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Opinion: China Must Wake Up to Injustice of High Drug Prices

* 2014 drug-smuggling case, in which defendant was convicted of bringing in cancer-fighting drugs, had Chinese citizens questioning the court’s idea of justice

* Some laws managing the pharmaceutical industry are contrary to the goal of saving lives, and it is time to rethink those rules

(Beijing) — China’s national team may not have made it to the World Cup, but “Dying to Survive,” a Chinese film based on a true story, has certainly scored many goals in the hearts of the country’s movie buffs.

The plot of “Dying to Survive,” which premiered in June to critical acclaim, is very simple. The year is 2002, and the place is Shanghai. Protagonist Cheng Yong, played by Chinese star Xu Zheng, is not a good man. He used to abuse his wife, and he has found himself with a mountain of debt after his divorce. Cheng’s only source of income is the small “pharmacy” he runs, called Prince’s Indian Miracle Oil Store. “Indian Miracle Oil” is an ointment, actually made in Hong Kong, that used to be popular among Chinese men as a purported cure for sexual dysfunction.

One day, an unexpected visit by leukemia patient Lü Shouyi turns Cheng’s life upside down. In order to stay alive, Lü must regularly take drugs imported from Switzerland that cost up to hundreds of thousands of yuan a year. Lü has found out about a much-cheaper generic drug manufactured in India, and he asks if Cheng will help him smuggle the drugs into China from India.

Cheng agrees. His business grows, attracting many cancer patients, who call him the “Medicine God.” But Cheng also attracts the attention of the Chinese police, who accuse him of breaking the law.

At one point in the film, Cheng asks, “What’s so illegal about wanting to stay alive?” That is the question at the core of this film.

I had previously written a very similar article about this topic, so when I first saw “Dying to Survive,” I wondered if the producers had plagiarized my work. After some research, I realized that the filmmakers and I had drawn our inspiration from the same true events, which happened a few years ago.

In 2014, a Shenzhen court sentenced a man to 13 years in prison and fined him 15 million yuan (about $2.4 million at the time) for “producing and selling counterfeit drugs.” Media reports said the man in question had smuggled drugs into the country that hadn’t been approved by the Chinese government, and then sold these drugs to cancer patients. The smuggled goods included the chemotherapy drug Melphalan, and Imatinib, which is used to treat leukemia.

As a doctor, I understood how the court’s idea of justice in this case could be hard for China’s disadvantaged citizens to swallow.

China has high rates of malignant-tumor diagnoses, and a diagnosis can be a huge emotional and financial shock for a family. Expensive treatment frequently plunges families into poverty, thanks to an inadequate medical insurance system. The drugs smuggled in the Shenzhen case have proved effective, and are favored by medical professionals and patients around the world. However, the brand-name versions of these drugs can be incredibly expensive, costing patients hundreds of thousands of yuan for each course of treatment, an amount few Chinese families can afford.

Yet, many patients and their families will hear tantalizing rumors of cheap, generic versions of the same drugs, available in neighboring India. But these generic drugs are banned in China because they violate other countries’ patent laws.

It’s true that it often costs billions of dollars to develop a drug. But once it has been developed, the costs of producing it are usually very low. As a member of the World Trade Organization, China has strict pharmaceutical patent protections in place. This means that even while the country’s hospitals teem with gravely ill patients who desperately need expensive foreign drugs, China cannot use the technology it already has to produce cheaper versions of these drugs.

So why has India become the world’s pharmacy? India produces huge volumes of cheap generic drugs a year. Not only do these drugs have huge appeal for customers in developing countries, they are also popular in the U.S., Europe, and Japan, with close to 40% of generic drugs in the American market originating in India. Aside from the country’s advantages of low technological and labor costs, India’s status in the generic-drug industry also stems from its unique laws: It refuses to register pharmaceutical patents, and allows local manufacturers to produce generic versions of foreign drugs.

This wasn’t always the case. In the 1960s, drug prices were so high in India that they attracted international attention. So, in order to allow Indian citizens access to reasonably priced medication, in the 1970s the country’s legislature passed a law that rejected product patent applications for food and pharmaceutical products, allowing patents covering only industrial processes. The law also allowed local businesses to apply for generic-drug production permits from the Indian government in situations where it was hard to obtain or pay for foreign versions of a drug. As a consequence, India’s generic-drug industry was able to grow rapidly.

Generic drugs help the poor. But could fewer protections for pharmaceutical patents hamper innovation in the industry? This is the question that has hovered over India’s pharmaceutical patent system for decades, resulting in numerous lawsuits.

Pharmaceutical drugs are not ordinary commodities, and the purpose of medicine is to save and improve lives. This is also the goal of technological development, as well as the original aim of many of our laws. However, some of the current laws managing the pharmaceutical industry go against this original aim, and it is time for us to rethink these rules.

One parting thought: If someone commits a crime in order to profit from it, they are simply a criminal. But if someone has to commit a crime in order to survive, society must take a look at itself and ask who the guilty ones really are.

Chen Zuobing is vice president of Zhejiang University Hospital and director of Kangfu Medical Center at Peking University Third Hospital.

Translated by Teng Jing Xuan (jingxuanteng@caixin.com)

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