A rare display of public anger is unfolding in China over the quality of domestically produced medicines.
A prominent Shanghai surgeon pointed to anesthetics that would keep patients awake. A respected Beijing cardiologist questioned blood pressure drugs that failed to regulate. A former editor of a major online health platform has accused domestic drug makers of fraud.
This week, concerns spilled over into public debate. This has led some doctors and hospital leaders to call on the government to change the way public hospitals buy drugs.
The burst of scrutiny was a rebuke to Beijing's campaign to cut health spending, in a country where authorities take a tight grip on public criticism of the government. Authorities are working to support China's national health care system. It is under financial pressure due to its rapidly aging population.
The policy, introduced in 2018, has fostered intense competition among pharmaceutical companies and succeeded in sharply lowering drug prices. But this year, foreign-branded drugs were largely absent from the government's list of medicines covered by China's National Health Insurance and provided in public hospitals.
This change effectively gave a boost to many foreign drug companies that did not want to compete with Chinese companies willing to sell drugs at rock-bottom prices.
Doctors are now sounding the alarm about the effectiveness of some home remedies. Doctors are pushing for changes that would allow patients to choose to pay more for alternatives.
“Manufacturers were complaining that they were cutting a corner when they lowered prices,” said Helen Chen, managing partner and healthcare expert at LEK Consulting in Shanghai. “Now there are some public voices saying that's happening.”
After years of failing to reduce costs, the government created a central bidding system that favored cheaper drugs, most often made by Chinese companies. In return, the government guaranteed to buy more from each supplier.
Public hospitals account for about 70% of China's drug market. Patients who use private clinics have easier access to a wider selection, including foreign brands.
The annual bidding system, known as volume-based procurement, has increased the prices of most drugs by more than half, saving Beijing in its first five years, according to the latest government data.
“The national procurement system keeps prices down,” said Zheng Minhua, director of the Department of Surgery and Shanghai's prestigious Ruijin Hospital, in a video interview with a local state media outlet.
However, he added, “At such low prices, the quality of the drug may not be reliable.” He cited several examples, including antibiotics that caused allergies, blood pressure medications that didn't lower blood pressure, and laxatives that failed to do their job.
Dr. Zheng was one of more than 20 doctors and Communist Party members who ensured that patients had access to original branded drugs even if they were not on the approved procurement list. Insurance reimbursements are adjusted depending on whether the drug is from the original brand drug or a generic.
Lu Changlin, head of cardiology at Beijing Chaoyang Hospital, submitted a similar proposal suggesting that doctors and patients should not be forced to use drugs on the procurement list.
The growing pushback from the medical community is so strong that China's National Medical Security Administration, which is responsible for national health insurance, has sent a dispatch to Shanghai to talk to doctors and examine the drug's clinical data. I did.
“There are no regulations prohibiting the purchase or use of imported and branded drugs,” it said in a statement this week.
After public outcry, some medical experts began looking into testing some generic drugs. In a social media post, Xia Zhimin, a doctor at Hangzhou Hospital of Traditional Chinese Medicine, compared data from trials of the original drug with that of the same drug in generic form and found too many similarities. , which raises questions about whether the data is there or not. Scammer, Dr. Xia said.
“The numbers are exactly the same even in the two decimal places,” wrote Dr. Xia, former associate editor of Ding Xiang Doctor, a popular online forum for medical professionals.
“It's the Chinese generic drugs that are of poor quality,” he said.
In a statement on Friday, China's National Medical Products Administration unit acknowledged the duplicate data, saying it was the result of an “editing error when the relevant product information was disclosed.”
The issue hit a raw nerve at a time when many people are feeling anxious from China's real estate downturn and sputtering consumer economy.
“If this isn't the bottom line, I don't know what is,” journalist and popular podcast host Meng Chang wrote in a social media post that has since been deleted. .
“The vast majority of good doctors are in the public system,” Meng wrote. “But now, when you want to import drugs or surgical equipment, you have to go to the private sector.”
Most Chinese families see a doctor at the hospital when they are sick. National health insurance, which varies by state, typically covers, on average, nearly three-quarters of the cost of prescribed drugs.
On social media, some patients and doctors say the rise of generic brands in hospitals is making it difficult to even find original foreign brand drugs like Bayer's Avelox antibiotic medicine.
Li Xiang, a doctor in northeastern China, shared a story about how one of his family members needed imported medicines that were no longer available in public hospitals. However, when she tried to contact the manufacturer's representative, she was told that the drug was out of stock.
Dr Li criticized the government's procurement system, saying it resulted in an oversupply of drugs that people did not want to use and left them with too few options.
“You say you have run out of medical insurance and cannot use it to purchase imported drugs,” Dr. Lee wrote. She added that she would be willing to do anything and even sell the house.
“There is no risk of switching to other alternatives for fear that the medication will not work and the condition will return,” she wrote. “This includes family life.”
