A panoramic analysis of traditional Chinese medicine injection

In China's drug market, besides chemicals, there are also proprietary Chinese medicines with Chinese characteristics. Among proprietary Chinese medicines, traditional Chinese medicine injections, as a modern product, have always been the most concerned. According to statistics, the market size of traditional Chinese medicine injections has exceeded 100 billion yuan in 2016. However, from the market feedback in recent years, traditional Chinese medicine injections have repeatedly fallen into the situation of constant doubts. The chain reaction caused by the recent step-by-step pharmaceutical incidents and Wang Zhian's comments on traditional Chinese medicine injections have pushed traditional Chinese medicine injections into a hot topic in the industry. Since the first Chinese traditional medicine injection Bupleurum Injection came out in 1940. Now, it has been nearly 80 years. In the early days of the founding of New China, drug supervision was not perfect, and a large number of "new drugs" emerged in the chaotic situation of disorderly running pharmaceutical factories and abusing pharmaceutical products. It is at this time that the development of traditional Chinese medicine injections began in large quantities. The 1953 edition of the Chinese Pharmacopoeia did not include injections of traditional Chinese medicine. By 1963, there were four kinds of injections of traditional Chinese medicine in the form of chemical medicine, while the 1977 edition of the Chinese Pharmacopoeia contained 24 kinds of injections of traditional Chinese medicine, which was the peak of the collection. 

In view of the feedback problem of Chinese traditional medicine injection market, the state has taken measures to manage it from various aspects. The instructions have been revised many times, including Xiaocangping Injection, Shuanghuanglian Injection, Qingkailing Injection, Shenmai Injection, Ciwujia Injection, Xuesaitong Injection, Thrombosis Injection, Bupleurum Injection, Yinzhihuang Injection, Breviscapine Injection, Shuxuening Injection, Houttuynia Injection, Xingnao Injection, Notoginsenoside Injection, Radix Astragali Injection, Danxiangguanxin Injection, Golden Fish Injection. Compound dandelion ejection, Lianbizhi ejection and Chuanhuning ejection, among which there are many restrictions on the use of children and pregnant women. In addition to the instructions, the 2017 edition of the Medical Insurance Catalogue restricts the use of 38 traditional Chinese medicine injections, as shown below. Medical insurance restriction is only the beginning. In December 2018, the National Health Commission issued the Notice on Doing a Good Job in Clinical Application Management of Auxiliary Drugs, emphasizing that the national version of the catalogue of Auxiliary Drugs will be formulated and published, and on the basis of the national version, provincial and Varieties shall not be less than the national catalogue. At the same time, the proportion of supplementary drug revenue is listed as the assessment content of tertiary public hospitals. When drugs enter the list of auxiliary drugs, they will face the risk of being strictly controlled by public hospitals or even discontinued. Previously, the number of traditional Chinese medicine injections was prominent in the local auxiliary drug catalogues. Referring to the local situation, the national version of the auxiliary drug catalogue has a high voice for traditional Chinese medicine injections. In addition to the crisis of supplementary drug catalogue, traditional Chinese medicine injections are also facing restrictions on their use. For example, in April 2019, Hunan Pharmaceutical Centralized Purchasing Platform issued the Notice on Adjusting the Use of Some Essential Drugs in Primary Medical Institutions, which excluded traditional Chinese medicine injections from primary medical institutions. In fact, there are 10 traditional Chinese medicine injections in the basic medicine catalogue, and they are ranked on the top of the list for two consecutive editions. Six of them have sold more than 100 million products and three of them have sold more than 1 billion products. In addition to Bupleurum injection, the other nine drugs are still limited in the use of medical insurance. If the grass-roots units are not included in the use trend, they will face a greater blow and the future is worrying.