Medical network on April 28 - recently, an eye surgery commonly used medicines out of stock of the country's news public opinion attention, on the subject of frequent emergency cheap life-saving drugs once again pushed to the forefront of public opinion. Looks over the past, many times in recent years appear protamine clotting disorders (rescue), bromine overlooks the Ming (specific) myasthenia gravis, pingyangmycin (such as children's tumor common medicine) cheap life-saving medicine out of stock. The public opinion thinks, cheap and safe and effective drug to disappear in the market, to patients caused great confusion and economic pressures, become a potential factor of the doctor-patient relationship nervous. The industry calls for the improvement of laws and regulations, the construction of information platform for the shortage of medicines, and the production of fixed points, and gradually crack down on the shortage of cheap life-saving medicines. 

 

Ophthalmologic surgery is used to break goods 

 

"Eye surgery a few days ago, a commonly used the out of stock, thousands of doctors signature for medicine" message through xinmin network, the economic information daily, platform is released, such as, medicine headlines king aroused public concern. It is reported that domestic YanKeJie glaucoma surgery with drug "mitomycin" main producers were acquired in 2014, stop mitomycin production, medical institutions have been using inventory, the last batch of drug batch number is valid for November 2016. This means that tens of thousands of patients will be at risk of blindness. 

 

Third military medical university, southwest hospital affiliated ophthalmology glaucoma group leader Dai Chao introduction, glaucoma is the leading cause of irreversible blindness, surgery is an important means for the treatment of glaucoma. In the 1990s, mitomycin began to enter the clinic, and its success rate increased from 40 percent to more than 70 percent, making it a necessary drug for glaucoma surgery. In the refrigerator of dai chao's office, seven mitomycin is the only "treasure" of the entire hospital, or even the entire south-west. 

 

Xinmin network "urgent! Eye surgery" standard "medicine out of stock, the article pointed out that the eye otolaryngology hospital affiliated to fudan university every day for more than 10 Taiwan glaucoma surgery, more than 3800 years since. Ophthalmologists say the success of glaucoma has been significantly affected by the availability of mitomycin, and many patients are at risk of blindness. The economic information daily, a "glaucoma surgery medicine" mitomycin "emergency" reported that guangzhou has collected more than thousand glaucoma professional eye doctor's signature, but the problem still unresolved. Dai chao also revealed that doctors in the branch of the Chinese medical association's ophthalmology group have called for the restoration of the production of mitomycin by means of WeChat, signatures and other methods. 

 

Search "by the state food and drug administration's official website for injection mitomycin" found that a total of six approval number, approved by the state involves three enterprises, in addition to the sea is Pfizer pharmaceutical co., LTD., prescription and jiangsu hengrui pharmaceutical co., LTD. And Shanghai new Asia pharmaceutical co., LTD. This, one of the drug firms said it is already stop production, other drug firms respond, since being acquired in February 2014, an approval number, the product has not production, at the same time, said to resume production need longer cycle; On the website of another drug company, there was no information on the use of mitomycin. 

 

Netizens' "let go" say, glaucoma surgery to take medicine to break goods, patient can't wait. WeChat user "worldwide" says he is a glaucoma patients with postoperative recovery, he said drug disappeared drug substitution of the same effect, no breakouts think about are afraid of, hope to related department to solve as soon as possible. 

 

Cheap life-saving drugs are now a "drug shortage" 

 

Through establishing and perfecting the basic medical insurance system in our country, strategic measures, such as encourage the development of medicine industry in the protection of drugs and has made some achievements. But the shortage of medicines has not been solved at all, and mitomycin is only a microcosm of the state of the drug shortage in China. Treatment of myasthenia gravis "bromine overlooks the Ming", "pingyangmycin" to treat tumor in children, the heart surgery protamine, drugs for the treatment of heart failure rescue medication "west orchid injection" and so on many kinds of cheap drugs have a shortage situation. 

 

The personage inside course of study points out, some cheap life-saving drugs, due to the demand of small, high production cost, result in factory production is not active, this is the main cause of shortage. Have expert thinks, raw material market prices higher, the original medicare bidding and policy limit system, hospitals, doctors, medical middlemen, drug companies, and other links of their respective interests also form a cheap medicine crisis factors. 

 

Affiliated children's hospital of chongqing medical university, director of surgical oncology, wang shan said last year, the hospital was facing children's cancer drug pingyangmycin break goods phenomenon, she the tortuous from other provinces to find a few box of inventory. Now, 'she said in the treatment of tumor drug developed unceasingly, the price went up but the effect is not necessarily the same, pingyangmycin low price effect is good, but small applicable people, manufacturers will not be put into production without profit. 

 

Southwest of third military medical university affiliated hospital pharmacy department director pharmacist Xia Peiyuan expressed, there are some cheap medicine is replaced by efficacy better, but more of the disappearance of cheap medicines is the price is too low, pharmaceutical manufacturers have no profit space, circulation, so reluctant to production and distribution. Alternatives to generic cheap drugs are either expensive or not effective. 

 

In the course of sorting out the "drug shortage" of cheap drugs, it is not hard to see that the process of disappearing cheap drugs can be summed up as "curative, unpromising" and "disappearing". Manufacturers of cheap medicines are the ones that determine the lifeblood of cheap medicines. But if you keep the business at a loss, that's something that no company can afford. As the public opinion points out, the pursuit of high profit is a commercial nature, and it is impossible to rely on commercial ethics and self-consciousness for the production of low-price drugs. Experts point out that the price has been 12.2 yuan for more than 30 years, for example, with 60 pieces of the top Compton. However, for more than 30 years, the cost of raw materials has risen 78 times. Such Numbers, can only use the contrast of "hard to imagine" to describe, we can't to condemn producers in the moral level, because in this case, the more they produce, the more losses will be. 

 

Do more and break the "drug shortage" 

 

There are several reasons for the current embarrassment of cheap medicine. Experts believe that the need to save cheap drugs, especially life-saving ones, is to crack down on the "drug shortage" for different reasons. 

 

To formulate and improve relevant laws and regulations, and standardize the market behavior of relevant stakeholders. In order to effectively interfere with the shortage of medicines and safeguard the supply of medicines, the United States has issued the orphan drug act, the guidelines for drug shortage management. There have also been policies on the shortage of medicines in China, but there is a shortage of detailed indicators, a lack of strict supervision and accountability, and there is a problem of implementation. 

 

Regulate the drug shortage management process and gradually establish an intervention mechanism at the core of early warning. Experts point out that drug shortage management is generally divided into three stages of short information collection, shortage assessment and emergency mechanism. In fact, the lack of cheap medicine is not unique to our country, and the exploration of the problem has been ongoing in the developed countries of the west. Such as America's approach is, on some important cancer drugs to establish national reserve, the house of representatives and the senate puts forward legislative Suggestions, giving the U.S. food and drug administration (fda) corresponding power, pharmaceutical companies issued in advance warning of likely breakdown in the drug supply. 

 

Establish a medical shortage information platform and publish the shortage information in real time. The personage inside course of study points out, the developed countries make use of the information platform of drug shortages release drug shortage information in time, make the pharmaceutical manufacturers, physicians, patients and other stakeholders fully understand drug shortage situation, adjust their own behavior, cooperate with the government to respond effectively to the drug shortage. 

 

From the production side, through the establishment of production incentive mechanism, to encourage other manufacturers to expand production, assist vendors to resume production, implements the shortage of common species of fixed-point production, improving the pharmaceutical reserve system, increasing the temporary measures such as import, make up the market balance, reduce drug shortages. Analysis, for the manufacturers of cheap drugs, countries can undertake fixed-point quantitative production, unified purchase and sale, or to build up reserves of special drugs to enterprise's production and marketing have no trouble back at home. 

 

Under our current drug pricing and tendering system, once the drug at a low price bidding and pricing, after entering the medical insurance payment system, even rising costs cannot change the price according to the market situation, simply shut down this leads to the manufacturer. Analysis thinks, to make cheap drugs to resume production, country cope with its back to reasonable pricing, allowing companies to raise the price of cheap medicine appropriately, and offer certain tilt in the capital, taxation policy and fiscal subsidies, meet the needs of the people of cheap drugs.