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In China, Desperate Patients Smuggle Drugs. Or Make Their Own.
Despite health insurance, terminally ill patients have to hunt around the world and on the internet for ways to stay alive.
Video
0:31
9:13
How China Creates Cancer Refugees
By Jonah M. Kessel
A rural resident in China is 30 percent more likely to die after a cancer diagnosis than an urban resident. Three rural families trying to beat these odds — “cancer refugees” — share their stories of battling the disease far from home and the financial ruin it causes.Published OnNov. 11, 2018
By Sui-Lee Wee
JINZHOU, China — Zhang Zhejun used a fat plastic straw to gently tap the pale yellow pharmaceutical powder onto a piece of silver foil that lay on an electronic scale. He made sure the amount was just right before he poured it into a clear capsule.
When you’re making cancer drugs at home, the measurements must be precise.
Mr. Zhang has no medical experience and no background in making drugs professionally. He did this out of desperation. His mother suffered from lung cancer and required expensive drugs that China’s ambitious but troubled health care system couldn’t provide.
He was aware of the risks. The drug he was making hadn’t been approved by regulators in China or the United States. Mr. Zhang had bought the raw ingredients online, but he wasn’t sure from whom, or whether they were even real.
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ADVERTISEMENT
To stay alive, many sick people in China — and the people who love them — break the law. Online marketplaces are filled with illegal pharmaceuticals. Dealers run underground pharmacies. In some cases, cancer patients and their families make the drugs themselves, finding the ingredients and the instructions online.
China’s challenges are playing out globally. Many of the same problems have pit world leaders, including President Trump, against big pharmaceutical companies. The companies complain about regulatory hurdles and approval delays. High drug prices have roiled trade talks.
China’s Health Care Crisis: Lines Before Dawn, Violence and ‘No Trust’
China is trying to relieve its overwhelmed system by introducing more family doctors. But in a country where people rush to hospitals for a fever, change won’t be easy.
Sept. 30, 2018
VIDEO
How Capitalism Ruined China’s Health Care System
Homemade cancer drugs, violence in hospitals, doctor shortages: We take you inside China’s broken health care system to reveal how dire the situation is for over a billion people.
Sept. 30, 2018
Lower prices send Americans to Canada and Mexico looking for the medicines they need. Patients from Russia to Britain desperately hunt for drugs through online “buyers’ clubs” — networks that scour the world for cheaper generic medicines.
In China, the public has become increasingly concerned about access to drugs, putting pressure on the leadership. This summer’s box-office hit “Dying to Survive” was based on the real-life story of a Chinese leukemia patient who ran a buyers’ club, smuggling generic drugs from India to save himself and others. It was almost universally lauded for shedding light on the difficulties of getting cancer drugs in China.
The movie’s popularity prompted Premier Li Keqiang to call for speeding up price cuts for the medication. China’s growing affluence has led to greater expectations among its people. The Communist Party’s grip on power depends heavily on providing improved opportunities for the public, including better health care.
“I don’t know whether they can do that,” said Zhou Jun, the executive director of the U.S.-China Healthcare Cooperation Program in Beijing, a group that fosters closer working relations between the countries. “It’s going to be a challenge.” (Mr. Zhou died of cancer several months after speaking to The New York Times.)
more innovative, less costly pharmaceuticals to combat life-threatening diseases.
Still, the agency remains short staffed. China had roughly 600 reviewers at the end of 2016, compared with thousands in the United States.
Once approved, the drugs have to qualify for coverage under one of China’s insurance plans. That means earning a spot on the National Reimbursement Drug List — and that can take years. Beijing added 36 drugs to the list in 2017 and 17 this year. The last update was in 2009.
When the drugs do arrive, many Chinese patients, like Yao Xianghua, can’t afford them, even if they have government coverage.
A petite former elementary school teacher with blunt bangs, Ms. Yao had lung cancer that didn’t respond to surgery or a form of treatment called biotherapy. She was 68 in 2011, when the cancer was first diagnosed, and she felt she was too old to undergo chemotherapy and radiation.
“I give up,” she told her son, Zhang Zhejun. “I’m resigned to my fate.”
Her doctor prescribed Iressa, a drug made by AstraZeneca that keeps cancer cells from multiplying. The drug had been added to the reimbursement drug list after AstraZeneca agreed to halve the price to just under $1,000 a month.
It was still too expensive. Ms. Yao was covered by China’s “rural cooperative medical scheme,” which provides only modest benefits compared with the insurance for urban residents. She received a monthly pension of $460. Her son said the rural scheme at that time did not pay for imported drugs.
Mr. Zhang vowed to save her. He quit a decent-paying job and moved in with his parents in a barely furnished apartment in Jinzhou, a largely industrial and heavily polluted city.
Mr. Zhang discovered that India made a cheaper, generic version of Iressa. It worked for a while. But Ms. Yao developed a resistance to it after about nine months. Mr. Zhang needed alternatives.
He went online.
Do-It-Yourself Drugs
China in recent years has become the world’s largest home of internet users. Many Chinese now shop almost exclusively in internet bazaars that offer everything from groceries and hot meals to jewelry and cars.
They can also buy pharmaceuticals — even the raw ingredients to illegally make drugs themselves.
Many start on forums devoted to patients and their loved ones when they can’t get answers anymore. The two most popular are “I Want Miracles,” which is dedicated to helping people with lung cancer, and “Dances With Cancer.” The forums combined have just over 440,000 members.
“This is the current state of health care in China,” said Chen Yun, who runs “I Want Miracles.” “Every doctor is just too busy, and there’s no way that they can explain many things to you clearly. But if you want to figure it out, you just have to learn by yourself.”
https://www.nytimes.com/2018/11/11/business/china-drugs-smuggled-homemade.html
Despite health insurance, terminally ill patients have to hunt around the world and on the internet for ways to stay alive.
Video
0:31
9:13
How China Creates Cancer Refugees
By Jonah M. Kessel
A rural resident in China is 30 percent more likely to die after a cancer diagnosis than an urban resident. Three rural families trying to beat these odds — “cancer refugees” — share their stories of battling the disease far from home and the financial ruin it causes.Published OnNov. 11, 2018
By Sui-Lee Wee
- Nov. 11, 2018
JINZHOU, China — Zhang Zhejun used a fat plastic straw to gently tap the pale yellow pharmaceutical powder onto a piece of silver foil that lay on an electronic scale. He made sure the amount was just right before he poured it into a clear capsule.
When you’re making cancer drugs at home, the measurements must be precise.
Mr. Zhang has no medical experience and no background in making drugs professionally. He did this out of desperation. His mother suffered from lung cancer and required expensive drugs that China’s ambitious but troubled health care system couldn’t provide.
He was aware of the risks. The drug he was making hadn’t been approved by regulators in China or the United States. Mr. Zhang had bought the raw ingredients online, but he wasn’t sure from whom, or whether they were even real.
On Instagram, Seeing Between the (Gender) Lines
This City’s Overdose Deaths Have Plunged. Can Others Learn From It?
Dorm Living for Professionals Comes to San Francisco
ADVERTISEMENT
To stay alive, many sick people in China — and the people who love them — break the law. Online marketplaces are filled with illegal pharmaceuticals. Dealers run underground pharmacies. In some cases, cancer patients and their families make the drugs themselves, finding the ingredients and the instructions online.
China’s challenges are playing out globally. Many of the same problems have pit world leaders, including President Trump, against big pharmaceutical companies. The companies complain about regulatory hurdles and approval delays. High drug prices have roiled trade talks.
China’s Health Care Crisis: Lines Before Dawn, Violence and ‘No Trust’
China is trying to relieve its overwhelmed system by introducing more family doctors. But in a country where people rush to hospitals for a fever, change won’t be easy.
Sept. 30, 2018
VIDEO
How Capitalism Ruined China’s Health Care System
Homemade cancer drugs, violence in hospitals, doctor shortages: We take you inside China’s broken health care system to reveal how dire the situation is for over a billion people.
Sept. 30, 2018
Lower prices send Americans to Canada and Mexico looking for the medicines they need. Patients from Russia to Britain desperately hunt for drugs through online “buyers’ clubs” — networks that scour the world for cheaper generic medicines.
In China, the public has become increasingly concerned about access to drugs, putting pressure on the leadership. This summer’s box-office hit “Dying to Survive” was based on the real-life story of a Chinese leukemia patient who ran a buyers’ club, smuggling generic drugs from India to save himself and others. It was almost universally lauded for shedding light on the difficulties of getting cancer drugs in China.
The movie’s popularity prompted Premier Li Keqiang to call for speeding up price cuts for the medication. China’s growing affluence has led to greater expectations among its people. The Communist Party’s grip on power depends heavily on providing improved opportunities for the public, including better health care.
“I don’t know whether they can do that,” said Zhou Jun, the executive director of the U.S.-China Healthcare Cooperation Program in Beijing, a group that fosters closer working relations between the countries. “It’s going to be a challenge.” (Mr. Zhou died of cancer several months after speaking to The New York Times.)
more innovative, less costly pharmaceuticals to combat life-threatening diseases.
Still, the agency remains short staffed. China had roughly 600 reviewers at the end of 2016, compared with thousands in the United States.
Once approved, the drugs have to qualify for coverage under one of China’s insurance plans. That means earning a spot on the National Reimbursement Drug List — and that can take years. Beijing added 36 drugs to the list in 2017 and 17 this year. The last update was in 2009.
When the drugs do arrive, many Chinese patients, like Yao Xianghua, can’t afford them, even if they have government coverage.
A petite former elementary school teacher with blunt bangs, Ms. Yao had lung cancer that didn’t respond to surgery or a form of treatment called biotherapy. She was 68 in 2011, when the cancer was first diagnosed, and she felt she was too old to undergo chemotherapy and radiation.
“I give up,” she told her son, Zhang Zhejun. “I’m resigned to my fate.”
Her doctor prescribed Iressa, a drug made by AstraZeneca that keeps cancer cells from multiplying. The drug had been added to the reimbursement drug list after AstraZeneca agreed to halve the price to just under $1,000 a month.
It was still too expensive. Ms. Yao was covered by China’s “rural cooperative medical scheme,” which provides only modest benefits compared with the insurance for urban residents. She received a monthly pension of $460. Her son said the rural scheme at that time did not pay for imported drugs.
Mr. Zhang vowed to save her. He quit a decent-paying job and moved in with his parents in a barely furnished apartment in Jinzhou, a largely industrial and heavily polluted city.
Mr. Zhang discovered that India made a cheaper, generic version of Iressa. It worked for a while. But Ms. Yao developed a resistance to it after about nine months. Mr. Zhang needed alternatives.
He went online.
Do-It-Yourself Drugs
China in recent years has become the world’s largest home of internet users. Many Chinese now shop almost exclusively in internet bazaars that offer everything from groceries and hot meals to jewelry and cars.
They can also buy pharmaceuticals — even the raw ingredients to illegally make drugs themselves.
Many start on forums devoted to patients and their loved ones when they can’t get answers anymore. The two most popular are “I Want Miracles,” which is dedicated to helping people with lung cancer, and “Dances With Cancer.” The forums combined have just over 440,000 members.
“This is the current state of health care in China,” said Chen Yun, who runs “I Want Miracles.” “Every doctor is just too busy, and there’s no way that they can explain many things to you clearly. But if you want to figure it out, you just have to learn by yourself.”
https://www.nytimes.com/2018/11/11/business/china-drugs-smuggled-homemade.html
