China’s domestic pharmaceutical products in a dilemma of ineffective sedatives and laxatives.

Recently, there has been widespread reflection in the Chinese medical community about the unstable effectiveness of domestically produced Chinese medicines obtained through centralized procurement. There are even embarrassing situations where patients experience “no drop in blood pressure, no sleepiness from sedatives, and no effect of laxatives” after taking these medications. These issues have become hot topics at local “two sessions.”

According to reports from mainland media, during this year’s Shanghai “two sessions,” 20 members including CPPCC member Zheng Minhua (who are senior executives in the Shanghai medical community) jointly submitted a proposal titled “How to Use Drugs with Good Efficacy in the Background of Drug Centralized Procurement.” The proposal pointed out that some centrally procured medicines have unstable effectiveness, but doctors do not have the choice when using them clinically, urging authorities to reserve space for the more expensive “original drugs” (innovative new drugs, mostly imported in China) and provide different reimbursement ratios for imported and domestically produced drugs.

Zheng Minhua, who also serves as the director of general surgery at Shanghai Ruijin Hospital, said in an interview that centrally procured drugs, due to their low prices, have unstable drug quality, leading to phenomena such as “no drop in blood pressure, no sleepiness from sedatives, no effect of laxatives,” leaving doctors feeling helpless in the face of patients’ reactions and doubts because they lack the choice and “have no channels to report to higher authorities.”

He mentioned that under compliance with laws and regulations, original drugs can be obtained from hospital pharmacies (if in stock) or regular retail pharmacies. The medical insurance department can provide different reimbursement ratios based on whether the drug is original or generic, imported or domestically produced.

Lu Changlin, a member of the Beijing Municipal People’s Political Consultative Conference and director of cardiology at Beijing Chaoyang Hospital, also raised concerns during a recent meeting of the Beijing Municipal People’s Political Consultative Conference. He directly pointed out that doctors generally report that the efficacy of centrally procured drugs is inferior to imported or original drugs.

Lu Changlin stated that through clinical findings, it was discovered that among new oral anticoagulants with the same dosage, imported drugs can effectively prevent strokes and pulmonary embolisms in patients. However, patients using centrally procured drugs have a higher incidence of strokes and pulmonary embolisms. Additionally, centrally procured drugs cause greater adverse reactions, including allergic reactions, indicating insufficient drug purity and manufacturing process issues.

According to reports, an anesthesiologist from a tertiary hospital in northern China, who wished to remain anonymous, revealed that compared to original drugs, domestically produced anesthetics in China have “slightly inferior effects.” The quality gap may result from differences in pharmaceutical manufacturing processes between domestic and foreign companies, or it may be due to some pharmaceutical companies lacking sufficient responsibility, leading to compromised quality control in drug production.

In response to the feedback from healthcare professionals mentioned above, the National Healthcare Security Administration of the CPC recently sent a letter to the Shanghai Healthcare Security Administration, entrusting Ruijin Hospital and Zheng Minhua to convey their gratitude.

China’s centralized drug procurement system is a government-led pharmaceutical procurement mechanism. The National Healthcare Security Administration of the CPC has been gradually promoting drug centralized procurement nationwide since April 2019 under the pretext of “ensuring that low-income groups can afford medication.” The core principle is to “exchange quantity for price” to reduce drug prices.

Over the past nearly six years of implementation, relevant units have collectively procured 10 batches of drugs, with the majority being domestically produced Chinese medicines. The proportion of imported drugs and “original drugs” has reportedly decreased to only about 5%.