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Patient deaths show darker side of modern Chinese medicine

Injectable forms of traditional herbal remedies are big business in China, where a legacy of poorly tested treatments has resulted in adverse reactions ranging from rashes to fatalities

By Li Hui  /  Bloomberg

Illustration: Yusha

Early on a snowy winter morning in January 2012, Wu Xiaoliang, a 37-year-old farmer, stopped by his local doctor to remedy a headache. At a small clinic near his village he received two injections made from traditional Chinese herbs. Hours later, villagers saw him struggling to prop himself up on his moped as he drove home. By noon, he was dead.

What killed Wu was later described in an autopsy report as a “drug allergy.” However, doctors could not pinpoint what he was allergic to because the shots he was given contained dozens, if not hundreds, of different compounds extracted from two herbs.

For centuries, Chinese have bought plant and animal parts from traditional clinics, and boiled them into bitter soups to treat colds, strokes and even cancer, but the Chinese medicine sector has modernized along with the rest of the country, with local manufacturers turning age-old recipes into fast-acting injectable drugs.

Chinese medicine injections generated sales of US$13 billion last year, according to the research firm Forward Industries Institute. Listed companies worth billions of dollars have thrived, benefiting major global funds like those managed by Schroders PLC, UBS Group AG and Skagen AS that hold their stocks.

Yet the industry’s ascent has also raised public health concerns. Over 100 injections based on traditional recipes are sold in China these days, some without stringent human trials. Doctors often prescribe them in an array of untested combinations. Adverse reactions, from skin rashes to fatalities like Wu’s, doubled to about 133,000 last year from 2011, according to government data.

Having struggled for decades to rein in the sector, regulators have recently begun pushing for an overhaul of Chinese medicine injections, seeking to weed out unsafe and ineffective products, but the process could take up to a decade, given the complexity of these intravenous pharmaceuticals.

“For the majority of these chemicals, their properties and their safety to the human body are not properly evaluated and some of them are not even discovered yet,” said Justin Wu (胡志遠), associate dean of the Department of Medicine at the Chinese University of Hong Kong. “If you just focus on this point, I don’t think traditional Chinese medicine injections can pass through any regulatory authority outside China.”

Drugmakers such as China Shineway Pharmaceutical Group, Guangxi Wuzhou Zhongheng Group, Tianjin Chase Sun Pharmaceutical Co and Livzon Pharmaceutical Group are now among the biggest public companies with substantial revenue from traditional injectable remedies. Manufacturers maintain their injections are safe and that the problems arise from incorrect use by doctors.

Still, due to the history of lax regulation, many injectables based on Chinese medicine have not been evaluated in strict scientific clinical trials. That means the reactions they set off in the body are not fully known. Chinese medicine is based on centuries of practical experience. However, it is traditionally taken orally, which gives the digestive system a chance to shield patients from harmful chemicals. Injecting the concoctions into the bloodstream can heighten side effects.

When Shineway first registered its traditional medicine injections in the 1990s, no clinical studies were needed, according to Chen Zhong (陳鍾), a vice president for research and development and quality at the company, which describes itself as the nation’s largest maker of these types of shots.

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