Can self quoted prices of "life-saving drugs" be solved?

Qingyuan people's hospital is a large public third class hospital in northern Guangdong, serving millions of local patientsThe above list of short drugs is the varieties reported by the hospital through the national medical and health institutions' short drug information direct reporting systemAccording to 1 ℃, there are 13 kinds of drugs in short supply< br / > since this year, the shortage of some drugs is still prominentIn Shanghai, Shandong, Hunan, Guizhou and other places, the prices of allopurinol, cytosine arabinoside, methotrexate, nitroglycerin and other drugs have been increased, or the supply is insufficient< br / > according to the survey of 1 ℃ reporter, there are still drug shortages and cut-off in some places, which are caused by multiple factors such as drug factory shutdown and API shortage< br / > a few days ago, the State Medical Security Bureau issued a document to allow operators to quote independently and directly access to the Internet for the varieties listed in the list of short drugs in the national and provincial short drug supply and security work consultation linkage mechanism officeMedical institutions can purchase according to the online price or negotiate further with the operatorsThe move is seen as an important opportunity to solve the problem of drug shortage, but it will take time to test the reality< br / > there is a shortage of "life-saving drugs" in many places < br / > antivenom is the only effective treatment drug after snake bite, which is a clinical emergency medicineQingyuan City is located in the mountainous area, and patients who are often bitten by poisonous snakes are sent to Qingyuan people's Hospital for treatment, "although the number is not large, it is very urgent to use this medicine once." < br / > the above series of antivenom drugs are exclusively produced by Shanghai salen Biotechnology Co., Ltd(hereinafter referred to as "Shanghai salen")< br / > according to the prospectus released by Shanghai salen in May this year, due to the lack of national data statistics, relevant reports pointed out that about 300000 people were bitten by poisonous snakes every year in ChinaAccording to the sales volume of Shanghai Sailun antivenom products in 2018 of 82100 pieces, it is estimated that each patient needs to use about 2 pieces, and only less than 50000 patients bitten by vipers are treated with Antivenom every yearIn other words, the remaining 150000 patients who were bitten by vipers failed to use antivenom in timeaccording to the prospectus, Shanghai Salem is not fully loaded with production capacity utilization rate of more than 80%In 2016, 2017 and 2018, the capacity utilization rate was 82.64%, 89.72% and 80.85% respectively < br / > behind the shortage of "life-saving drugs", the price is very expensive, "anti snake venom serum has been sold to 2500 yuan / piece." According to the list of short drugs sent by Qingyuan people's hospital to 1 ℃ reporter, from January 2017 to now, the anti Bungarus venom serum injection (specification, 10000IU / bottle) in the hospital has increased from the initial 503.53 yuan to the current 1400 yuan; the anti cobra venom serum injection (specification, 10000IU / bottle) has increased from the initial 1322.7 yuan to the current 2500 yuan < br / > in the report period of planning A-share listing, in order to "thicken" the company's performance, Shanghai salen significantly increased the price of antivenom related products < br / > Through the price adjustment of products, the company's performance has been greatly boosted indeed According to its prospectus, "the increase of sales price of antivenom serum products is the main factor of the company's performance growth in the reporting period < br / > bromepyramine tablets in Qingyuan people's hospital were also in short supply before, but the supply has been restored The drug is mainly used in the treatment of myasthenia gravis, which can alleviate the symptoms of patients For the vast majority of people, bromepyramine tablets are very strange However, for myasthenia gravis patients, bromepyramine tablets are regarded as "life-saving drugs" < br / > according to the introduction of Beijing Aili myasthenia gravis rare disease care center, medical experts concluded that there are about 650000 patients in China, and myasthenia gravis crisis due to respiratory myasthenia is still the main cause of death < br / > according to the medical records of myasthenia gravis patients, bromepyridine tablets need to be taken orally, with the dosage "three times a day" "Just like eating every day, we can't do without one meal." Ms Qing Zhao, a Beijing based patient, told the 1 ℃ reporter that if the drug was stopped, it would affect normal swallowing, drinking water, breathing and all other daily actions < br / > Qingzhao has Beijing medical insurance If it needs to be reimbursed, it has to go to the hospital It needs to line up to register and pick up the medicine The process is extremely inconvenient The doctor only opens two bottles at a time, and the large quantity can only take 10-20 days " < br / > according to the incomplete analysis of 1 ℃, bromepyramine tablets have been included in the list of drugs in shortage in 2019 by many provinces For example, in September 2019, Guizhou Province issued a list of medicines in short supply (the second batch), with bromopyrimidine listed < br / > in addition to bromopyrimidine, betalone, a drug that can reduce the frequency of multiple sclerosis, has been called for by patients from all over the world and is in short supply, which is very inconvenient to buy According to a 1 ℃ reporter survey, the main reason is that there are fewer medical institutions available for drugs Take Beijing as an example According to the Beijing Sunshine procurement platform, only three hospitals are available, all of which are public top three hospitals < br / > there is more to the shortage According to a list of drugs in short supply released by Qingyuan people's Hospital, the manufacturer reported that it had stopped production to alleviate the swelling caused by surgery and trauma Pingyangmycin hydrochloride (powder injection, 8mg / dose) for injection, a commonly used drug for the treatment of lip cancer, tongue cancer and other cancers, has also been listed as the off supply variety by Qingyuan people's Hospital mentioned above, with the shortage starting in June 2015 < br / > in addition, a number of drugs including nitroglycerin tablets (0.5mg / tablet) were listed as "short drugs" in each province As a life-saving drug for patients with coronary heart disease and angina pectoris, nitroglycerin tablets have been in short supply in many areas of the country before Qingyuan people's Hospital also listed nitroglycerin tablets as a medicine in short supply The supply of nitroglycerin tablets has been cut off since October 2018 and has been restored However, the supply is still tight 1 ℃ reporter visited many chain drugstores in South China and found that the drug was out of stock in some drugstores, while some drugstores were in short supply < br / > there are various reasons for insufficient supply < br / > What are the reasons for the shortage of some drugs? < br / > Ms Mao Mao, 25, from Beijing, has suffered from multiple sclerosis for many years She told 1 ℃ reporters that after beitailong went on the market, most hospitals still refused to purchase because of the small number of patients, the high cost of drug storage and transportation, the proportion of drugs and the upper limit of the total number of drugs in the hospital sales suck is not enough enthusiasm, but the main reason is the "no power" of the production end < br / > according to 1 ℃ reporter's investigation, behind the lack of clinical supply, some enterprises shut down for a long time is one of the reasons Some enterprises do not produce such drugs at all Dopamine hydrochloride injection, which is suitable for myocardial infarction, trauma and endotoxemia, has been listed in the list of drugs in short supply in Suzhou At present, there are many domestic enterprises with the approval documents of the drug, one of which is in South China Relevant people of the company told 1 ℃ that the product company has been approved for many years, but it has not been put into production because the raw materials cannot be purchased < br / > the above-mentioned manufacturer of Pingyangmycin is Harbin laibotong Pharmaceutical Co., Ltd (hereinafter referred to as "laibotong") The shortage is due to "insufficient production capacity due to the transformation of enterprise production line" Laibotong sales people told 1 ℃ reporters that the main reason is that the production line of Pingyangmycin has been transformed due to environmental protection, and it is expected to resume production and supply at the beginning of 2020 < br / > according to the survey of 1 ℃ reporter, at present, there is only one domestic manufacturer of bromopyrazine tablets - Shanghai Zhongxi 3D Pharmaceutical Co., Ltd (hereinafter referred to as "Shanghai Zhongxi 3D"), which is a wholly-owned subsidiary of Shanghai Pharmaceutical (601607 SH) < br / > in fact, according to the official website of the State Food and drug administration, 3 enterprises in total have obtained the approval documents for the production of bromepyramine tablets, i.e Shanghai Zhongxi 3D, Shanghai Shangyao Xinyi Pharmaceutical Co., Ltd and Hainan Kaijian Pharmaceutical Co., Ltd (hereinafter referred to as "Hainan Kaijian") However, neither of the latter has been produced < br / > according to the Sales Department of Hainan Kaijian, "it has been many years since we obtained the approval of bromepyramine tablets, but we have not been able to produce them because we have no APIs Before that, the company had installed production lines, but environmental protection (procedures) has not been able to pass " < br / > the above-mentioned sales person of Hainan Kaijian said, "we also want to produce, but the three-dimensional bromine pyrimethamine API of Shanghai sinowest is not for sale." This statement was confirmed by the sales person in charge of bromepyramine API of Shanghai Pharmaceutical < br / > Shanghai Pharmaceutical previously announced that In 2017, Sinochem Shanghai expanded the capacity of BPM to 8000kg / year, and established the dominant position of BPM tablets through the strong production and distribution capacity of Shanghai Pharmaceutical "The BPM is mainly used to supply the tablets of BPM produced by the company's internal enterprises." Shanghai Pharmaceutical announced < br / > 1 ℃, the reporter found that for a long time, bromepyramine tablets were only produced by one enterprise in Shanghai, China and the west, and there were deep-seated reasons behind it < br / > according to the data of several years ago, there are about 650000 myasthenia gravis patients in China Although the number of patients continues to increase in recent years, it is rare disease after all, and the number of patients is relatively small, which also means that the market capacity of the corresponding drug bromopyrimethamine tablets is small < br / > Shangyao, a person in charge of the sales of APIs, was outspoken < br / > according to iqvia-chpa data, the purchase amount of bromepyramine tablets sold exclusively by sinowest 3D in Shanghai is 27.76 million yuan < br / > It's estimated that the cost of so much investment can't be earned back in a few years It needs to be evaluated carefully " Said the person in charge of API sales < br / > the number of patients is small, the volume of drug market is small, the API is controlled by an exclusive enterprise, and it is not sold externally or at a high price, but it is also necessary for clinical medical treatment The production and sale of bromepyridine tablets reflect the embarrassment of many drugs in clinical shortage < br / > the above-mentioned enterprises in South China with dopamine hydrochloride injection recently want to produce the drug for clinical use However, the head of procurement of the enterprise found that the raw material of dopamine hydrochloride injection, dopamine hydrochloride, is currently only produced by one enterprise, but the price is more expensive < br / > according to the official website of the State Food and drug administration, there are two enterprises producing dopamine hydrochloride API, namely Changzhou Yabang Pharmaceutical Co., Ltd (hereinafter referred to as "Yabang pharmaceutical") and Tianjin Zhongrui Pharmaceutical Co., Ltd (hereinafter referred to as "Tianjin Zhongrui") < br / > according to the sales personnel of Yabang pharmaceutical, the company has stopped production of dopamine hydrochloride API for more than half a year due to environmental protection reasons, and the company has existing stock of raw materials, which are only used for internal production, not for external sales < br / > on December 16, the quotation letter sent by Tianjin Zhongrui API salesperson to 1 ℃ reporter showed that "the quotation for packing 10kg / barrel of dopamine hydrochloride is 16000 yuan / kg, and the validity of this quotation is this month." < br / > The head of procurement of the South China enterprise that produces dopamine hydrochloride injection said to the reporter at 1 ℃ < br / > can independent quotation solve the problem? < br / > to ensure the supply and price of medicines in short supply is not only a matter of people's livelihood, but also a matter of market It is not only a matter of patients' concern, but also a matter of drug production