"About 3~4 months ago, suddenly the price increased, before it was 1ml:5mg specification, about 2 yuan. Later, it became 2mg 18.84 yuan, and until now, there is only this one in the entire hospital." Du Min (pseudonym), a doctor from the anesthesiology department of a tertiary hospital in Jiangsu Province, said so.
The drug that Du Min said "increased in price overnight" is a very common drug in clinical departments - dexamethasone.
Last month, Lilac Garden
"The price of rice has risen 282 times, and the West Continent is 83, and the doctor sighs: I can't save the patient soon"
Under the tweet, many doctors have shared the price fluctuations of dexamethasone that they have observed in their clinical work.
So, what exactly is the price of dexamethasone today?
Prices vary in different regions, and some pharmaceutical companies have been fined 700,000 yuan for raising prices
In the comment section of Lilac Garden's previous article, some doctors said that the price increase of dexamethasone this year is "really outrageous".
Some doctors in Liaoning commented: "We are indeed more than 30 meters here"; The doctor from Guangxi said: The current price of hanging nets is already more than a dozen; There is also a reply post from Lilac Garden forum users: "Fifty or sixty meters of rice have been used, I can't stand it, it's really too expensive."
"Although the price has increased, there are other cheap options." Hu Mingyu (pseudonym), a pharmacist at the emergency pharmacy of a county-level tertiary hospital in Henan, said, "At present, our hospital has 9 cents of 15mg, 38 pieces of 5mg, and 98 pieces of 2mg."
In addition, doctors in IP Guangdong said that during the new crown epidemic, the price of rice that can be bought in his hospital rose to 28.8 yuan per tube.
In the new crown epidemic, glucocorticoids such as dexamethasone play a significant role in the rescue of critically ill patients, and WHO guidelines recommend glucocorticoids such as dexamethasone for severe or critically ill patients with new crowns. This also led to an unusual wave of price increases and out-of-stock stocks during the epidemic.
As mentioned in the typical cases of illegal epidemic-related drugs announced by the State Administration for Market Regulation, the sales price of dexamethasone phosphate sodium injection sold by Sinopharm Qiandongnan Pharmaceutical Co., Ltd. increased the sales price to 9.8 yuan per unit from January 2023, with a purchase price increase of 20.69% and a sales price increase of 1455.56%. Constituting a price-gouging offence, he was eventually fined $700,000.
Screenshot of the official website of the State Administration for Market Regulation
While some doctors reacted to the increase in the price of dexamethasone, a considerable number of doctors posted the price of dexamethasone in their hospitals, indicating that the price fluctuation was not obvious. For example, the doctor's inquiry in IP Sichuan found that the price of dexamethasone in his hospital was 5mg 0.77 yuan; There are also IP doctors in Qinghai who said that the current price of dexamethasone is 0.64 yuan a piece.
"Our hospital now only has one brand of rice and the current price is 5mg for 2.54 yuan a piece." Yang Fan (pseudonym), a general surgeon at a tertiary hospital in Shanghai, said, "We surgeons generally use it when they are allergic. The supply has also been sufficient, and there has been no out-of-stock."
After the price of rice increased, doctors: it was cheaper to switch to methylprednisolone
Tang Ming (pseudonym), a doctor from the pharmacy department of a third-class hospital in Qinghai Province, said that the dexamethasone of his hospitals is currently in the interprovincial alliance procurement catalog, so the price remains at 0.64 yuan per unit. "The suppliers are relatively fixed, the prices are relatively cheap, there has been no significant fluctuation in recent years, and there has been no shortage of stock."
The inter-provincial alliance centralized procurement mentioned by Tang Ming is led by Guangdong and jointly participated by 6 provinces (XPCC) including Shanxi, Henan and Jiangxi. According to the announced selection results, the lowest price is 1ml: 2.0mg dexamethasone sodium phosphate injection from Tianjin Jinyao Pharmaceutical Co., Ltd., 0.185 yuan / bottle.
For areas that are still not covered by centralized procurement, the price increase of dexamethasone is more obvious. Lei Dongzhu, deputy to the National People's Congress and secretary of the Party Committee of the First People's Hospital of Chenzhou City, believes that at present, there are problems such as insufficient supply and incomplete coverage of centralized procurement drugs in the guarantee of drug supply. She suggested that the coverage of similar drugs should be accelerated and the loopholes of high-priced drugs should be strictly blocked; Introduce policies to normalize the supervision of drug prices and achieve supply and price stability for shortage drugs.
Lei Dongzhu also mentioned a data: the original price of dexamethasone acetate injection (1ml: 5mg) was 0.35 yuan / tube, and the online price was increased to 98.76 yuan / piece in 2022, calculated according to the 2021 dosage of 144,700 pieces of the First People's Hospital of Chenzhou City, if dexamethasone of 98.76 yuan is used, it will increase the burden of patients by 14.24 million yuan per year.
However, when discussing the price change of dexamethasone, it should be noted that there are two different common preparations for common dexamethasone injection, namely dexamethasone sodium phosphate and dexamethasone acetate, and there is a large price difference.
There is a large price difference between the two different dexamethasone preparations. For example, dexamethasone sodium phosphate, taking the centralized procurement of common chronic disease drugs in Guangdong Alliance as an example, the winning bid price is up to 0.642 yuan / bottle (bottle); And dexamethasone acetate, according to the 2022 data of Liaoning Province Centralized Procurement Network for Drugs and Medical Consumables, the original online prices of two dexamethasone acetate injections from Chengdu Tiantaishan Pharmaceutical Co., Ltd. were 129 yuan and 219.3 yuan, respectively, and adjusted to 58.09 yuan and 98.76 yuan after pharmaceutical companies took the initiative to reduce prices.
In recent years, the winning price of dexamethasone sodium phosphate injection of different companies (Source: Insight database screenshot)
It can be seen that there is a gap of more than 100 times between the price of dexamethasone acetate and the price of dexamethasone sodium phosphate. Clinically, dexamethasone acetate injection should not be used for intravenous and neuraxial injection, so dexamethasone sodium phosphate injection is relatively more commonly used.
In the comment area of the previous tweet, some doctors commented: "Dimi is indeed too expensive, resulting in many doctors in the department now more accustomed to using methylprednisolone."
Du Min (pseudonym), a doctor in the anesthesiology department of a tertiary hospital in Jiangsu Province, mentioned a similar situation: "Our department generally uses intravenous infusion of rice 5~10mg to prevent nausea and vomiting after surgery, and now after the price increase, it still has a very obvious impact on our work, many doctors, including myself, basically do not use rice, switch to methylprednisolone sodium succinate 40mg, only about 5 yuan."
However, many doctors said that the current price changes around dexamethasone have little impact on clinical work.
"I will still use it when I should use it, and it can be regarded as a life-saving medicine." Chen Cheng (pseudonym), a doctor in the emergency department of a tertiary hospital in southwest China, said, "But if patients can also have channels to understand changes in drug prices in real time, or why the prices of commonly used drugs have increased, it may reduce some of the pressure of doctor-patient communication for doctors." (Curator: z_popeye | Executive Producer: Gyouza)
Source: Visual China