Personal views do not represent any organization or unit
Saw this news in the morning:
It is said that a lung cancer patient was prescribed traditional Chinese medicine with a price of more than 23,000 yuan by a hospital. The price was so high that the patient went to 12345 to report the problem.
This thing is quite ridiculous, the ridiculous thing is not the high price of traditional Chinese medicine, but according to the drug, this price is not high at all, it is really a bit of "friendly surprise".
First of all, 23,000 is 30 doses of Chinese medicine, not a single serving. The unit price is less than 800 per dose, which is not so scary.
What's more, this is a cure for lung cancer, not a cold medicine, and the price standard is already high. Lung cancer, especially the more common non-small cell lung cancer, happens to be one of the types of tumors that have made huge breakthroughs in recent years. It is mainly due to the breakthrough of two types of therapies - immunotherapy represented by PD-1 monoclonal antibody, and targeted therapy for specific tumor genomic variants, including EGFR inhibitors. Let's take the pricing of these two types of therapies as an example.
PD-1 monoclonal antibody is now the undisputed king of the world, Merck in the United States, pembrolizumab, the trade name Keytruda, tumor patients and many people in the medical community call it K drug. K medicine is generally injected every three weeks, 300 mg each time. How much is the price of 300mg for such a single use? In the United States it is $10897.12.
This is not made up by me, this is clearly marked by Merck's K drug US website:
Some patients will use a 600 mg dose to reduce the frequency of injections to once every 6 weeks, do you think it will be cheaper to buy more at a time? No, the price of 600 mg per serving is to multiply 300 mg by 2, and you won't even return the money saved for a box. Even if the price of domestic PD-1 antibodies is greatly reduced during the negotiation of the medical insurance catalog, each drug is 2-3,000, and the annual treatment cost is 3-50,000.
The star osimertinib (osimertinib), the star of lung cancer targeted drugs, has a monthly drug list price of almost $17,000 in the United States. The drug is now insured, priced at 4966.2 yuan (30 pills) per box. The cost of treatment for one year is also close to 60,000 yuan.
I'm not sure how long the 30 doses on the news should be used, but the price of 23,000 yuan is not outrageous for drugs to treat lung cancer. Moreover, the domestic pricing of domestic PD-1 and osimertinib was lowered through medical insurance negotiations. If you feel that the price of traditional Chinese medicine is high, then you can also suggest that medical insurance also negotiate and reduce the price through reasonable methods.
As for questioning the weight of the prescribed Chinese medicine close to two pounds per dose, if the weight is included, it is even more inexpensive. K medicine can be priced at 10,000 US dollars for 300 mg, and 300 mg is 0.3 grams, and each gram is sold for more than 30,000. 800 grams of medicine for 800 yuan, shouldn't you steal pleasure? The specification of osimertinib is 80 mg, and the price of medical insurance is calculated down, and the price of one gram exceeds 2,000 yuan.
According to the standard of lung cancer treatment, 23,000 prescriptions of traditional Chinese medicine are not expensive, according to the actual corresponding amount of drugs, 23,000 in exchange for 2.4 kilograms of medicine, which is sold at a low price.
So I wondered why 23,000 TCM prescriptions were so controversial. Looking at the prescription that burst out, the price of a single ingredient, ranging from a few dollars to tens of dollars, is not a sky-high price, what is there to dispute?
Does Chinese medicine have to be priced at a price that does not exceed a certain limit? No matter what kind of disease is treated, it must be like the price of Banlan root and Lianhua Qingwei?
The pricing of drugs should be based on the effect of treatment. Lung cancer is a terminal disease, and if it is effectively treated, the patient's life time may be extended or the quality of life may be improved after use – for example, the time to recurrence is delayed. These improvements in life time or quality of life can be converted into value gains through economics.
Therefore, even if a gram of K drug is worth 10,000 gold, as long as the life benefits it brings to patients exceed the price, it is worth the money. This principle is the same when put into Chinese medicine. If the hospital feels that the prescription of the Chinese medicine is beneficial to the patient's body and can cure lung cancer, and there is medical evidence to support this view, then whether the pricing is high should also be based on the identification of the actual life gains, rather than one-sidedly pointing to the price figures.
Of course, if the prescription of this traditional Chinese medicine itself is not clear, or there is no evidence at all to prove that it is effective for lung cancer, then the problem is not the list price of 20,000, but the hospital provides the ineffective drug. Even if the price tag is not 20,000 3, it is two cents three, can't this money go to buy an onion, why should the patient spend money on an ineffective "drug"?
But all the things related to traditional Chinese medicine, I suggest that you can go back and read Mr. Lu Xun's article "Father's Disease", the article is very short, and you can read it for free on the Internet without cost. There is this paragraph in it:
Is the problem with this "famous doctor" that the diagnosis fee is too expensive and the drugs used are too difficult to find? According to this logic, can we also help Mr. Lu Xun negotiate with this famous doctor, the famous doctor's diagnosis fee is reduced a little, collect two cents, change the composition of a subordinate, find something that can be found without special search for two or three days, Mr. Lu Xun will stop making radical remarks and make medical trouble, go home and buy a few pennants of rejuvenation?
A hundred years ago, the problem of traditional Chinese medicine was not the price, and a hundred years later, how can we still fall into the eyes of this false money and can't get out? If the prescription of traditional Chinese medicine issued by Zhengzhou Hospital is 2 Mao 3, should we be grateful to Dade as some masters claim how much medical expenses Chinese medicine saves the society?
Lung cancer patients get 23,000 prescriptions for traditional Chinese medicine, which is not expensive to sell, but to sell human life cheaply.
Resources
https://www.keytruda.com/financial-support/
https://www.healio.com/news/hematology-oncology/20180531/osimertinib-not-costeffective-for-egfrmutated-lung-cancer