They are both amlodipine, so why do the prices differ by dozens of times? Which one should I choose?

An elderly friend told Huazi that he had high blood pressure and had been taking imported amlodipine 5mg 7 tablets, which cost more than 20 yuan per box. But recently he could not buy it anymore, and when he went to the hospital to get a prescription, he only got domestic amlodipine 5mg 14 tablets, which cost 0.84 yuan per box. He was a little worried that the price difference was too big, and whether the efficacy would be different.

Huazi said that the efficacy of the two drugs may be slightly different, but the difference is not large. Many patients did not experience significant fluctuations in blood pressure after switching from imported drugs to domestic drugs.

1. The cost of drugs lies mainly in research and development. Most people have the impression that imported drugs are always more expensive than domestic drugs. This is because most drugs are developed by foreign pharmaceutical companies. The cost of drugs lies mainly in research and development.

Most drugs are ordinary compounds, which can be produced at a very low cost as long as the chemical reaction formula is obtained. But the difficulty lies in how to find such a substance that is effective and safe for the human body from billions of compounds.

Therefore, the research and development process of each drug requires an investment of no less than $1 billion, more than five years, and a huge amount of manpower and material resources. This cost will be added to the final selling price and shared by all users of the drug.

Second, after the development of the "volume-for-price" drugs purchased by the state, they will generally be granted a patent protection period of several years. During this period, other pharmaceutical companies are not allowed to imitate them in order to ensure sales profits. This is a positive incentive measure. Only when pharmaceutical companies are profitable can they generate the driving force for continuous innovation. Drugs produced by the original research and development pharmaceutical companies are called "original research drugs", which include research and development costs and are the most expensive.

However, when the patent protection expires, other pharmaceutical companies can copy the product. Because there is no investment in research and development, the price of generic drugs will be much lower than that of original drugs. However, when the drug is circulated, distributors at all levels need to add price increases step by step, and there are also costs for promotion, publicity, logistics, etc., so there is still water in the drug price.

The centralized procurement of drugs in my country is an act of "squeezing out the water". By predicting the market and "guaranteeing" the sales of drugs, all intermediate links are skipped, so that drugs can be sold at the cost price of the pharmaceutical factory. Therefore, the price of drugs will be greatly reduced, which can be several times or even dozens of times different from the original research drugs.

However, some original research drugs have voluntarily given up the R&D costs and accepted the "volume-for-price" policy. For example, imported acarbose originally sold for more than 50 yuan per box, and domestic generic drugs also sold for more than 20 yuan. But after participating in centralized procurement, the price of a box in the hospital was only 5.42 yuan.

3. Ensure consistent evaluation of quality Many people ask if Huazi Pharmaceutical’s price is so low, will the quality of the drug decline? In fact, all generic drugs purchased by the state are required to undergo consistent evaluation. Generic drugs are required to be the same as original research drugs in terms of impurities, dissolution rate, bioavailability and other indicators.

However, the key information of the original drug, such as the process, excipients, and procedures, will be kept confidential, and generic drugs can only rely on themselves to explore production technology, or reverse engineer the original drug. Therefore, in reality, the effect of generic drugs may not be 100% the same as that of the original drug.

But in general, the difference between generic drugs that have passed the consistent evaluation and original drugs can basically be "80% to 100% accurate."

To sum up, for drugs, the biggest cost lies in the initial research and development. Original research drugs have high prices due to the research and development costs, but the quality is stable. Generic drugs are evaluated in a consistent manner, and their quality is almost the same as that of original research drugs. People with good economic conditions can choose original research drugs, and those who want to pursue cost-effectiveness, generic drugs are also a good choice. Drugs must be used under the guidance of a doctor. If you have any questions about the use of drugs, please consult a doctor or pharmacist. I am pharmacist Huazi, welcome to follow me and share more health knowledge.