During the seminar on the construction of a centralized production base for small-variety drugs (drugs in short supply) held in Shanghai in July, the supply guarantee consortium for national small-variety drugs (drugs in short supply) was established (hereinafter referred to as "drug combination"). It is reported that the "pharmaceutical consortium" was initiated by 24 enterprises, including zhejiang haizheng, changzhou yabang and huzhou prospect pharmaceutical co., LTD., and can guarantee the supply of 57 small-variety drugs (short supply drugs). The member enterprises of the "pharmaceutical federation" said that they would actively participate in the reform of the national medical and health system and the supply-side structural reform of the pharmaceutical industry, earnestly implement the supply guarantee system for small-variety drugs (drugs in short supply), and help solve the problem of drug shortage. Timely feedback the operational information of the enterprise that may affect the stable supply of drugs (such as the suspension of production and the significant increase in the upstream supply cost) and the risk information of drug shortage discovered in the business activities of the enterprise, so as to realize the early detection, early warning and early prevention of drug shortage; Actively participate in the research of drug supply guarantee policy and make policy Suggestions and Suggestions for government departments. This time, enterprises set up a "pharmaceutical consortium" to solve the problem of small varieties of drugs (drugs in short supply) spontaneously. Compared with the previous policy drivers and government promotion, it can be said that there is a new atmosphere.

 

"A burden of shaving one's head -- a hot head."

 

The shortage of small-variety drugs has been a long-standing problem, and all parties concerned are well aware of the reasons, namely, small audiences, low profits, insufficient enthusiasm for production, imperfect policies and management mechanisms, and even speculation and monopoly factors. As for the shortage of small varieties of medicine, the prime minister and local government officials all attach great importance to it. For example, premier li keqiang has pointed out that it is necessary to strengthen the monitoring and early warning of the supply of drugs in short supply across the country, establish a system of stopping production and filing of drugs in short supply and API, increase the reserves, and ensure the continuous supply of drugs to patients.

 

In recent years, the state and relevant government departments have also made great efforts to address the shortage of small-variety drugs, such as building a centralized production base for small-variety drugs, establishing a joint mechanism for consultation on the supply of drugs in short supply, implementing a list management system for drugs in short supply, and developing a monitoring and early warning reporting system for enterprises in short supply of drugs. While state and local "movements" continue, they do not seem to be working. So far, the list of medicines in short supply has reached 139 varieties, 27 of which have failed to make progress in production and supply, according to cnr.cn. What are the main sticking points?

 

Dai xulin, a special observer, licensed pharmacist and patent agent of this newspaper, said that the problem of the shortage of small varieties of drugs is that the price is too low, the input of enterprises is large, output is small, and benefits cannot be guaranteed. To a certain extent, the establishment of the "pharmaceutical federation" can promote the flow of information, reduce the cost of communication, and make drug shortage early discovered, early warning and early prevention. Ultimately, however, it is important to find ways to make small drug producers and operators profitable.

 

According to dai xuelin's analysis, the government had always been "hot at the head" in solving the shortage of small varieties of drugs, and there was even a suspicion of excessive intervention.

 

Shen Ming, another industry expert and President of anhui medical alliance, also said that it could be said that the government was leading unilaterally before, but it was not enough to rely on the government alone. However, this participation is not driven by administrative compulsion, nor is it attracted by market profits, but relies more on corporate social responsibility. In this way, the effect may be better.

 

Dai further stressed that enterprises should be guided to produce through market regulation, and that the government's pharmaceutical bidding and purchasing department should not blindly depress prices. The government should pay more attention to solving market information asymmetry, timely release market supply warning information on medicines in short supply, and take measures such as price adjustment as soon as possible to restore market supply.

 

The creation of the "pharmaceutical federation" is expected to bring companies to the front of the table and make the government less of a "haircut burden -- a fever". Shen said that this indicates that these enterprises have seen the social problems. From the perspective of corporate responsibility, they are obligated to be responsible to the vast number of patients, to the society, and to respond positively to the government's appeals and guidance. But Mr Dai is not entirely optimistic. He said that the establishment of the "pharmaceutical federation" does not represent the formal arrival of market forces. From the perspective of its statement, it only expresses the collective and active willingness to communicate with the government.

 

Government and business can ensure supply

 

It is understood that the first members of the "pharmaceutical federation" have a total of 24 enterprises, which can guarantee the supply of 57 small-variety drugs (drugs in short supply) varieties, covering more than 10 areas such as cardiovascular system, digestive metabolism, blood system and anti-infection. It includes 47 varieties in the "139 catalogue" of drugs in short supply (139 varieties listed in the list of drugs in short supply through the national key monitoring system and the list of drugs in short supply released by the former health and family planning commission in 2017) and 10 varieties in provinces and regions.

 

For a long time, drug companies have been acting almost independently. This time, why can these 24 companies get together? To this end, shen said, the above enterprises, led by yao xinyi, are large in scale, capable of producing small varieties of drugs, have certain brand influence and social influence, and even have some national capital background, which are enough to make these enterprises "stand out". The lead enterprise of "pharmaceutical federation" introduced that, in the future, it will implement information sharing and industrial resource linkage mechanism in the production of shortage drugs through various working mechanisms, such as communication of supply chain information, improvement of supporting capacity, application of special funds, and strengthening of research and development cooperation. The upstream industry chain strives to ensure the continuous supply of small variety of pharmaceutical raw materials and preparations. The enterprises involved will also provide timely feedback on their business activities that may affect the stable supply of drugs (such as production halts and a significant increase in upstream supply costs), as well as the risk information of drug shortage found in their business activities.

 

So, can this "drug combination" model completely solve the problem of small variety of drugs? Shen said that the above enterprises themselves have the ability to produce some small varieties of drugs. Even if they cannot solve the shortage of all small varieties of drugs, it should be a positive signal that they can at least solve the shortage of 57 small varieties of drugs they have proposed. As for the others, we should try to solve them again. We should not solve all the problems because of the emergence of a "drug combination". In addition, shen believes that the "pharmaceutical association" itself is cross-regional and therefore has the value of spreading to the whole country. In the future, the scope of similar "drug combinations" will be more and more extensive, more and more varieties will be produced, and the shortage of small-variety drugs will be gradually solved.

 

However, according to dai, without solving the existing medical bidding system and giving more play to the role of the market in price adjustment, the final effect of the "pharmaceutical federation" is limited and cannot fundamentally solve the shortage problem. If you can't make a profit, you can't do it, even if you're willing to.

 

In any case, the creation of the "pharmaceutical federation" is, after all, a positive sign that companies are taking the initiative and taking on social responsibility. In fact, under the encouragement of the national policy, although the profit is small, there are still many enterprises insisting on the production of small varieties of medicine. Recently, zhejiang zhebei pharmaceutical co., LTD has produced the first batch of 45,000 mercaptopurine tablets in 2018, which can ensure the national market supply. The company's deputy general manager said: "the reason for adhering to production is that local governments attach great importance to it and provide certain policy support. Many family members of the patients called to ask, leukaemia children do not have the choice of medication, is really a life-saving drug.

 

Indeed, in the case of many policies, the government and the market should form a joint force, so that "god belongs to god and Caesar belongs to Caesar", so that the shortage of small varieties of medicine in our country can be completely solved.

 

Dai said that to solve the problem of shortage of small-variety drugs, the government only needs to contribute to promoting openness and transparency of information and reducing information asymmetry. As for the price, production or non-production, use or non-use, it shall be decided by the parties themselves, such as the production and business operation enterprises and medical insurance institutions, and finally completed through market adjustment. Supply exceeds demand, prices fall and companies reduce supply.

 

Mr Dai stressed that much of the previous problem was caused by excessive government intervention. For example, in a fully competitive market, drugs costing 100 yuan can be sold for 200 yuan. For patients, their clinical value is more than 200 yuan, and both patients and enterprises benefit. However, in order to solve the problem of "expensive medical treatment", the government may push the price of drugs with clinical value of 200 yuan to 90 yuan. It hopes that enterprises can supply drugs with a price of 10 yuan. Companies, of course, will not be so stupid, and will eventually have to shut down production. I hope this will never happen again.

 

Nishi k also calls for the emergence of couplet of "medicine", shows that companies take the initiative to "stand up", willing to take social responsibility, the government should give the pay of enterprise, to provide specific policy support, whether taxes, or otherwise, to have real support, cannot "only it doesn't rain thunder", this will affect the enthusiasm of the enterprise. The government wants to keep good deeds to themselves, good deeds to be done, good deeds to be sustained.