In China, Desperate Patients Smuggle Drugs. Or Make Their Own

JINZHOU, China, 11 Nov 2018: 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.

“We’re not picky. We don’t have the right to choose,” he said. “You just hope the sellers have a conscience.”

It’s a desperation born out of necessity. China’s aging population is increasingly stricken with deadly diseases like cancer and diabetes, but many can’t find or afford drugs.

The country’s rudimentary insurance system doesn’t begin to cover the ever-rising prices of treatments and drugs. Coverage also depends on where somebody lives, and some rural residents still lack access to certain drugs.

Despite a costly new safety net from the government, illness remains the leading reason Chinese families fall below the poverty line, according to official figures.

Many of China’s problems are self-inflicted. Major bureaucratic hurdles keep lifesaving drugs out of the reach of millions who need them. Drug approvals, while accelerating, remain dauntingly backlogged. Until October last year, pharmaceuticals approved in the United States and Europe had to go through an extensive vetting process in China. Even now, foreign-made drugs have to clear another hurdle before insurance companies will pay for them.

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.

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.”The New York Times