Cross-post da: https://beehaw.org/post/18183849
A prominent Shanghai surgeon pointed to anaesthetics that do not put patients to sleep. A respected Beijing cardiologist questioned blood pressure medication that failed to regulate. A former editor at a leading online health platform went as far as to accuse domestic drugmakers of fraud.
The concerns became public discussions this past week when some top doctors and hospital leaders called on the government to change how it buys drugs for its public hospitals.
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The outburst of scrutiny, unusual in a country where the authorities keep a tight grip on public criticism of the government, was a rebuke of Beijing’s campaign to lower medical costs. Officials are working to shore up China’s national healthcare system, which is under financial pressure in part because of a rapidly ageing population.
The policy, which was put in place in 2018, encourages fierce competition between drug manufacturers and has been successful at sharply driving down drug prices. But in 2025, foreign-branded drugs have been largely absent from the government list of medicines covered under China’s national health insurance and offered at public hospitals.
The change has effectively pushed out many foreign pharmaceutical companies that do not want to compete against Chinese companies willing to sell their drugs at rock-bottom prices.
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Now, doctors are sounding the alarm about the efficacy of some of the domestic drugs. The doctors are seeking changes to give patients the choice to pay more for alternatives.
“There have always been grumblings that if you cut the price, manufacturers will cut corners,” said Ms Helen Chen, a managing partner and healthcare expert at L.E.K. Consulting in Shanghai.
“Now there are some public voices saying it is happening,” she added.
After years of failing to reduce costs, the government created a central bidding system that favoured cheaper medicines, which in most cases have been generics made by Chinese companies. In exchange, the government guaranteed to purchase more from each supplier.
Public hospitals account for about 70 per cent of China’s drug market. Patients who use private clinics have easier access to a wider choice of medication, including foreign brands.
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“The numbers are exactly the same, down even to two decimal places,” wrote Dr Xia, former deputy editor-in-chief of Ding Xiang Doctor, a popular online forum for medical professionals.
“It’s Chinese generic drugs that have bad quality,” he said.
In a statement on Jan 24, a unit of China’s National Medical Products Administration acknowledged the duplicated data, saying it was the result of “editing errors when the relevant product information was disclosed”.
The issue has hit a raw nerve at a time when many people are feeling a sense of insecurity from China’s real estate downturn and sputtering consumer economy.
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