Some medicines, especially first-aid medicines, do not have a large amount of their own, and they have been on the market for many years. Prices are relatively low, and there are fewer manufacturers. Some are because the shortage of raw materials can not keep up, and some are because the government's pricing is too low, companies feel that there is no profit, and even do not participate in the tender, directly abandon the market, switch to production of more profitable products.

Reporter's investigation: domestic cheap medicine is hard to find similar imported drugs 56 times as expensive as yesterday. Ms. Sun called the newspaper yesterday. She had recently been diagnosed with gynecological diseases at Qilu Hospital. The doctor stated that she needed to perform an examination of tubal angiography. But in the end her inspection was not done because of the lack of medicine called "Compound Meglumine Injection". Later, Ms. Sun found that more than one patient had this type of encounter.

An interview with the reporter found that compound diatrizocine meglumine injection as a commonly used domestic angiography examination drugs, some hospitals in Jinan has become "tight goods", and some hospitals through different channels in the "marginalization", and some hospitals have even been out of stock for a long time. What caused this drug to be in short supply? Behind it, but also reflects the helplessness of domestic cheap drugs? The reporter investigated this.

Clinical out of stock, the hospital around to steal cheap domestic drug Ms. Sun told reporters that because of suspected tubal unreasonable, she thought of the hospital to do a fallopian tube examination. When the doctor prescribed for her, she said that diatrizoate is a contrast agent used for angiography. However, at present, the hospital has no goods. It has alternatives of the same efficacy, all of which are imported drugs. The price is higher than that of five or six. Times. If Ms. Sun can't afford it, she needs to buy it at another hospital. “My family’s condition is not good, so I went to the city’s Maternal and Child Health Hospital to buy it. The doctor told me that recently people who have been in the outer court have come to the hospital to buy medicine. Because there are not many medicines in this hospital, so give me Blocked back." Ms. Sun is puzzled: "Since the clinical needs, why the hospital does not quickly get into it?" "Compound diatrizocine meglumine injection of this drug, we are selling, but for a long time has no goods According to the staff of Qilu Hospital Pharmacy Department, in the hospital, the compound diatrizocine meglumine injection was sold for 66.5 yuan per box, which was imported from Jinan Ai Xin Zall Pharmaceutical Co., Ltd. However, the medicine company was no longer available. “In fact, this medicine is a substitute, and it is all imported medicines, and the price is higher. At present, there are still some doctors who are using this medicine in clinical practice. It may be easier to use it.”

"Sometimes it is very helpless, clinical often give us this medicine, but how much we can enter, we can not call the shots, because the pharmaceutical company supplies intermittently, 76% diatrizoate meglumine gone, we can only use 60% ubiquitous Glucosamine, and later 60% of them are also out of stock. It is no exaggeration to say that this drug we all rely on 'grabbing'. This pharmaceutical company does not have to go to the pharmaceutical company to 'defining edge'." Maternal and Child Health Hospital Pharmacy Chief Cui Xiujun said.

Ma Chuanjiang, deputy director of the Department of Pharmacy of Shandong Province, told reporters that the diatrizoate meglumine in the hospital is indeed very tense, because sometimes there is no medicine, and some tests to be done can only be done again. “In recent years, the clinical use of diatrizoate has been tense, and hospitals have ordered 10 and 20 sites from pharmaceutical companies. When pharmaceutical companies come to the market, they give an average of one point to several hospitals. The use of drugs in the enhancement of CT, intervention and other aspects of the use of more.” In addition, the reporter learned from the Second Hospital of Shanda, the provincial hospital learned that diatrizoate meglumine in these hospitals also have varying degrees of scarcity.

Small amount of clinical use, drug upgrades have been eliminated?

According to the reporter’s review, the compound diatrizocine meglumine injection is an injection suitable for intravenous and retrograde urography, brain thoracoabdominal and limb angiography, venography and CT, can also be used for arthrography, fistula angiography, Hysterosalpingography, endoscopic retrograde cholangiopancreatography.

During the interview, the reporter also heard another argument: The compound diatrizocine meglumine injection has not been used clinically at present and belongs to the old drug that was eliminated. The director of the imaging department of a top-three hospital told the reporter that, in addition to the occasional use of urologic imaging, the drug Meglumine Diatrime has not been used in this hospital 10 years ago because of its high iodine concentration and high allergy rate. Has a greater impact on kidney function. "We found that after the application of diatrizoate, the renal function was significantly decreased and creatinine was increased within 30 days. Now we use imported drugs such as Onaitec and You Weixian. Onaitec's price is 416 yuan. /bottle."

The director introduced that diatrizoate meglumine is used for imaging, mainly to increase the contrast between the diseased tissue and normal tissue, to judge whether the diseased tissue is benign or malignant, and to grade the malignancy of the lesion. "Currently, the contrast effect of imported drugs is better than meglumine."

The director of the radiology department of another hospital also told reporters that the hospital had not used diatrizoate over 10 years ago. "This kind of medicine is infused into blood vessels and has a high rate of allergies. It is only used when the surgical system occasionally enemas."

However, unlike large hospitals, many smaller hospitals still use diatrizoate. “As a contrast agent, in fact, the amount of diatrizoate meglumine is not very large in clinical practice, but it is not without it.” Cui Xiujun said, diatrizocine will also be more than ten dollars, which is considered relatively cheap. The medicine. Most of its substitutes are imported drugs, which are several times higher than the price of diatrizoate meglumine. "Because our hospital has strict control over drug prices, doctors in general would choose diatrizoate, a cheap and easy-to-use drug."

Cui Xiujun said that the compound diatrizocine meglumine injections each have an experimental needle. Before doing the angiography, they can use the experiment to do a skin test for patients first to see if they are allergic to iodine. If they are not allergic, they can continue to use it. Diatrizocine can still achieve diagnostic results. "The imported drugs do not have to do skin tests. The large hospitals do not use meglumine. There is a reason why the patient may not be too busy. I am afraid that I will be allergic to the diatrizoate meglumine test. The diagnosis is more complicated."

Raw material costs have risen. Since Shandong's supply has decreased, since clinically necessary, where is the crux of drug supply? Cui Xiujun said that diatrizocine is a drug in the National Essential Drug List, and the price is set by the country and there is no room for growth. “Because it has a small amount of clinical use, but the production cost is the same as other large-volume drugs, which will lead companies to make ends meet. Therefore, as far as I know, there are few pharmaceutical companies in the country that produce this drug, and the largest one The manufacturer is a pharmaceutical company in Shanghai."

After many setbacks, the reporter contacted Ma Qiang (a pseudonym), the total sales manager of Shanghai Pharmaceutical Industry Co., Ltd. in Shandong. Ma Qiang told reporters that because its predecessor was a large-scale contrast-ray machine manufacturer, they are still insisting on producing contrast agents such as meglumine. "In recent years, we have provided diatrizoate meglumine very tight, mainly because of the shortage of raw materials, the cost rises, we are producing a bottle of loss."

Ma Qiang said that the main raw material for diatrizoate meglumine is sea iodine, and the supply countries are mainly Japan and Chile. Since the Great East Japan Earthquake last year, Japan's sea iodine supply has basically stopped production. Orders have only been sold to Europe and there is no domestic order. This has led to a shortage of raw materials and rising costs. The price of sea iodine sold in Chile is also rising. “Originally, 200,000 to 300,000 metric tons of iodine per ton of seawater has risen to 800,000 per ton. The cost has risen, but because of the basic drugs, the retail price of this drug has not increased.”

“The ex-factory price of diatrizoal meglumine is 61.3 yuan, and the retail price is 75 yuan. In fact, in recent years, ex-factory prices have been rising because of rising costs, but the retail price has not changed. So many pharmaceutical companies also pour us Kushui: The drug was given to a hospital bottle to lose a bottle.” Ma Qiang said that before the amount of diatrizoate supply to Shandong was 1400 boxes/month, and now it has dropped to 280 boxes/month. “Our company CEOs have been running the Development and Reform Commission a lot, and want to mention the price of this medicine, but they all ended without results.” Ma Qiang smiled.

When asked whether the clinical drug dosage of diatrizoate is lower than before, due to clinical use of imported drugs, Ma Qiang said that in fact, the demand for diatrizoate has not changed in the past few years. "There is no substitute for meglumine meglumine. It is equipped with an experimental needle. Patients can do skin tests before use. This is also the reason for the high cost of diatrizoate meglumine. In my opinion, in fact, every iodine-containing imaging The skin test should be done because the individual's allergies to iodine are not the same."

For the clinical efficacy of diatrizoate meglumine, Ma Qiang said that compared to diatrizocine, the import medicine process must be advanced, but the quality of diatrizoate meglumine is absolutely reliable. “The diatrizoate meglumine was gradually replaced by imported drugs. It can be said that it is also a kind of tragedy for state-owned enterprises. Although there are many pharmaceutical companies in Shanghai, they have not formed scale, and they have not done enough for the public relations of hospitals and doctors. Pharmaceutical companies to contend." Ma Qiang frankly.

Drug prices were low and cheap drugs gradually disappeared. During the course of the visit, the reporter found that, in fact, the shadow of meglumine is only a microcosm of the gradual disappearance of cheap drugs, and there are still many basic medicines that are clinically affordable to various medical units in Jinan. problem. “For example, residents can now buy instant effects pills, which are just like lottery tickets; about 80% of residents with needs can't buy this medicine. Because of the large demand, we actually order 100 boxes each time we order, but Each time the pharmaceutical company gave us only 10 boxes, the 10 boxes of medicine could be sold out in an afternoon, and the rest of the time became an 'empty window period'.” The person in charge of a community health service center told reporters that the quick effect Jiuxin Pill Still an exclusive variety, there is no alternative medicine. Shorter than the Suxiao Jiuxin pill, the "Wei Nao Tong Tong Pian" for treating cerebral thrombosis has been out of stock in recent months.

Experts told reporters that some cheap medicines were actually stopped due to the decline in pharmaceutical production enthusiasm and the hospital's lack of profits due to lack of profit. Some cheap drugs, for example, were falsely delisted and they were replaced, and a new packaging was re-listed. "For example, the cold medicine acetaminophen is basically difficult to buy in pharmacies, but the main ingredient of the common cold medicines such as Tylenol, Baked Black and Cold Clear is acetaminophen, but the price of these medicines is The difference is very big, ranging from RMB 67 to RMB 10-20.” “Everything is about profits. The criteria for basic drug bidding, on the premise of guaranteeing quality, depends on who has a lower price. Because the basic drug is Wide coverage, so many pharmaceutical companies try to minimize profits to ensure the success of bids, and then rely on small profits." The head of a pharmaceutical company Shandong Office revealed that the reason why the drug was not available after winning the bid, because Drug production costs continue to rise. In the original bidding process, you could also go for a paltry and profitable way, and the increase in raw material prices has dried up the last profit of pharmaceutical companies. If you sell one box of medicine, you will lose more than one box of money. Therefore, the successful bidder prefers to abandon the basic drug market and does not want to lose money and earn money.

The person in charge told the reporter that some drug prices do exist in a situation of "delusions," but they are overkill and there are hidden dangers in the drug "deficiency." In this regard, the Chinese Association of Chinese Medicine even publicly appealed: "The medicines are related to people's life safety. Drug prices must fully consider the most basic cost of medicines, and leave reasonable profit margins for innovation and development of enterprises. Bidding cannot be done at the same price, and most people What is needed is a truly safe and effective essential medicine.” “On the one hand, the new medical reform hopes to reduce the burden on the government as much as possible. On the other hand, it tries to provide the general public with reliable and reliable basic medical protection.” Analysis of the industry. However, this kind of basic guarantee must inevitably make some investments in the government, support the pharmaceutical companies, and not transfer all the pressure to the manufacturers. Otherwise, it may harm the enthusiasm of a large number of honest manufacturers.