Ineffective' generic drugs fuel rare public anger in China

Public anger in China over concerns raised by doctors that generic drugs used in public hospitals are increasingly ineffective has led to a rare response from the government.Doctors say they believe the country's drug procurement system, which incentivises the use of cheap generic drugs over original brand-name pharmaceuticals, has led to costs being cut at the expense of people's safety.

But officials, quoted by multiple state media outlets on Sunday, say the issue is one of perception rather than reality.One report said different people simply had different reactions to medicines and that claims about them being ineffective had "mostly come from people's anecdotes and subjective feelings".The official response has done little to allay public fears over the reputation of drugs in public hospitals and pharmacies. It is the latest challenge to a healthcare system that is already under enormous strain because of a rapidly ageing population.The debate surrounding the use of generic drugs began in December, when authorities announced the list of nearly 200 companies that had won contracts to sell medicines to Chinese state hospitals. Almost all were domestic makers of generic pharmaceuticals.

This intensified in January, when, in a video interview that went viral, the director of a hospital department in Shanghai, shared his concerns about the drug procurement system.Zheng Minhua cited "antibiotics that cause allergies, blood pressure that won't go down, anaesthetised patients who won't sleep" and laxatives that did not clear the bowel as being among the issues that had been encountered.Dr Zheng's words immediately struck a chord and have been condensed into a social media slogan that has been viewed by millions in the past month - though much of the discussion of the topic has since been censored on Weibo. Many people have come forward to share their own bad experiences with alleged substandard drugs.

"I underwent intestinal surgeries in 2024, which required me to consume laxatives beforehand," one Weibo user wrote. They said the drugs they were given had "no effect whatsoever", even after the dose was doubled, and that they had to turn to drinking coffee to help clear their bowel The concerns raised over the efficacy of generic drugs has caused distrust and made some people unwilling to use them.

A person on Xiaohongshu, China's Instagram-like app, said that when hospital doctors prescribed them the generic version of an antibiotic, they immediately went online to buy the "original" "real" one, since the generic version "tasted different There have been many people catching colds recently. A lot of them might have bought this drug. Quickly send reminders to your friends now and get them to check the brand before buying," the user warned.

Some of the most popular posts discussing the procurement controversy have been taken down, though it is unclear by whom. China's heavily monitored internet has a strong culture of censorship by both authorities and users themselves.In a scathing, now-removed post by popular podcast host Meng Chang, he lambasted the lack of imported drugs in the public sector: "If this isn't a bottom line, I don't know what is."

Public anger has also been focussed on the difficulties of accessing imported drugs that people believe to be of better quality.

In response to authorities' attempt to reassure people of the quality of generic drugs, one Weibo user wrote: "As long as we are allowed to buy brand-name drugs ourselves, I have no other complaints."