□ Our reporter Zhao Li
□ Our intern Zhao Jingyi Jia Jingxiao
If the outdoor time is not enough, atropine will make up for it - this is the choice of Beijing "chicken baby parent" Li Hao for the past year.
In order to ensure his son's study time as much as possible, Li Hao rarely takes his son to carry out outdoor activities, but in order to prevent his son's glasses degree from becoming the "bottom of the bottle" in the future, Li Hao aimed at atropine eye drops, and passed the Internet hospital every three weeks. Buy.
But recently, this "myopia medicine" has "fallen down" amid a chorus of doubts.
Several eye drug companies have announced that online sales of atropine eye drops have been suspended, but they can still be prescribed in offline physical hospitals.
According to industry insiders, the drug has not yet been approved for marketing through strict clinical trials in China, and it is sold through the "Internet hospital channel + in-hospital preparation qualification" method, which may lead to lax prescription review, expansion of the scope of use, and difficulty in follow-up and observation. risks of.
Only then did Li Hao understand that the "magic medicine" that he often bought belonged to the preparations in the hospital, that is, the preparations developed by the hospital itself.
Fear and anxiety follow: Is there any drug that has not been approved for marketing, is it true, and how is the safety guaranteed?
There are not many people like Li Hao who buy preparations in the hospital at will without knowing it.
Some people have acne on their faces, so they go to social platforms to buy "acne medicine"; some people have sequelae after being injured, they go to buy "trauma cream for national athletes"; some people suffer from gastritis, they go to buy "XX Hospital" The developed gastritis nemesis"...
When there is demand, there is market.
Some merchants seized the business opportunity and started the purchasing business by placing orders and mailing online.
A reporter from the "Rules of Law Daily" recently investigated and found that home-made medicines in hospitals in Beijing, Nanjing, Shanghai and other places are selling hot online.
So, how did this grey interest chain of in-hospital preparations come into being?
Good quality and cheap medicine
patients flock
The medicine is in a white bottle, and there is nothing else in the bottle except for the red instructions. This acne liniment prescribed by a dermatologist in a tertiary hospital in Beijing is regarded by Beijing resident Jia Xiaoqi as a "magic medicine for acne".
At the beginning of this year, Jia Xiaoqi's face suddenly developed a large area of acne, which was not only red and swollen, but also persisted for a long time.
After going to the above-mentioned hospital for consultation, the doctor quickly filled out a list of medicines and told Jia Xiaoqi that two of the medicines were made by the hospital themselves without medical insurance, and told him how to use it.
Jia Xiaoqi paid attention to the two self-made medicines mentioned by the doctor, namely acne liniments for external application and acne granules for internal use.
The two medicines are not expensive, only a few dozen yuan. The common point is that the outer packaging is extremely simple, and the words "hospital" are highlighted at the bottom.
After taking the medicine as prescribed by the doctor for a period of time, Jia Xiaoqi's facial skin improved.
"For patients, as long as the medicine is useful, they will definitely repurchase it, especially since these self-made medicines are often backed by the reputation of the hospital, which is more convincing." Jia Xiaoqi said that some self-made medicines are a bit like "magic medicine secret recipes", and it is strictly forbidden to spread them out. , except that it is a bit difficult to buy, no other disadvantages can be seen.
According to Zheng Xueqian, vice president of the Chinese Society of Health Law, in-hospital preparations are the product of a special era. At the beginning of the founding of New China, due to the backwardness of my country's pharmaceutical industry, the production and supply of drugs could not meet social needs. Therefore, the state encouraged hospitals to make their own Research and develop medicines for internal use in hospitals to fill market gaps.
This move promoted the development of in-hospital preparations, and many hospital preparations were formed during this period.
"At the same time, some hospital preparation rooms also have problems such as many varieties, miscellaneous dosage forms, rough preparation quality standards, and backward testing equipment." Zheng Xueqian said that in-hospital preparations can only be purchased by patients at their own expense, and cannot be reimbursed through medical insurance, "because in-hospital preparations It is to facilitate doctors to treat patients and achieve better results of diagnosis and treatment, not to promote it in the market, so its pricing is not for profit, there is a special pricing formula, which is sent by medical institutions to the national price management department for reporting, There is no zero spread problem.”
Despite its flaws, in-hospital preparations have become a new "top stream" because of their low prices and "endorsements" by hospitals, and they have many fans.
The reporter's investigation found that on various social platforms, there are many people who like Jia Xiaoqi respect the preparations in the hospital.
Searching with keywords such as "hospital's own medicine", "hospital magic medicine", and "in-hospital preparations", you can see a large number of posts by netizens sharing relevant medical treatment experiences and recommending in-hospital preparations. Easy-to-use hospital-made medicine."
In the comment area of these posts, many netizens are asking for recommendations and purchases.
Beijing resident Yan Bei is keen to search for "magic medicines" made by various hospital skin research on social platforms.
She showed reporters a screenshot of her drug "Zhongcao", including a topical drug for acute exudative dermatitis or eczema developed by the dermatology research of a tertiary hospital in Beijing, "This ointment can only be prescribed by the dermatology department of this hospital. If you get it, you can only buy one at a time, and the unit price is 6 yuan.”
The reporter noticed that the label of the drug stated that "this preparation is only for use in this medical institution", and its approval number was "Jingyao Zhizi".
"On social platforms, this kind of 'small medicine' sharing blog is very popular, and almost every article has many users 'begging for purchasing'." Yan Bei told reporters that in addition to offline medical treatment, purchasing agents also buy such in-hospital preparations One of the methods of ointment.
demand-driven market
Purchasing free pricing
According to regulations, in-hospital preparations can only be purchased in the research and development hospital, but the huge demand has spawned an online sales chain.
The reporter searched and found that under some posts and blog posts mentioning the pharmaceuticals in the hospital, from time to time netizens asked "can I buy it on behalf of someone", and most bloggers would reply "can be on behalf of".
"Sometimes I see someone recommending some dermatology drugs on social platforms. I will go to the e-commerce platform to search for the name of this drug, and I will see that there are daigou selling these drugs." Yan Bei said.
The reporter searched for the name of the ointment mentioned by Yan Bei on an e-commerce platform, and found that there are indeed merchants engaged in purchasing, and the drugs of several well-known tertiary hospitals in Beijing are within the scope of their purchasing.
In order to avoid risks, some merchants have started purchasing business on social platforms, claiming to "sell preparations in major hospitals" and "provide various medical services".
After the reporter contacted a purchasing agent and added his private chat account, the other party said that "the preparations in the hospitals in the top three hospitals in Beijing can be purchased, and there are also channels in the hospitals outside the city, but it will take longer."
His circle of friends has published many self-made medicines from hospitals, with a variety of copywriting, such as "The popular trauma cream, the best gift for parents! XX hospital star products! Now this season, there are many people with leg pains and arm pains. The effect of smearing is great! National athletes' special medicine" "Treasure of the largest hospital of traditional Chinese medicine in Asia, compound Suanzaoren ointment, life-saving straw for people with insomnia" "The nemesis of various gastritis, Weishu Capsule, 30 years of clinical trials in × × Hospital The results of scientific research have solved the pain for countless stomach patients"...
After asking the price, the reporter found that the price of the in-hospital preparations it sold was more than double the original price.
Taking acne liniment as an example, the official website of the hospital is clearly priced at 30 yuan a bottle, and its price is 80 yuan, excluding postage.
Regarding the pricing, the purchasing agent explained that all the medicines in his hands are regular medicines issued by registration, and the registration fee, labor fee, errand fee, etc. are added to the original price.
Issues such as arbitrary pricing and sky-high asking prices are nothing new among the in-hospital pharmaceutical agents.
The reporter found from a purchasing agency that can buy self-made medicines in a hospital in Nanjing that it publishes a video of himself queuing up to buy medicines in the hospital once a month. The names of the four people appeared repeatedly, and the diagnosis column basically showed common skin symptoms such as "post-inflammatory hyperpigmentation", "eczema", and "hair loss". On average, 3 to 5 kinds of ointments were purchased at a time, and some ointments were prescribed 2 at a time. Branches, and some can open 10 to 20.
During the exchange between the reporter and the purchasing agent, the other party stated that the ointment was not restricted to purchase, and the final transaction price of the "nicotinamide gel" purchased by the reporter was more than four times the price stated by some users on the social platform.
The outer seal of the purchased ointment also showed "This preparation is only for use by this medical institution", the approval number is "Su Yao Zhi Zi", and the shelf life is less than 1 year.
Another purchasing agent recommended a set of in-hospital preparations to improve the skin to the reporter, saying that the medicines were obtained through hospital registration and were "absolutely reliable".
The original price of the relevant drug hospital is 55 yuan for a set, plus the registration fee and errand fee, and the purchasing price is 120 yuan for a set.
Purchasing and running
It is difficult to distinguish between true and false drugs
It is worth noting that the reporter's investigation found that the purchasing of pharmaceutical preparations in the hospital has almost become a "group".
Through the search, the reporter added several in-hospital preparations purchasing agents, and found that their circle of friends all claimed that "experts can be registered on behalf of experts, special effects medicines can be prescribed on behalf of major hospitals in Beijing, and medical beauty cosmeceuticals are available."
When the reporter asked one of the purchasing agents if they had stockpiled goods for distribution, the other party explained that: at present, the hospitals are strictly controlled, and they cannot prescribe enough at one time. The price can be reduced.
The reporter asked how to ship 80 sets at one time, and the other party said that it would take about a week to send them out one after another.
"In order to avoid overstocking, this line seldom stockpiles goods, so it is currently impossible to prescribe such a large amount of medicine, and it is necessary to find a partner to 'borrow medicine'." The purchasing agent said.
The above-mentioned one is not the only one who mentioned the "partnership system" of in-hospital preparations purchasing.
There are also purchasing agents who bluntly stated that the "scalpers" of preparations in the hospital have formed their own "small circle", and each purchasing agent has a different "mouth".
When the reporter asked a self-made drug purchaser from Nanjing XX Hospital about the regular medicines for children, the other party said that he no longer makes medicines in the children's hospital, and has given this "mouth" to others to run away, but he can recommend other purchasing agents to the reporter. .
The reporter contacted another purchasing agent through his business card recommendation.
During the investigation, the reporter also asked for medicine in the name of pubic pain, and a purchasing agent recommended the "magic medicine" of a well-known orthopaedic hospital in Beijing.
When the reporter searched for the drug on the Internet, they found a website dedicated to purchasing medicines made by hospitals in Beijing. The page design is perfect, and the packaging is no different from the official company website.
The composition of the website section includes the self-pharmaceutical display of major hospitals in Beijing, the introduction of major hospitals in Beijing, news information and contact information. There are many hospitals involved, and each hospital has a very detailed introduction page.
There are 200 kinds of hospital-made medicines that can be purchased on behalf of others, including most of the "magic medicines" made by hospitals.
In the news information column, there is a message saying, "All medicines are purchased on behalf of the registration, please rest assured to use, it is definitely the genuine product of the hospital".
The site also uses code words to notify buyers of the latest drug arrivals.
In the contact information column, the seller's various platform account numbers are attached.
Mr. Ma, a pharmaceutical representative who has been in the business for two years, revealed that the purchasing agent generated by the preparations in the hospital is different from that of the pharmaceutical representative: the business method of the pharmaceutical representative is to obtain the agency rights for the medicine, and negotiate cooperation with the relevant hospitals and surrounding pharmacies to provide the partners with medicines , Many medical representatives choose to "wait for the rabbit" outside the clinic, and when the patient comes out, they recommend their own medicines, so as to open up sales; and today's in-hospital preparations require a registered prescription before they can be prescribed.
"Although all daigou claim that their sources of medicines are absolutely legitimate and that they are obtained by personal registration, it is actually difficult to guarantee." Mr. Ma said.
A doctor of traditional Chinese medicine in a hospital in Beijing also told reporters that in-hospital preparations are prescription drugs, not what patients can buy if they want, and the dosage is determined by the doctor according to the patient's condition. The purchasing agent may be selling fake goods.”
Abuse without face-to-face
Risk not to be underestimated
In addition to looking for purchasing agents to buy in-hospital preparations, online consultation has now become another "off-the-beaten-path".
On the social platform, a blogger gave the whole process of purchasing in-hospital preparations through compliant channels for online consultation: Click "Medical Services" in "Internet Medical" under the "XX Health Link" official account to complete the registration After that, you can choose a hospital for "online follow-up".
The reporter noticed after the experience that during this process, the platform will repeatedly remind those who do not have an offline initial diagnosis record that they cannot conduct online follow-up visits, which not only limits the number of service purchases within one month and one day, and when filling in the "diagnosis details" It is also necessary to upload a photo of the medical record of the most recent visit, and indicate that the doctor has the right to determine whether the picture is compliant, and the non-compliant will be refunded directly. The price of a single service is 12 yuan.
However, although the reporter only uploaded pictures of partial skin on the face, he also received a "re-visit" from the doctor.
After a brief description of the condition, the doctor prescribed 3 ointments of vitamin e cream, niacinamide gel and arbutin ointment, and explained how to use it and how to express it.
On some social platforms, there are also many netizens who provide their own methods of obtaining these ointments through online follow-up without initial consultation, such as providing themselves with the name of the doctor who prescribes the medicine, changing to a cosmetic surgery department to prescribe medicine, etc.; and Netizens said they spent two or three hundred yuan on dozens of ointments with different effects.
However, is it really safe to buy and use hospital preparations at will?
A pharmacist in charge of the pharmacy department of a tertiary hospital introduced to reporters that the general approval number of a listed drug is "National Medicine Zhunzi", such as "Z" for traditional Chinese medicine; while the in-hospital preparations are produced by the hospital itself, and the level of the approval number has no national level. so tall.
She also said that in general, the shelf life of preparations in hospitals is relatively short, and there are certain safety risks in the absence of face-to-face consultation. It is not recommended for patients to choose purchasing.
Taking the "myopia magic drug" atropine as an example, Zheng Xueqian told reporters that atropine eye drops is an anticholinergic drug and an M-receptor blocker.
Clinically, there are many side effects and contraindications, which may lead to blocked sweating, high fever, dry mouth, nose and throat, blurred vision, skin flushing, difficulty urinating, rarely increased intraocular pressure, allergic rash or herpes and other adverse reactions.
Long-term use of this drug in eye drops can cause local allergic reactions and drug contact blepharoconjunctivitis.
Even low-concentration atropine should not be used indiscriminately. Patients should follow the prescription and doctor's instructions to use the drug rationally under the guidance of the doctor to ensure the safety of the drug.
Comics / Gao Yue