Public anger in China because of the concerns set by doctors that generic drugs used in public hospitals have increasingly brought to a rare government response.
Doctors say they believe that a system of procurement of drugs in the country, which promotes the use of cheap generic drugs over the original brand pharmaceuticals, has led to reducing the costs of people’s safety.
But officials, who quoted more state media on Sunday, say that this issue is perception, not reality.
One report says that different people simply had different reactions to medicines and that the claims that they were ineffective “mostly originate from the anecdotes of people and subjective feelings.”
The official response has done a little to relieve the public fear due to the reputation of drugs in public hospitals and pharmacies. This is the latest challenge for the health system that is already under huge stress due to rapid aging of the population.
How did it all start?
The debate on the use of generic drugs began in December, when the authorities published a list of nearly 200 companies that won contracts for sale of medicines to China’s state hospitals. Almost everyone was domestic producers of generic drugs.
This amplified in January, when, in a video interview that became a viral, director of the Shanghai Hospital Department, he distributed concern about drug procurement system.
Zheng Minhua quoted “antibiotics that cause allergies, blood pressure that will not be reduced, anesthetized patients who will not sleep” and laxatives who did not clean the gut as among the issues that came.
The words of Dr. Zheng immediately hit the chord and condensed in the slogan of social media, which have watched millions in the last month – although much of the discussion on the topic has since been censored on Weibou. Many have reported to share their own bad experiences with allegedly greased drugs.
“I was undergoing intestinal operations in 2024, which required that before consuming laxatives,” wrote one Weib user. They said that the drug gave them a “no effect”, even after the dose had doubled and had to turn to a coffee drink to help them remove the gut.
The concern that was set up due to the effectiveness of generic drugs caused distrust and made some people not want to use them.
The person on the Xiaohongshu, a Chinese Instagram -like application, said that when their hospital doctors prescribed a generic version of antibiotics, they immediately went on the net to buy “original” “real” because the generic version “tasted different”.
“Recently, a lot of people have caught colds. Many of them may have bought this medicine. Send the reminders quickly to your friends now and make them check the brand before buying,” the user warned.
Some of the most popular posts that discussed the controversy of procurement were demolished, although it is unclear from whom. Chinese strictly controlled internet has a strong culture of censorship and authorities themselves and users themselves.
In a terrifying, now abolished publication of the popular host of Podcast Meng Chang, he broke through the lack of imported drugs in the public sector: “If this is not the bottom, I don’t know what is.”
Public anger is also focused on difficulty in approaching imported drugs that people believe are better quality.
In response to the attempt to assure people of the quality of generic drugs, one Weib user wrote: “As long as we are allowed to buy medicines for brands, I have no other complaints.”
How does a drug procurement system work?
It was introduced in 2018 as a way to lower state expenses on medicines and includes local self -governments that set tender processes for about 70% annual requests for state hospitals drugs.
Different drug manufacturers then compete to offer the lowest drug prices to win these lucrative contracts.
This gives priority to generic drugs produced in the country, containing the same active pharmaceutical ingredients as the original patented drugs, but are often several times cheaper because they do not include high costs of research and development.
China has emerged as one of the world’s largest players on the global generic pharmaceutical market, exporting both finished products in consumers abroad and key ingredients with foreign companies. At home, thousands of generic drug manufacturers compete to sell their products at competitive prices on the growing domestic market.
In order for generic drugs to be acceptable to the Chinese procurement process, they must test them and determine that they are sufficiently similar to the drug version.
In the first five years, Beijing attributed a drug supply system to save millions of inhabitants of more than $ 50 billion (£ 40 billion).
However, the procurement process saw some medication manufacturers offer medicines at incredibly low prices. One of the winning offers in December was the Apiline tablet that is sold for less than one Cent.
“Are drugs that cost less than one centers of edible?” She became a trend of the topic at Weibou at the time.
“Processors who win offers often set prices so low that they can fight for high quality drugs with the correct ingredients, which potentially leads to ineffective drugs,” said BBC Stacy Zhang, Associate Professor at NYU Langone Health.
She added that although the procurement system “was not designed to limit access to imported medicines with brand”, he may still “influence their accessibility”.
Questions about data and efficiency
The proposal provided by 20 doctors, including Dr. Zheng, to the Shanghai authorities, stated last month that “there are broad concerns in the industry that the procurement prices are preniska, which cannot be encouraged by non -ethnic companies to reduce the corners to reduce cost drug efficiency. ”
“Doctors are helpless because they have no choice and there are no channels for escalation of feedback.”
A recent article Xia Zhimin, a doctor in Hangzhou, added control. In it, he emphasized what he said was that questionable data from the generic drug experiments on the procurement list were identical to the information from the original drug on which it was based. Dr. Xia suggested that this could be proof of fraud.
The National Medical Products Administration replied, saying that his discovery was due to “editorial mistake”. His article has since been removed.
Adding quality concerns is forged drugs that have been decaying on the market for generic and brand names around the world and it is not difficult to discover them. The World Health Organization described this global health problem.
“In order to improve accessibility, it is necessary to introduce economic generics,” said BBC Kevin LU, an associate professor at the University of South Carolina.
He added that the procurement procedure needed “strengthened quality control” and “continuous improvement of drug approval and production standards”.
Sector in crisis
Controversy comes at a time when the Chinese health system is already under assembly pressure.
The rapid aging of the population meant that the total health expenditures in the country had increased almost 20 times in the last 20 years, reaching 9 trillion yuan ($ 1,25 trillion; £ 1 trillion) in 2023.
Throughout the country, public medical insurance agents go out in thin. Deficits have already appeared in some provinces, where local self -governments that have largely relied on the sale of land for revenue are now struggling with debt as a real estate crisis swallowing the Chinese economy.
At the same time, the healthcare system has experienced a crisis of trust. Violent attacks on medical staff rose from the 2000s, encouraged anger due to lack of resources and erosion of faith in doctors.
Unlike the questions that were considered politically sensitive and strongly censored, such as the persecution of political dissidents or the suppression of Uyghurs in Xinjiang, constant controversy over drug procurement, the state at least acknowledged as a problem to be resolved.
The National Health Care Administration stated in a statement on January 19 that the authorities “attach great importance to” these issues of security and will seek feedback on drug procurement policy.
“It is indisputable that national centralized procurement is still in its infancy. There are many pharmaceutical companies with different qualities of production,” the Times State media life quoted. Other experts listed in an article who asked to improve the standards for drug assessment.
While the authorities are trying to repair the picture image of the procurement system, all control now overshadows the system designed as a gain: saving life and saving money.
As one Weib user claimed, saving of lower drug prices is just a “drop of bucket” of Chinese national health care costs. On the other hand, they wrote, allowing potentially incorrect drugs widely used, it is related to “drinking poison for thirst extinguishing”.
