In the overseas consignment market, due to the relaxed supervision policy of Indian pharmaceutical industry, many pharmaceutical companies have copied the mature pharmaceutical preparations that have been put into the market by European and American pharmaceutical companies. They have occupied a huge global market share with relatively low prices and become one of the most important overseas consignment markets in China.
Just like the movie Im not the God of drugs, generics is like life-saving straw, and many patients buy drugs through various channels, or even open up channels, eventually forming a business. Under the efforts of intermediaries, procurement agents and pharmaceutical factories, generic drug procurement has become a mature underground industrial chain with clear roles and clear division of labor. Serious Investigation Unit 37 found that in the industry of generic drug substitution, which seeks to survive and profit each other, generic drugs without supervision are faced with a lot of hard injury of failure and fake. Some generic drugs even manufacturers have clearly indicated that they are fake drugs. Many patients can not distinguish the quality and authenticity of generic drugs. At this time, generic drugs are purchased on behalf of others. The word of mouth of the channel has become their only support.
July 16th, the busy drug wholesale market in New Delhi, India.
_16 July, a local Indian drug exhibits its sale of Oxitinib (AZD9291 Chinese name: Teresa) at a drug wholesale market in New Delhi, India. The drug is not a India agent. It is probably a fake drug.
India does not need prescription or evidence to purchase drugs.
July is the rainy season in India. Near GreenPark, New Delhi, a trunk road less than five metres wide cuts the market in two, on both sides of a bumpy, waterlogged road, and stores scream at the crowds passing through the door to sell goods. In what looks like a domestic towns wholesale market, New Delhis largest drug wholesale market is located. The field.
Since the end of the 20th century, India has become the worlds third largest producer of drugs and the worlds largest exporter of drugs, most of which are generic drugs. This has also led to a relatively concentrated pharmacy in India, where a street of pharmacies can be found in the vicinity of some hospitals, in addition to a centralized pharmacy wholesale department in the wholesale market. With the rise of Chinas purchasing market, many Chinese faces gradually increase in the wholesale market of medicines in India.
On July 16, 2018, local time, the No. 37 Heavy Case Unit met a number of Chinese people who came to the Delhi wholesale market to buy drugs. Li Yang and his girlfriend Wang Jing were two of them.
When Agent 37 of the Serious Crime Unit saw them, they were sending dozens of buyersphone and address information to the pharmacy to send the Iressa couch for lung cancer to China by mail. After receiving the information, Li Yang handed over more than 200,000 rupees (RMB 20,000 yuan) to the pharmacy owner.
Li Yang from Hebei came to India three years ago and worked in a India mobile accessories company. For the past three years, Li Yang Jingren has introduced that he has to go to New Delhis wholesale drug market every other time to pick up the goods. In the market, he has the resources of drug dealers who have long cooperated with him. He does not need to provide any prescriptions or certificates to buy drugs here, unlike other countries or regions.
Drug stores and distributors are the main sources of drugs exported from India, which can be divided into two types: local generic drugs in India and original research drugs listed in India by foreign enterprises. Generally, generic drugs are taken orally, and most of the drugs originally developed are injections, including oral anticancer drugs that are not yet on the market in China. In terms of price, the price of generic drugs in India averages about one-tenth compared with the price of the original research drugs in China, and the price of the original research drugs on the market in India averages about one-half.
Li Yang said that once these drugs are exported to China, the profits are very considerable, making millions every year is not a problem.
Dozens of retail pharmacies are lined up in a street opposite the ALLMS of India public hospital. More than 50 meters of streets, annual turnover of nearly 1 billion yuan. Li Yang says its only a small number in the entire drug market in New Delhi, and many of these drugs have been sold to consignees from China.
In recent years, more and more Chinese people have traveled to New Delhi while going to the drug wholesale market and some drug retail stores to buy their targeted anticancer drugs, an Indian Times reporter told the Serious Cases Unit No. 37. This includes three types of people: professional purchasing, patients themselves and travelers. And when these people buy drugs from pharmacies, they often do not provide the corresponding prescriptions, at the same time, pharmacies will not take the initiative to ask for them to show.
July 18th, a drug retail street near ALLMS, public hospital in New Delhi, India.
Purchasing drugs doubled to sell to domestic patients
The high-priced drug consignment business has attracted a large number of Chinese who want to specialize in consignment, using their resources in India to nicely link up the Chinese market and make good profits from it.
According to Li Yang and his girlfriend Wang Jing, purchases specially for a living are usually sold at least twice or twice the price on the basis of the purchase price.
Wang Yufen, a lung cancer patient in Shaanxi Province, recommended the use of Oxitinib from India at the recommendation of a doctor in a third-class hospital and recommended it to a drug dealer, offering 4,000 yuan per box. However, the drug in Indias underground market is only 1000 yuan per box.
From the doctors introduction of purchasing channels, the price is always the highest. In this regard, Li Yang and many of the respondents who engaged in drug purchasing in India agree with this point.
A Shandong purchasing agent uses an example of lenalidomide generic drug in India. The 10-mg dose of Lenadomide, an Indian generic drug, was sold for about 600 yuan. The patient who came to see him for the drug told him that the price of the Indian generic drug, which was introduced by the doctor, ranged from 1,500 yuan to 3,000 yuan.
The huge price difference and demand have also formed the way to make a fortune on behalf of purchasers. Many distributors and agents have even built drug warehouses in China.
A lot of people are buying medicine from India on behalf of the purchasing business, and then sending them to the domestic fixed warehouse. Since 2016, more and more Chinese in India have started this business, including some overseas students or Chinese who have left behind after graduation, Li Yang said. After purchasing the resources from the buyers, they began to look for drugs in the wholesale market. When the drugs are purchased at the lowest price, they can be transported to the Buyers by mail or by human flesh.
A local drug dealer in India told the unit that it had more than 20 regular Chinese customers, including a few regular outsourcing professions and occasional Chinese scatterers. When Agent 37 of the Serious Crime Unit asked about the shipments from Chinese pharmacies, the dealer cited Iressa, a molecular targeted drug for non-small cell lung cancer, as an example, saying that the local price of the 500-yuan-a-box generic drug was more than 2,000 boxes a month for Chinese customers.
Krish, a salesman at a pharmaceutical business in India, used to supply mainly to Indian hospitals, but in the past three years, Chinese consignments have become one of his main buyers.
Krish provides WeChat services to Chinese buyers. When the buyer is Chinese, he will take the initiative to add a Wechat, and then on Wechat using network translation software to communicate with the buyer in Chinese.
Krish promotes his agents products through Wechat, and his circle of friends is filled with pictures and videos of various cancer drugs, each with a brief Chinese translation from English. In addition to the original drugs listed in India, there are also a considerable number of Indian generics, the purchase of all the common varieties in the list. When SG 37 asked Krish how much generic drugs he was selling in China, he wrote concisely: Store drugs in Chinese warehouses.
In July 16th, Li Yang took out three boxes of generic drugs and negotiated with local drugmakers. Throughout the drug purchase process, pharmacists did not ask Li Yang to provide prescriptions.
Bangladesh counterfeit drugs in India Market
In South Asia, the production of generic drugs is not Indias.
Benefiting from WTO rules, Indias neighbor Bangladesh, as one of the less developed countries in the world, will be granted exemption from patent protection for pharmaceutical products and clinical data in developed countries until 2033. In other words, Bangladeshs pharmaceutical companies can imitate similar products under the protection of their own patent laws as long as expensive drugs are on the market in Western countries. Bangladesh and India are also known as pharmacies for the poor because of their low price advantage and popularity with patients around the world.
Beacon Pharmaceutical Company is a well-known pharmaceutical company in Bangladesh, which has produced up to 200 generic drugs and 65 kinds of cancer drugs, many of which are also sold to China through substitution.
On the morning of July 11, Beacons executive director, Mohamed Abdul Karim, told the Serious Crime Unit in an interview on July 37 that Beacon Pharmaceuticals had issued a notice at the end of 2017 that a number of counterfeit Teresa (Tagrix) products were passed through the Indian market. Low price inflows into China, and many patients have bought it.
Beacon has no authorized distributor in India so far, and the company has commissioned a third-party survey to obtain data confirming that more than 95% of Tagrix counterfeit goods are sold in India, and only about 5% of the products are made by Beacon.There are already patients in China. Cheated.
In addition, Mohammed Abdul Karim said that all black boxes of Oxitini purchased through India (AZD9291 Chinese name: Teresa) were not guaranteed to be authentic until the company formally authorized them.
On the afternoon of July 16, at the drug wholesale market in New Delhi, India, through the introduction of Li Yang, Agent No. 37 of the Serious Cases Unit saw a local drug manufacturer take out a black box of Oxitinib (AZD9291 Chinese name: Teresa), the drug packaging box showed that the manufacturer was Beacon (Bikong) Pharmaceutical Company, Bangladesh.
Li Yang said the black box Oxitinib (AZD9291 Chinese name: Teresa) is one of the best-selling anticancer drugs in Indian pharmacies to the Chinese market, the price in Indian local pharmacies is about 1500 yuan / box.
According to local pharmacists, there are not a few Chinese patients who need black box Oxitinib (AZD9291 Chinese name: Teresa) among the Chinese buyers he contacts, and there is still some information about trading with Chinese buyers in his office computers.
The medicine was bought from Bangladesh, the pharmacist gave the answer. In response, Mr. Chang, a Chinese marketing officer at Beacon, told the Serious Cases Unit No. 37 that the retail price of the drug was RMB 3000 and that the pharmacy in India was only RMB 1500 according to market rules. It was difficult to guarantee the authenticity of the drug in violation of market rules. There is no supply of Oxitinib generic drugs to the Indian market, and it is absolutely counterfeit if someone buys or sells them in India.
Chang said that their medicines are generally exported in bulk. Private buyers are required to provide patient records when they buy medicines, and each box of medicines is filed through a channel. So, like professional consignment, it is impossible to buy genuine black boxes of Oxitinib in Bangladesh.
On July 13, a local man in Bangladesh was converting more than 2 million Taka (local currency) into nearly 200,000 yuan (RMB) from Chinese purchasers for medicines.
It is difficult for patients to buy drugs to distinguish true or false from word of mouth.
Some of them cant distinguish between the genuineness and efficacy of drugs bought on their behalf, let alone patients.
How do I know if the medicine is real or false? I will ask others what the effect is, or whom I will buy. Gu Qianfen, a lung cancer patient, told the Serious Cases Unit No. 37 that for most Indian generic patients, the drug channel is really opaque, and they can not guarantee the efficacy and authenticity of the drug, they can only treat themselves as mice, to test drugs.
Or in this circle, whose reputation is good and reliable, he will be ordered. This is the view of Wang Dong, a lung cancer patient in Hebei Province. For patients, the price is not the main thing, as long as it works, as long as it is genuine medicine, the price difference is two or three hundred yuan, nobody cares. He believes that the quality of the procurement channel word-of-mouth has become the main way for patients to determine the quality and efficacy of the procurement of drugs.
Oncologists in a third-class hospital in Beijing said that the same disease, for different people, taking the same medicine is not the same effect. Among the cancer patients he received, those who took the same generic drug had different efficacy, and each had different levels of resistance, which made it more difficult to distinguish the good from the bad.
Zhou Peng, a resident in India, said that some conditional patients will take the Indian medicine to relevant agencies or domestic testing agencies for effective ingredient testing, the results will be considered the most convincing one.
However, there are very few people who have the conditions to do the tests. Another buyer, Tsai Yu, said that among the thousands of patients he had contacted, few had the ability to test for drugs, and no one could guarantee that the next Indian generic he ate was the same as the last one.
Everyone in the buying circle knows the existence of counterfeit drugs. Zhou Peng said that even though a large number of authentic Indian generic drugs have entered the country, there are still many counterfeit drugs in China. They completely imitate Indian drugs, make their own packaging, make their own medicine. Where are the counterfeit drugs produced? In this opaque industry, no one knows.
Bangladeshs Chinese professional purchasing agent is preparing to deliver white box of esitinib to the country.
Overseas anti cancer drugs to accelerate the pace of entering the market
With the growing concern about generic drugs, the relevant domestic departments have also increased the pace of entry into the market of overseas generic drugs, and decided to implement zero tariffs on imported anticancer drugs and encourage the import of innovative drugs.
On July 19, 2017, the Ministry of Social Affairs announced the negotiation results of the second batch of 44 varieties within the scope of medical insurance negotiations. Finally, 36 varieties were successfully negotiated, with an average decrease of 44%, and entered the Category B of National Medical Insurance Reimbursement. Among them, cancer drug rituximab reduced 48.3%, Herceptin cut 64.8%, Rui Fu Mei cut 60.6%. Herceptin and Rui Fu Mei are among the top 36 varieties.
The Ministry of Peoples Affairs and Social Security requires the competent departments of social insurance of all provinces (autonomous regions and municipalities) not to transfer the relevant drugs out of the catalogue, nor to adjust the limits of payment, so as to speed up the adjustment of class B drugs in the province (autonomous regions and municipalities) and issue them as soon as possible. As of October 2017, 36 countries have been negotiating drugs in all provinces and municipalities. Among them, Henan province made clear that 20% of the 36 patients who negotiated drugs paid 20% and the medical insurance reimbursement was 80%.
When Merlot and Herceptin cut prices at home and were able to reimburse for health insurance, Zhou Peng clearly felt that the number of patients coming to India to buy anticancer drugs was much smaller. According to Zhou Peng, from the second half of 2017 to now, the number of people he received has declined rapidly. A local Indian drug dealer said: After some anti-cancer drugs entered Chinas health insurance, the flow of Chinese customers to many pharmacies in India has gradually declined. There used to be more than a dozen per day, and now there may be only one or two. In April 12th, the Executive Council of the State Council decided to impose zero tariffs on imported anticancer drugs and encourage the import of innovative drugs. On April 27, the Ministry of Finance posted a notice on the VAT Policy on Anti-cancer Drugs on its website, announcing that the VAT on imported anti-cancer drugs will be levied at a reduced rate of 3% from May 1, 2018. Tax cuts are also seen as a direct benefit to reducing drug prices. The source of this article is No. 37 editor in chief of case group: Qian Yue Xiao _NBJ10675.
When Merlot and Herceptin cut prices at home and were able to reimburse for health insurance, Zhou Peng clearly felt that the number of patients coming to India to buy anticancer drugs was much smaller.
According to Zhou Peng, from the second half of 2017 to now, the number of people he received has declined rapidly. A local Indian drug dealer said: After some anti-cancer drugs entered Chinas health insurance, the flow of Chinese customers to many pharmacies in India has gradually declined. There used to be more than a dozen per day, and now there may be only one or two.
In April 12th, the Executive Council of the State Council decided to impose zero tariffs on imported anticancer drugs and encourage the import of innovative drugs. On April 27, the Ministry of Finance posted a notice on the VAT Policy on Anti-cancer Drugs on its website, announcing that the VAT on imported anti-cancer drugs will be levied at a reduced rate of 3% from May 1, 2018. Tax cuts are also seen as a direct benefit to reducing drug prices.