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according to economic observer, a father wrote a story about seeking medical treatment: his child was treated in a hospital in zhejiang for mycoplasma pneumonia. among the drugs for symptomatic treatment, the hospital could only give the child a domestic azithromycin, not an imported original drug. after two days of intravenous drip, the child still had a high fever, and the fever did not subside until he was transferred to another hospital and switched to an injection of an imported original drug, pfizer's zithromax. the father asked: why did the imported drugs that were previously available disappear?

first of all, we should clarify that we cannot easily judge that the side effects of domestic generic drugs are definitely greater than those of original drugs based on the subjective description of the parents, nor can we assert that domestic generic drugs are ineffective. in clinical practice, there is a saying that "lucky doctors treat the end of the disease." the disease itself has a course of disease, and it takes a certain amount of time for the drug to take effect after use. the fever subsided after switching to imported drugs on the third day, and it is difficult to rule out the efficacy of the domestic generic drugs "laid down" before.

however, the parent of the child raised a very important clue: imported original drugs like xishumei are indeed not easy to get in the hospital.

the original intention of the national healthcare security administration was to help patients save money. in 2021, the national healthcare security administration guided the national drug procurement office to implement the fifth batch of national drug volume procurement. pfizer's imported original drug was not selected due to its high bid. it is natural for high-priced bidders to be eliminated, but patients' right to choose medicines should also be guaranteed. a current reality is that drugs that are not selected in the centralized procurement are difficult to enter hospitals, and patients have little choice.

in fact, the national healthcare security administration has never said that hospitals cannot purchase drugs that are not selected in the centralized procurement. however, in order to balance the use of the selected varieties in the centralized procurement, the national healthcare security administration has set several prerequisites: first, within a one-year cycle, hospitals participating in the centralized procurement must first complete the use of the selected varieties in the centralized procurement (the hospital shall declare the use independently) before they can use the unselected varieties in the centralized procurement. generally speaking, the unselected varieties in the centralized procurement can be allocated no more than 30% of the space. otherwise, the "quantity" of centralized procurement with volume will lose its meaning. under this policy, some hospitals simply "one size fits all" to only purchase the selected drugs in the centralized procurement in order to meet the medical insurance assessment indicators, and do not purchase unselected drugs at all.