Abstract :
On July 1, 2019, the website of the National Health Commission of the People’s Republic of China issued the “Notice on printing and distributing the first batch of national key monitoring and rational drugs (chemicals and biological products)” (National Health Office Medical Letter [2019] No. 558) [1], where the third article stipulates: “Other types of physicians, after not less than one year of systematically studying Chinese medicine professional knowledge and passing the examination, in accordance with the basic principles of syndrome differentiation, can issue prescriptions for Chinese patent medicine”. This mandates that Western medicine doctors in China no longer prescribe Chinese patent medicines (CPM) without completing the required training. Before the implementation of this regulation, it was common for Western medicine doctors to prescribe CPM. The market for CPM is quite large [2]. Many traditional Chinese medicine (TCM) doctors believe that Western medicine doctors who have not received specific training in TCM run the risk of incorrectly prescribing CPM [3]. In fact, the vast majority of CPM are subject to the same evaluation criteria and assessment procedures as are chemical drugs. CPM are evaluated using modern medical evaluation systems, are evaluated after they are marketed, and are subjected to standardized clinical trials rather than to evaluation using the TCM theory. Patients experiencing toxic effects from the use of TCM are found to be genetically susceptible to the effects of certain herb ingredient. For example, a recent study found that the genetic basis for susceptibility to Heshouwu (Fallopia multiflora), resulting in liver damage, is the HLAB*35:01 allele [4]. It is difficult for Western medicine doctors to identify which patients may be genetically susceptible to the toxic effects of Heshouwu (Fallopia multiflora). The method of syndrome differentiation based on TCM theory has also proven to be unsuccessful in identifying this susceptibility. In China, Chinese and Western medicine systems are equally important, and both are held in high regard [5]. As early as the 1950s, China organized various “Western Medicine Learning TCM” classes [6] and successfully trained a group of integrated medicine physicians. At the present time, 70% of CPM are prescribed by Western medicine doctors [7]. This abovementioned regulation restricts Western medicine doctors from prescribing CPM that patients can purchase from pharmacies, and, furthermore, compels Western medicine doctors to gain knowledge in TCM. We question whether this will result in Western medicine doctors abandoning the use of CPM. Interestingly, the stock prices of CPM companies offered in the Ashare market fell after these new regulations were announced.
