Shortage of cheap lifesaving drugs due to market difficulties

After the abolition of pharmaceutical government pricing, although the predicament faced by most of the cheap drugs can be resolved, the market alone cannot solve the production problems of all cheap drugs. There are always short markets in the market and there are always places where they cannot be adjusted. The cheap medicines with very low doses belong to this category.

The high quality and low price should have been welcomed by the market and consumers. However, at the crucial moment, some cheap and good medicines that can save lives have become “lone medicines” in reality. One case has less than 8 yuan worth of injections of corticosteroids for injection. Difficult to find, the black market is sold for several thousand dollars. Ms. Zhou of Hangzhou sent the information for the drug to the WeChat circle of friends and caused widespread concern. Why are low-cost lifesaving medicines "a drug difficult to get"? A survey by the reporter found that missing life-saving medicines often have some common characteristics, such as limited production facilities, low output, limited demand, and low prices.

Although this short-acting injection of corticosterone (ACTH) has a specific effect on infantile spasms, the incidence of this disease is very low, resulting in very little use of this medicine, coupled with low drug prices. It is cheap and scarce medicine. This point is different from the “drug scarcity” phenomenon that used to occur in the past. The medicines that were previously lacking included these types of medicines. However, they are more commonly used as family-owned cheap medicines and cheap medicines commonly used in hospitals.

After the government cancelled the pricing of the vast majority of medicines on June 1 this year, several medicines that had appeared "drug shortage" had the characteristics of cheap and scarce drugs. For example, on August 4th, a father in Guangdong issued a “pharmacy” on the Internet, claiming that it is urgently needed to actonomycin D. This drug has special effects on rare diseases Wilms tumor, and the price is also low to less than each. 20 yuan, and ACTH has a common characteristic. In addition, anti-venom serum and many special drugs for rare diseases all have the same characteristics and are in the same predicament. In the past, the shortage of commonly-used generic drugs has rarely occurred after the elimination of drug pricing.

Why does the market show this new trend? This is because opening up government pricing can solve the shortage of cheap and commonly used drugs. Because of the large market demand for cheap generic drugs, the amount of useful drugs as a support, once the price has risen, it will stimulate the production of pharmaceutical companies enthusiasm. After the pricing of drugs was liberalized, there was a wave of rising prices of cheap drugs. Although the price increase rate of individual drugs once caused concern in the community, overall, this price increase was a reasonable adjustment in the market and was a cheap and commonly used drug. The return of prices, but this time the price increase, so that cheap common drugs re-common in the market, no longer as in the past, "a drug difficult to find."

But letting go of government pricing is still difficult to solve the trap of cheap and scarce drugs. Because the amount of medication is too small, even if the unit price is raised high, the pharmaceutical company may not be willing to produce, because it is not worthwhile to open a production line just to satisfy a small number of specific groups. More importantly, the circulation and storage costs of this type of scarce drugs are also relatively large, and the waste phenomenon is also very prominent. For example, if pharmaceutical companies distribute such drugs to a certain place, or hospitals enter such drugs, they may not be able for several years. None of the patients appeared, leading to a waste of medicines. As a result, even if the price of drugs rises sharply, there will be a phenomenon of “having no market”. This shows that after the government's pricing of pharmaceutical products was abolished, although most of the difficulties faced by cheap drugs could be resolved, the market alone could not solve the production problems of all cheap drugs. There are always short markets in the market and there are always places where they cannot be adjusted. The cheap medicines with very low doses belong to this category.

It can be seen that the serious shortage of cheap life-saving medicines is mainly due to the market's difficulties and the market cannot rely on its own power to solve the problems. It can only seek solutions to the problems outside the market. As a matter of urgency, it is necessary to explore the establishment and improvement of the designated production system for scarce drugs, and to achieve planned production through government subsidies and centralized procurement. In February this year, the four ministries and commissions including the Ministry of Industry and Information Technology and the National Health and Family Planning Commission issued notices on the trials of the fixed-point production of essential drugs, indicating that the market dynamics after the release of drug prices had already been foreseen, except that this pilot was only aimed at For the four kinds of scarcity drugs, not only are there too few species, but also lack a dynamic scarcity drug production list. Only the accelerated trials for the production of scarce drug fixed-points, the identification of the rules for the increase and decrease of scarcity drugs, and all scarce drugs that cannot be solved through the market When it is covered, the scarcity of cheap and scarce can be resolved sooner.

In addition, a scarce drug trading platform should also be established to dynamically observe the evolution of scarce drugs through the platform, collect different shortages of demand, and make fixed-point production more targeted. At the same time, a nationwide unified storage and distribution system should be explored so as to reduce the waste caused by separate purchases of drugs by medical institutions, and to disseminate scarce drug information to the whole country. This can prevent black market drugs from taking advantage of poor information to place prices, or Reduce the trouble of patients and their family members blindly looking for medicines in the world.