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牛黄解毒丸、红霉素软膏……这些廉价药都去哪了?

2017-05-07 07:36:04   中国网

原标题:3元一盒的牛黄解毒丸、1元一盒的红霉素软膏……这些廉价药都去哪了?

对于家住天津的刘希恭来说,今年春天“很难过”。已近80高龄的他,为寻找给儿子治病的一种短缺“救命药”——青霉胺,心急如焚地跑遍天津各大医院,然而却被告知已停产。

像刘希恭老人这样,期盼能买到短缺药的患者家属不在少数。3块钱一盒的牛黄解毒丸、1块钱一盒的红霉素软膏、2块钱100片的复方新诺明……曾一度为老百姓熟知的多种廉价药身影如今也愈加难寻。青光眼手术必用药丝裂霉素近日被曝在多地面临断货。

“救命药”去哪儿了?短缺药又“荒”在哪儿?如何破解药品短缺困境?

救命药“断供”,病重的他们怎么办?
  青霉胺曾经8块多一瓶,如今卖到98元仍“一药难寻”。作为肝豆状核变性疾病的重要治疗药物,对长期服用该药物的患者而言,堪称救命药。
  记者在采访中了解到,刘希恭辗转联系到药品生产厂家,却被告知因原料紧缺,加之不挣钱,企业已停止生产,最大的可能也是今年底生产。
  鱼精蛋白,是治疗心脏病手术的必用药,十几块钱一支,而去年大半年这种药物在全国多地出现短缺甚至断供。
  世界卫生组织在1977年提出,各国要提供廉价药,满足基本医疗需求。国家卫生计生委卫生发展研究中心研究员傅鸿鹏介绍,美国药监局也曾对短缺药作出定义:“指一个药品及其替代品种都供应不上、影响治疗的情况。”
  事实上,我国遭遇的廉价药“荒”远不止鱼精蛋白和丝裂霉素。
  业内人士指出,基层医疗机构短缺问题更为突出。因廉价药品短缺,一些农村患者面临因病致贫、因病返贫的危机。中国人民解放军总医院副院长范利说:“高血压是农村地区的高发疾病,"降压0号"被大多临床医生公认疗效好,而最近调研发现,患者被建议换成更贵的复方药。”

廉价变高价,短缺药到底怎么了?
  记者在调查中发现,廉价“救命药”的共同点,就是安全、必需、有效,价格不高、临床用量少、企业生产厂家少。但是少了它,患者不是找不到替代药物,就是替代药价格奇高。
  低价救命药缘何会出现“有需求、无供给”的怪象?中国医药企业管理协会副会长牛正乾指出,药品是特殊商品,对病人属于“刚需”。完全靠市场,药品生产成本上涨,利润空间下降,药企不愿意生产,医生不愿意开方子,价格低、用量小的药品就容易短缺。
  “我国是原料药的生产和出口大国,总体上看,原料药工业属于精细化工,生产工序多、投入大、高耗能。”专家表示,原料药分为发酵型和合成型两类。发酵型的上游为粮食,合成型的上游是原油,这些上游材料价格的波动都会影响到药品的生产。
  原料药到底有多重要?药品价格相关监管机构负责人曾表示,我国上千种原料药中,有50种原料药只有一家企业取得审批可生产,一家原料药甚至要供应上百家制剂生产企业,市场依赖度可见一斑。
  “一些地方招标一味追求低价格,这也无形中加速了廉价药的消失。”重庆天圣制药集团董事长刘群表示,“在利润过低的情况下,厂商干脆停产,或者换新包装再涨价。”
  按照现行政策,基本药物实行省级集中采购,并实行零加成。“不少企业为打开销路会以廉价药作为"敲门砖"挤入采购目录。”中国医学科学院专家孙建方说,招标几年一次,药品一旦以低价招标并定价进入医保支付体系,即使成本上涨也无法根据市场情况改变价格。
  与此同时,“黄牛”倒买倒卖,市场药品购销秩序混乱,使廉价药更“难求”。有关调查显示,注射用促皮质素正常零售价是七八元,而“黑市”上竟被炒到上千元。即使价格高得如此离谱,仍旧一药难寻。

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