中国阿片类止痛药市场快速增长

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岁的曾长河(音)今年被诊断出前列腺癌，他依靠鸡尾酒药物疗法减轻病痛：每天3次、每次5片奥施康定(OxyContin)，如果止痛效果还不够，就再注射吗啡。

“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.”

“我们知道阿片类药物容易上瘾，但他不得不依靠这类药物，”他的妻子任忠琼(音)表示，“他痛得太厉害了。只有这些止痛药能让他感觉正常一些。”

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.

随着癌症发病率迅速增加推动对止痛药的需求、同时患者不再惧怕上瘾，合成阿片类药物已成为中国制药市场的佼佼者。

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.

中国化学制药工业协会(CPIA)数据显示，去年中国止痛药市场增长20%，达到36亿元人民币(合5.3亿美元)，比整体药物市场增速快一倍多。中国是全球第二大药物市场。

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.

尽管中国绝大多数止痛药都用于外科手术中，但分析师们表示，最近的增长主要是受到新增癌症病例增加的推动——从2000年的210万新病例上升至2015年的430万，这催生了对慢性疼痛管理的需求。肺癌是中国发病率最高的癌症，部分是由于较高的吸烟率和空气污染。

“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.”

“癌症晚期治疗的发展是主要原因，”中国全国疼痛诊疗研究中心主任樊碧发表示，“癌症晚期患者承受着剧烈的痛苦……一般我们会按照指引使用阿片类药物。”

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

他补充称，在口腔外科上的支出增加、以及外科手术增多，都推动了对止痛药的需求。

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.

中国对鸦片滥用存在创伤性的历史记忆：19世纪英国迫使中国接受从英属印度进口的鸦片，结果很多中国人染上鸦片瘾，直到1949年共产党上台后才基本上根除了(有时采用粗暴手段)鸦片瘾。

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

以前，阿片类药物持续存在的污点形象、以及对药物上瘾的担忧，使医生和患者都不愿使用阿片类药物。

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”.

但中国政府推动人们转变了观念。政府在2011年发起“良好的疼痛管理”项目——培训医院工作人员辨识不同程度的疼痛，并“通过及时给药提供有效缓解”。

“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.

根据《全球肿瘤学杂志》(Journal of Global Oncology)对该项目的评估，“在适当使用的情况下，一国的阿片类药物消费量可能是确定其癌症临终护理质量的良好指标”。该杂志报告称，中国的这个项目使得一些医院的阿片类药物年度用量增加近两倍。

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.”

瑞银证券中国医药行业分析师赵冰表示：“近年来疼痛治疗在临床上越来越受重视。全国各地的医院都建立了面向门诊病人的疼痛管理诊所。”

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

与过去外国商人成船运往中国的鸦片不同，如今中国使用的大多数阿片类药物都是本土生产的。

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.

根据中国医药工业有限公司(CNPIC)数据，扬子江药业集团(Yangtze River Pharmaceutical Group)生产的地佐辛(Dezocine)以近40%的市场份额，成为了去年销量最好的止痛药。这种药主要用于术后止痛。相比之下，最受欢迎的外国品牌是巴德制药(Bard Pharma)的羟考酮(Oxycodone)，占据了6.5%的市场份额。

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.

据健康调查公司QuintilesIMS表示，与去年价值近1170亿美元的整个制药市场相比，中国止痛药销量很少，这让制药企业看到了巨大的增长潜力。

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.

中国止痛药市场仅为美国市场规模的二十分之一。在美国，阿片类药物滥用情况愈演愈烈，自上世纪90年代初以来，这些药品的处方量增长一倍以上，数以万计的人死于用药过量。

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，中国销量第三的止痛药是舒芬太尼(Sufentanil)。这是为手术室止痛所研发的强效合成阿片类药物，在美国也出现不断上升的上瘾率。

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.

在美国政府试图应对药物滥用的问题，劝说医生少为慢性疼痛开止痛药之际，制药企业开始在中国等发展中市场寻求增长机会。

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.

萌蒂制药(Mundipharma)在中国开展了大规模推广活动，其中包括针对医生和患者群体的卡通视频。该公司生产的奥施康定被指加剧美国药物上瘾危机。

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.

该公司的网站称，迄今中国各地超过6000家医院的医护人员观看了由萌蒂制药平台举办的疼痛管理在线讲座，观看次数约为6.4万次。