Protamine sulfate injection, digoxin oral solution, compound sulfamethoxazole injection, injection using the new amino acid sodium ergot alkali, actinomycin D, such as shortage of medicine is already famous in medicine cycle.
Due to high production costs, low profits, small audience, certain anti-cancer, wonder drug has not been approved in China listed, seasonal fluctuations of raw materials, the standard revision, drug bidding system, the drug shortage is always a difficult problem to market supply and policy regulation.
In the past two years, the production, circulation and supervision policies of shortage drugs have been frequent. In addition to the designated bidding, production, procurement, shortage of formulating drug supply security mechanism, on August 14, the national development and reform commission issued the operator shortage of drugs and drug ingredients price behavior guidelines (draft) ", emphasizes the operator may not collude with shortage of drugs and drug ingredients, shortage of drugs or API market price manipulation, damage the lawful rights and interests of other operators or consumers; The operator shall not hoard the principles such as odd and high-priced sales.
Released in June 2017, the national health development planning commission on the reform to perfect the shortage of drug supply security mechanism implementation opinion "pointed out that at present, our country medicine shortage is no longer before the reform and opening up" underserved "universality of shortage, but a handful of clinical medical supplies necessary for the quality and efficiency is not high, not enough supply security policy refinement, related links to connect smoothly, some drug clinical tight supply shortages even happen.
As a special commodity, it is difficult for some medicines to be fully marketized. In addition to the government's "leading role", civil society organizations continue to work on "drug seeking".
Health to restart a shortage of medicine on July 26, ali platform, initiated by "global medicine union", aimed at to public welfare organizations, medical institutions, drug makers, Internet application and media, for the needed drugs patients and families to provide an online real-time query drug information public welfare products. The user can obtain the information of the drug instruction and the circulation channel through the search, and it is now connected with the national drug data, some e-commerce B2C enterprises and offline pharmacies.
"Ali's health is an Internet company that is in the field of drug circulation and has certain capabilities and advantages in drug information and channel search." Find medicine project manager Tmall medicine pavilion Liang Sujuan to 21st century business herald, said the current phase I project online, taobao search "to find medicine captain" on cell phones can enter the page looking for medicine, alipay, ali health APP also have entrance, "as a pure public good positioning, the project not for commercial use, the only evaluation criteria is the needs of user satisfaction."
Periodic problem
Shortage of medicine mainly divided into two kinds, one kind is due to the small dosage, low profits, price is low, but no alternative medicines, plus some pharmaceutical raw material supply conditions, such as the season, and include the formulation of standards and changes, resulting in foreclosures.
"There is a shortage of medicines in countries around the world because drugs are a special commodity and cannot be fully liberalized." Ubs securities Zhao Bing pharmaceutical industry analyst for the 21st century economic report, said the "life-saving drug scarce can fry to tens of thousands of pieces, but if the cost of protamine but more than ten dollars, pharmaceuticals market can not completely rely on the supply and demand adjustment."
The shortage of these medicines is complicated. According to national health development planning commission on the reform to perfect the shortage of drug supply security mechanism of the implementation opinions ", shortage of factors mainly has four aspects: one is the productive factors, some of the raw material supply is seasonal characteristics, such as the protamine; Some clinical dosage is small and unstable, enterprises are reluctant to produce, such as digoxin oral solution; Some pharmaceutical ingredients or pharmaceutical production enterprises have only 1-2, and once there is a problem, there will be a temporary shortage, such as penicillide.
Second, policy factors. The shortage of drugs is mostly low - price medicine and women's junior college, urgent (snatching). Currently, the supporting policies for the production of these drugs are not perfect, and the production enthusiasm of enterprises is not high.
The third is the institutional factor. In the process of public hospital reform, some medical institutions are underpowered by the purchase and use of low-price drugs.
Fourth, speculative monopolistic factors. Individual drugmakers control the raw materials, stock up and sell, and raise prices, resulting in tight market supply.
The second type of shortage is mainly the anti-tumor drugs, specific drugs and orphan drugs that have not been listed in China. In recent years, cancer drugs have become more "difficult to take", and patients have been looking for more than the price of cancer.
Including the current most aggressive pd-1 / pd-l1, BMS for melanoma, non-small cell lung cancer (NSCLC) and other indications of Opdivo, silent sand east of its products Keytruda; Roche's Tecentriq, the first FDA approved for the treatment of bladder cancer, has not been listed domestically.
Except for cancer, some of the major diseases, acute even auxiliary drug, shortage of chronic drug is out of stock situation, such as mutation JAK2 inhibitors (bone marrow fibrosis), ACTH adrenocorticotropic hormone (infantile spasm), and compound new Ming injection (adjuvant, the fever) after bone marrow transplantation, morey west oxazine hydrochloride (anti-arrhythmic), etc.
The shortage of the drugs also intuitive reflect on ali healthy looking for medicine platform, look from the operation during the retrieval results, users usually need to query medicines, prescription drugs, scarce drug, imported drugs in hospital, orphan drug, etc. "From the perspective of the demand of end user C, at present our data platform can meet the demand of 60% of the users, we can feedback to the user a effective channels of information, such as hospital or pharmacy, allowed him to buy medicine." But there are more than 40 percent of the demand for unlisted Chinese medicines, such as anti-tumor, rare disease drugs or generic drugs from abroad, said liang.
"This is our challenge now, with the users every day for a week on the platform of the message for medicine, because the children had some rare disease in the home, looking for drugs on the market in the United States and the European Union, but there is no help user to solve a legal compliance."
Government regulation plus civil participation
"There is a shortage of medicines and the government should take responsibility for the very least that these medicines should be guaranteed, equipped and organized." "The government must be in control," said gan rongfu, a senior consultant at sinopharm holdings limited, in an interview with the 21st century business herald. "it's a responsibility that cannot be evevable." For the production enterprise, also bear the corresponding social responsibility."
In recent years, the government has also been pushing the regulation of shortages.
On May 8, 2014, the national development and reform commission promulgated the catalogue of low-price medicines priced within the national development and reform commission. In January 2015, no. 7 of the state council, in June, the health and family planning commission of the state of the state of the state of China issued a notice of urgency to purchase the drug directly linked to drug use. On March 10, 2015, the first batch of production of the four basic drugs, such as acetylmao glycosides, was first set up; On April 29, 2016, the national health development planning commission issued the 2016 clinical drugs, dosage is small, the market supply shortage of necessary tender announcement "designated production enterprise, will include new maleic acid ergot alkali injection, injection actinomycin D, digoxin oral solution, protamine sulfate injection of 9 kinds of pharmaceutical production enterprises, through the bidding selection for government-run grassroots medical institutions and public hospital supplies fixed-point production of varieties.
But the contradiction between demand and supply still stands out, and the necessary drugs are often broken.
For this, Mr Dry says, "while the government is playing the leading role, profits are small and there is little appeal to companies and hospitals. Therefore, in the premise of ensuring raw materials, there is a certain policy inclination for the designated production enterprises. The NDRC guaranteed profit margins, the ministry of industry and information technology guaranteed production, and the health and family planning commission guaranteed clinical use, CFDA guarantees drug quality and multi-sectoral linkage.
From the experience of dealing with drug shortages abroad, the government has intervened in different ways in different ways. The main practice is to establish a shortage of information platform for medicines, update information regularly, advance warning and guide industry production and supply.
"There are designated enterprises in Europe and the United States, the pharmaceutical industry is relatively mature, and the government has a relatively good tilt policy towards drug companies, such as tax exemption, subsidy, fixed-point purchasing and payment capability." Zhao Bing says, "but because of the industry as a whole in China starts late, not policy implementation in place, price adjustment of relative lag, periodic shortages of drugs is more serious, need to establish a system of dynamic price adjustment and response mechanisms."
In addition to government, ali's healthy "drug seeking alliance" is also a supplementary supplement to information and channels.
Alliance are preparing Liang Sujuan introduction, current existing national medicine online, rare disease development (CORD), the broad medicine group, the fountain show large pharmacies, hall large pharmacy, drug companies, manufacturers such as public welfare institutions and ali healthy interaction, is willing to join "the global alliance for looking for medicine.
Due to the dispersion of drug distribution information, it is not possible to meet the needs of scarce medicines by relying on current partners.
According to liang, the alliance's target cooperation group mainly includes: one is drug distribution, wholesale and chain enterprises, "because we are most in need of drug circulation information"; Second, pharmaceutical companies, "they have more professional and authoritative pharmaceutical information"; "We hope to cover more patients and areas."
Platform operation of the logic is: users search for drugs, such as optimal, drugs will first come first corresponding approval, approved by the state and then click the drugs into drugs that page, and provides three kinds of current information, hospital pharmacy, entity pharmacy and online pharmacies, respectively.
"We are will B side such as its background, hospital data, such as the distribution and C end user demand docking, then according to the user's location, near and pharmacies or hospitals sort, do not do any business recommended."
In addition to the above is difficult to find some specific drugs, the platform operation problems include, how to with more high-quality, docking of database B end, Liang Sujuan admitted that "some flow there is competition between trade, will be nervous when talk about cooperation; Besides, ali health is a latecomer to the industry, and some partners are concerned about whether we will have other commercial purposes.
Currently, the challenge and risk of doing medical search is very high. According to ali's health, the potential conflicts of public interest orientation and the ongoing investment in resources, the coordination and coordination of social forces, and the government support are all difficulties in operation.
"The industry is inherently ethical or public. We want to work deep in the industry, and the rewards for doing pure public welfare projects are clear." Liang Sujuan said, "because there are some users problems because of information asymmetry in or lack of on sources, possibly can only as a supplementary means to solve a small part of the problem, but in the long run, to solve the demand for increasing corporate reputation and increase user's perception of ali health, are good in return." |
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