In recent years, traditional Chinese medicine injections have been controversial, and have even been repeatedly "black", and the scope of their use has been restricted. According to the 2017 version of the national basic medical insurance drug catalog, the grass-roots use of traditional Chinese medicine injection varieties increased from 6 in 2009 to 26, and can only be used in the second hospital. In fact, whether or not it can enter the medical insurance catalog determines the life and death of a drug in the market. If it does not enter the medical insurance catalog, it is bound to suffer a devastating blow.
Chinese medicine injections are restricted because their safety has been questioned. So, is traditional Chinese medicine injection really unsafe?The 2015 National Adverse Drug Reaction Monitoring Network showed that among the medicines with adverse reactions, chemical drugs accounted for 81.2% and traditional Chinese medicines accounted for 17.3%. Compared with Western medicines, the adverse reaction rate of Chinese medicine injection is not high. In terms of the principle of medication, it should be taken orally not intramuscularly, and it should be injected intramuscularly not by infusion, because the risk of intravenous injection is the highest, and Chinese medicine injection is no exception. However, Chinese medicine injections have a rapid onset of action in the clinic, and if doctors use them appropriately, the benefits to the patient outweigh the risks. Analysis of national adverse drug reaction monitoring data shows that the grassroots level has become a high risk area for the safety of Chinese medicine injection, mainly due to irrational use. Among the adverse reactions occurring in TCM injections, more than 40% of them are due to the combined use of medicines. This means that the occurrence of adverse reactions is not simply a problem of Chinese medicine injection. This, coupled with the more limited treatment equipment and facilities in primary healthcare organizations, and the relative lack of experience and ability of healthcare personnel in treatment, affects the effectiveness of resuscitation and prognosis. Therefore, the safety problem of Chinese medicine injection is mainly due to improper use and not entirely a fault of the drug itself.
Chinese medicine injection, unlike antibiotics, does not need to be strictly limited to doctors. Chinese medicine injections are still essentially Chinese medicine, just a different route of administration, designed to improve the body's immunity and make the shield of defense stronger, and there is absolutely no need to restrict their use based on the level of hospitals and doctors. To prevent the safety risks of Chinese medicine injections, it is better to prevent them from being used than to block them, and the use of them by the grassroots should not be restricted, or else they will be choked off. Training grassroots doctors to standardize their use is the right way to reduce safety risks.
The advantages of TCM injection are irreplaceable in solving the problem of difficult and expensive grass-roots visits to the doctor. Historical data show that 60%-70% of Chinese medicine injections are used in primary hospitals, and the grassroots is the "main battlefield". If restrictions are placed on the use of Chinese medicine injections at the grassroots level, it would be contrary to the national basic drug system. For example, of the 26 Chinese medicine injections whose use has been restricted, seven are national essential medicines. The Measures for the Administration of the National Catalogue of Essential Medicines stipulate that "all government-organized primary healthcare institutions are equipped with and use essential medicines, and all other types of healthcare institutions must use essential medicines in accordance with the regulations." Taking Qingkailing injection as an example, the drug made great achievements during the SARS period, and is indispensable clinically, is a national strategic reserve drug, and is widely used in primary medical institutions. Through administrative means to force the use of drugs to limit the scope of reimbursement, contrary to the original intention of the national system of essential medicines, this is a typical departmental policy "fight", the victims are the grassroots people. If the people can not use the medicine, have to go back to the big hospitals, not only is not conducive to the hierarchical diagnosis and treatment, but also aggravate the economic burden of patients. The most reasonable explanation for restricting the use of Chinese medicine injections is cost control, as the medical insurance department is the "big manager" of medical insurance funds. In fact, the grassroots use of Chinese medicine injection is not a fee increase, but a fee reduction. Many varieties of Chinese medicine injections have an average daily cost of no more than 5 yuan, which belongs to the national standard for low-cost drugs. From the point of view of cost control, Chinese medicine injection should not be limited to the use of varieties, but should be encouraged to use varieties.
Chinese medicine is China's original advantage of scientific and technological resources, contains a huge potential for innovation. Compared with the traditional pills and creams, Chinese medicine injection has only 70 years of history, but has become the most clinically used varieties of traditional Chinese medicine, which can be called a "heavy bomb" originating from the Chinese mainland. Looking forward to the relevant departments for the Chinese medicine injection name to loosen the bondage, so that the innovative gene of the traditional medicine to grow tall and grow up, for the health of China to make new achievements.