中國阿片類止痛藥市場快速增長

Diagnosed with prostate cancer this year, 77-year-old Zeng Changhe relies on a cocktail of drugs to treat his pain: five pills of Oxycontin three times a day, and morphine injections if the tablets fail to provide sufficient relief.

77歲的曾長河(音)今年被診斷出前列腺癌，他依靠雞尾酒藥物療法減輕病痛：每天3次、每次5片奧施康定(OxyContin)，如果止痛效果還不夠，就再注射嗎啡。

“We knew that opioids are addictive but he has to rely on it,” says his wife Ren Zhongqiong. “He’s suffering too much. Only these painkillers can make him feel like himself.”

“我們知道阿片類藥物容易上癮，但他不得不依靠這類藥物，”他的妻子任忠瓊(音)表示，“他痛得太厲害了。只有這些止痛藥能讓他感覺正常一些。”

Synthetic opioids have become the star performers in China’s pharmaceutical market, as a rapid increase in cancer cases drives demand for pain-reducing drugs and patients lose fears about addiction.

隨著癌癥發(fā)病率迅速增加推動對止痛藥的需求、同時患者不再懼怕上癮，合成阿片類藥物已成為中國制藥市場的佼佼者。

The market for painkillers in China grew 20 per cent last year to reach Rmb3.6bn ($530m), according to the China Pharmaceutical Industry Association, more than twice the rate of the overall drug market, which is the world’s second largest.

中國化學(xué)制藥工業(yè)協(xié)會(CPIA)數(shù)據(jù)顯示，去年中國止痛藥市場增長20%，達到36億元人民幣(合5.3億美元)，比整體藥物市場增速快一倍多。中國是全球第二大藥物市場。

While most painkillers in China are used in surgical contexts, the recent growth has mainly been driven by a rise in a cancer rates from 2.1m new cases in 2000 to 4.3m in 2015, creating demand for management of chronic pain, analysts say. Lung cancer is China’s most common, partly due to high rates of smoking and air pollution.

盡管中國絕大多數(shù)止痛藥都用于外科手術(shù)中，但分析師們表示，最近的增長主要是受到新增癌癥病例增加的推動——從2000年的210萬新病例上升至2015年的430萬，這催生了對慢性疼痛管理的需求。肺癌是中國發(fā)病率最高的癌癥，部分是由于較高的吸煙率和空氣污染。

“The development of treatment for late-stage cancer is the cause,” said Fan Bifa, director of China’s national centre for pain treatment. “The pain of advanced stage cancer patients is intense . . . generally we will use opioids in accordance with guidelines.”

“癌癥晚期治療的發(fā)展是主要原因，”中國全國疼痛診療研究中心主任樊碧發(fā)表示，“癌癥晚期患者承受著劇烈的痛苦……一般我們會按照指引使用阿片類藥物。”

Increased spending on dental surgery and a growth in surgical operations had also driven demand, he added.

他補充稱，在口腔外科上的支出增加、以及外科手術(shù)增多，都推動了對止痛藥的需求。

China has traumatic historical memories of opioid abuse after Britain forced it to accept imports of opium from British India in the 19th century, leading to widespread addiction that was mostly eradicated, sometimes brutally, by the Communist party after it seized power in 1949.

中國對鴉片濫用存在創(chuàng)傷性的歷史記憶：19世紀(jì)英國迫使中國接受從英屬印度進口的鴉片，結(jié)果很多中國人染上鴉片癮，直到1949年共產(chǎn)黨上臺后才基本上根除了(有時采用粗暴手段)鴉片癮。

A continued stigma about opioids created a reluctance to use them among doctors and patients alike because of associations with addiction.

以前，阿片類藥物持續(xù)存在的污點形象、以及對藥物上癮的擔(dān)憂，使醫(yī)生和患者都不愿使用阿片類藥物。

But China’s government has driven a change in attitudes with a “good pain management” programme launched in 2011, which trains hospital staff to recognise different levels of pain and “provide effective relief through timely dispensation of medication”.

但中國政府推動人們轉(zhuǎn)變了觀念。政府在2011年發(fā)起“良好的疼痛管理”項目——培訓(xùn)醫(yī)院工作人員辨識不同程度的疼痛，并“通過及時給藥提供有效緩解”。

“When used appropriately, consumption of opioids in a country can be a good proxy for determining the quality of palliative cancer care,” according to a review of the programme in the Journal of Global Oncology, which reported that it had led to a near-threefold annual increase in opioid use at some hospitals.

根據(jù)《全球腫瘤學(xué)雜志》(Journal of Global Oncology)對該項目的評估，“在適當(dāng)使用的情況下，一國的阿片類藥物消費量可能是確定其癌癥臨終護理質(zhì)量的良好指標(biāo)”。該雜志報告稱，中國的這個項目使得一些醫(yī)院的阿片類藥物年度用量增加近兩倍。

Zhao Bing, a China healthcare analyst in UBS securities, said: “In recent years pain treatment has been getting more and more clinical attention. Hospitals across the country have established outpatient pain management clinics.”

瑞銀證券中國醫(yī)藥行業(yè)分析師趙冰表示：“近年來疼痛治療在臨床上越來越受重視。全國各地的醫(yī)院都建立了面向門診病人的疼痛管理診所。”

Rather than arriving on the ships of foreign merchants, now most of the opioids consumed in China are locally produced.

與過去外國商人成船運往中國的鴉片不同，如今中國使用的大多數(shù)阿片類藥物都是本土生產(chǎn)的。

With a nearly 40 per cent market share last year, the Yangtze River Pharmaceutical Group’s dezocine was the bestselling painkiller in China, according to CNPIC data. The drug is mostly used after surgery. By contrast, the most popular foreign brand is Bard Pharma’s Oxycodone, with a 6.5 per cent market share.

根據(jù)中國醫(yī)藥工業(yè)有限公司(CNPIC)數(shù)據(jù)，揚子江藥業(yè)集團(Yangtze River Pharmaceutical Group)生產(chǎn)的地佐辛(Dezocine)以近40%的市場份額，成為了去年銷量最好的止痛藥。這種藥主要用于術(shù)后止痛。相比之下，最受歡迎的外國品牌是巴德制藥(Bard Pharma)的羥考酮(Oxycodone)，占據(jù)了6.5%的市場份額。

Companies see high growth potential as Chinese painkiller sales are small compared with an overall pharmaceutical market worth nearly $117bn last year, according to QuintilesIMS, the health research company.

據(jù)健康調(diào)查公司QuintilesIMS表示，與去年價值近1170億美元的整個制藥市場相比，中國止痛藥銷量很少，這讓制藥企業(yè)看到了巨大的增長潛力。

The Chinese market is just one-twentieth the size of the US’s, where a slow-burning epidemic of opioid abuse has seen prescription rates more than double since the early 1990s, while tens of thousands have died of overdoses.

中國止痛藥市場僅為美國市場規(guī)模的二十分之一。在美國，阿片類藥物濫用情況愈演愈烈，自上世紀(jì)90年代初以來，這些藥品的處方量增長一倍以上，數(shù)以萬計的人死于用藥過量。

The third most popular painkiller in China last year was Sufentanil, a powerful synthetic opioid developed for use in operating theatres, which has also seen growing rates of addiction in the US.

去年，中國銷量第三的止痛藥是舒芬太尼(Sufentanil)。這是為手術(shù)室止痛所研發(fā)的強效合成阿片類藥物，在美國也出現(xiàn)不斷上升的上癮率。

As the US government tries to tackle the epidemic by discouraging physicians from prescribing painkillers for chronic pain, companies are seeking growth in emerging markets such as China.

在美國政府試圖應(yīng)對藥物濫用的問題，勸說醫(yī)生少為慢性疼痛開止痛藥之際，制藥企業(yè)開始在中國等發(fā)展中市場尋求增長機會。

Mundipharma, which produces OxyContin — a drug blamed for intensifying the addiction crisis in the US — has launched a large-scale campaign in China involving cartoon videos aimed at both doctors and patients.

萌蒂制藥(Mundipharma)在中國開展了大規(guī)模推廣活動，其中包括針對醫(yī)生和患者群體的卡通視頻。該公司生產(chǎn)的奧施康定被指加劇美國藥物上癮危機。

So far staff from more than 6,000 hospitals across China viewed online lectures hosted by Mundipharma’s platform to promote pain treatment some 64,000 times, according to the company’s website.

該公司的網(wǎng)站稱，迄今中國各地超過6000家醫(yī)院的醫(yī)護人員觀看了由萌蒂制藥平臺舉辦的疼痛管理在線講座，觀看次數(shù)約為6.4萬次。