A large number of varieties are out of supply! The hospital fixed the total amount of money at one time, but the drug companies were worried about it

One south and one north, the story of drug "disconnection" is staged in a fancy wayAfter "4 + 7" centralized mining, medical institutions have become more generousThey have to pay the full amount once a year at a timeIn the past, pharmaceutical enterprises should be happy to bloom, but now they are facing the situation of being unable to provide and being scolded if they limit their supplyOn the other hand, with the support of the government, the medical institutions are very "economic"The price is the lowest in the country, almost close to the 50% discount of the whole countryThe raw materials have gone up, and the pharmaceutical companies are unable to provide themThey have received the investigation notice< br / > the fact that half of the varieties are purchased by the state, the drugstores can't get them, and the medical institutions rush to directly order enough for the whole year at a time has led to the pressure on the enterprise's production capacity and the pressure of public opinion on supply restrictionThe truth of "supply interruption" of some varieties of the state-owned procurement in Yunnan province gradually surfacedHowever, in Liaoning, on the other side of China, there is another "cut-off": the price of APIs has risen sharply, and the supply of "life-saving drugs" for heart surgery is insufficient< br / > recently, the health insurance bureau of Yunnan Province issued a list of abnormal supply varieties for the state's centralized drug purchase enterprises in Yunnan ProvinceThe appendix shows that there are eight varieties in short supply, including entecavir, atorvastatin calcium, amlodipine besylate, The supply enterprises involved include Suzhou Dongrui, Xing'an pharmaceutical, Changzhou No.4 pharmaceutical, Yangzijiang Pharmaceutical Group Jiangsu pharmaceutical, Sinopharm Rongsheng pharmaceutical, Hanhui pharmaceutical, Guangzhou Baiyunshan Tianxin pharmaceutical and Hunan Warner pharmaceutical< br / > it is worth noting that the 8 varieties in this time are all collected and expanded varieties, and the total number of expanded varieties is only 25, close to one third of the proportionThe reasons behind this are worth exploring< br / >People familiar with the company told e drug managers that it was mainly affected by three factors: < br / > first, it was affected by the epidemic, including the delay in the resumption of production of many companies including Hunan Warner Pharmaceutical Co., Ltd., Xing'an Pharmaceutical Co., Ltd., Dongrui Pharmaceutical Co., Ltd < br / > Second, volume reporting Many pharmaceutical companies reserve certain supply space when they accept the offer, but the current situation is to purchase the whole year's volume half a year in advance It has no impact on medical institutions, but it has a huge impact on production enterprises, such as irbesartan provided by Hanhui pharmaceutical < br / > for example, a pharmaceutical company can purchase 5 million tablets with volume, and the company can arrange 6 million tablets at most, but now it needs 6 million tablets in half a year These production capacity can not be solved by working overtime, but by increasing production lines, which need a series of complex procedures, so it is not realistic to fill these gaps in the short term " Said the business people < br / > Third, after "4 + 7", many products actually flow back to the hospital from the retail channel, because the hospital has become the price "depression" of these products "As far as I know, more than half of the products, that is, the first batch and the second batch of products purchased with volume, can not be delivered to the drugstore." After refluxing, there are some abnormal fluctuations in the consumption of medical institutions, which may be considered normal by the medical institutions, but for the supply enterprises, such a sudden and substantial increase in demand cannot be tolerated in a short time < br / > < br / > "In fact, there are still a large number of hospitals that do not purchase products These hospitals have undertaken some indicators of purchasing volume, and some hospitals that did not report excessive products in the past have been robbed as soon as they arrived." For example, the original box costs 20 yuan, and medical institutions need 400000 yuan to purchase 20000 boxes It is unrealistic to pay in full at one time But now, the price of a box is reduced to 2 yuan, 40000 yuan is purchased at a time, and some medical institutions directly order the whole year at a time < br / > now many provinces purchase based on this principle: as long as you have reported excessive or online purchases, they all use the centralized purchase price and how much to offer "Of course, a lot of industrial enterprises are also limited They are also scolded by medical institutions and ordinary people However, some enterprises have not made a great impact because of various factors such as strong market control ability." < br / > Liaoning, more than 3000 kilometers away from Yunnan Province, also announced a similar news a week later < br / > on June 11, Liaoning Medical Insurance Bureau issued a summary of drugs not supplied according to the agreed price and regulations reported by medical institutions from January to may 2020, involving 15 injection varieties such as articaine adrenaline injection, aminobenzoic acid injection, protamine sulfate injection and 5 other dosage forms It involves many famous pharmaceutical enterprises, such as the subordinate company of Yangtze River Pharmaceutical Group, Shanghai Xinyi, Jilin Aodong, Shuanglu pharmaceutical, Lisheng pharmaceutical, yuekang pharmaceutical, etc < br / > < br / > in order to find out the reason for the cut-off, drug Manager e contacted yuekang Pharmaceutical Co., Ltd., one of the parties at the first time The company provides protamine sulfate injection It is reported that protamine sulfate is an anti heparin biological agent isolated from the spermary of deep-sea fish It has the effect of relieving anticoagulation and preventing massive bleeding It is a common drug in surgical operations, especially in cardiac surgery At present, there is no alternative drug < br / > interestingly, protamine, known as "life-saving medicine", has a "cut off supply" every five years In 2011 and 2016, there was a nationwide shortage, and this time Liaoning Province announced a shortage of protamine Yuekang pharmaceutical, as the only supplier, said to the manager of E medicine that the company's supply of protamine was limited by the shortage of imported APIs Affected by the overseas epidemic, either it could not be bought or the price was increased by a large margin, resulting in the previous negotiation price could not be implemented at all According to yuekang, the price comes from the negotiation with the drug administration department four years ago The price is 45 yuan a box (5ml: 50mg * 5 pieces), while the price in many other provinces is around 70 yuan, including the southern provinces < br / > four years ago, Liaoning health and Family Planning Commission issued an early warning notice on drug shortage, which included 10 kinds of drugs, such as protamine sulfate, etc., and the enterprise fed back the situation that they could not be supplied normally Seven manufacturers, including Kaifeng Pharmaceutical (Group) Co., Ltd and Shanghai first biochemical pharmaceutical Co., Ltd., were warned that they could not supply in time and in full according to the bidding price < br / > it is reported that at present, only yuekang and Shanghai No.1 biochemical industry can produce protamine in China The production capacity of yuekang is mainly supplied to the north and the No.1 biochemical industry is mainly supplied to the south < br / > this is not a new problem In fact, this year, in addition to antiviral APIs and imported APIs, the supply of other APIs is relatively stable, including prices, according to a person from Hunan based API company < br / > it is worth noting that Jiangsu subsidiary of Yangtze River Pharmaceutical Group Co., Ltd appears in the list of "cut off supplies" from one south to one north, and the reasons can be analyzed in combination Tianjin Lisheng Pharmaceutical Co., Ltd also has two tablets included in the abnormal list, namely chlorphenamine maleate tablets and hydrochlorothiazide tablets As for the reasons, the enterprise has not replied as of the publication However, due to the location, Tianjin's resumption of production is also relatively late in the country < br / > in addition, the articaine adrenaline injection produced by the French products dentaires Pierre Rolland won the bid in the medical institution in Shenzhen on April 10, although there was a supply problem in Liaoning from January to May Obviously, the reason may not be the supply problem, but more is the price problem < br / > according to the analysis of pharmaceutical companies, the approximate rate of such local short supply may be the price, not the capacity.