The recent results of the tenth batch of centralized drug procurement by the Chinese authorities have been officially announced, sparking concerns among the public about the efficacy of domestically produced drugs as imported drugs are gradually being phased out of public hospitals in China.
The results of the tenth batch of centralized drug procurement by the Chinese authorities were officially announced on December 30th last year. This procurement, dubbed the “largest in history” within the industry, had the smallest initial purchase amount in the first year, totaling only 85.13 billion yuan, compared to the highest amount of 55 billion yuan in the fifth batch. It involved the highest number of products in history, with 778 products from 493 companies participating in the bidding process. Unfortunately, 393 products failed to secure bids, with a bid failure rate exceeding 50%, the highest on record. The price reductions were the largest in history, with drug prices hitting an all-time low, averaging over 70% reduction, with many products experiencing reductions of over 90%. For example, the winning bid price for enteric-coated aspirin dropped to three cents per tablet, and the bid price for sulfur hexafluoride injection by Sichang Pharmaceuticals was 0.89 yuan per bottle, compared to the pre-procurement price of 165 yuan per bottle at local pharmacies, representing a reduction of over 96%.
The most surprising revelation was that none of the original innovative drugs were selected in this round of centralized procurement.
In China, imported drugs refer to foreign patented drugs and original innovative drugs. Original innovative drugs are manufactured by the first developer. The general public is more aware of and has relatively stronger trust in original innovative drugs, which are relatively higher priced. Corresponding to original innovative drugs are generic drugs produced by pharmaceutical companies in other countries, which are favored for their relatively lower prices.
On January 14th, “Economic Observer” stated on Weibo that this procurement process indicates the gradual exit of original innovative drugs from Chinese public hospitals.
Similarly, on January 14th, “Nanfeng Window,” under the Guangzhou Daily Newspaper Group, mentioned that the government’s centralized procurement has led to a surge of generic drugs infiltrating hospital pharmacies; while on the other hand, many original innovative drugs, due to their high prices making it difficult to compete in the market, have had to gradually withdraw from hospital pharmacies, leading to a trend of foreign pharmaceutical companies largely withdrawing from the Chinese public hospital market.
In addition to market factors, the Chinese authorities have also set price limits for imported drugs. If the price of imported drugs exceeds the allowable range set by policies, they will be forcibly excluded from the market.
In early January, a parent posted that after their child received the first shot of the Merck Hepatitis A live attenuated vaccine, Verorix, the second shot was delayed due to supply shortages. Parents in multiple places are facing the dilemma of not having the same type of vaccine available.
China Big Wei and “Da Fei Financial,” a high-quality financial content creator, disclosed that imported drugs that were once seen as efficient and reliable are gradually disappearing from the market in a kind of “magic disappearance.” Pfizer’s azithromycin, once considered a “miracle drug” for pneumonia, is now hard to find at major hospital pharmacy counters. Similarly, longstanding imported drugs such as Viagra, Runitide, and Betonping have also successively exited the Chinese market.
These developments have sparked concern online, with netizens questioning, “Where have all the imported drugs gone?” and “Can domestically produced drugs really match the efficacy of original innovative drugs?”
According to a survey by the Chinese Pharmaceutical Society, 49% of respondents believe that original innovative drugs are more effective, 47% believe that generic drugs are about the same as original innovative drugs, and only 4% think generic drugs are better.
A doctor at a top-tier hospital in Guangzhou told Yen Caijing that while many generic drugs have some similarity in efficacy, achieving the same effects as original innovative drugs is not easy. For example, there may be differences in excipient selection, and absorption rates and extents of the drugs may also vary. He said, “It is advisable to closely monitor your indicators. If the generic drug can control your indicators well, then it can be used, especially considering its cheaper price. However, if you feel the effects are not good after taking the generic drug or experience some complications, then you should quickly switch to another drug, whether an original innovative drug or another suitable drug that can be purchased outside of the hospital.”
Nanfeng Window revealed that a child of a parent suffering from pneumonia has been unable to find imported azithromycin injection, which was previously prescribed by the hospital, as only domestic azithromycin is available. After using domestic azithromycin for two days, the child still had a high fever that did not subside until switching back to the original innovative drug.
Some netizens expressed online that domestically produced generic drugs, when produced without cutting corners, could be acceptable. Whereas, the imported drugs are more effective with just one pill compared to several pills of domestically produced generics to achieve the same effect, making them prefer imported drugs.
Others shared their experiences, with one stating that a physician at Xinhua Hospital recommended them to buy imported drugs.
Another netizen suggested, “I hope to give the people the right to choose, allowing a higher proportion of self-payment for imported drugs.”
Da Fei Financial believes that for domestic drug companies to truly win the trust of patients, they need to invest more in innovative research and development, gradually closing the gap with foreign pharmaceutical companies.