Investigation on the chaos of 9-valent HPV vaccination： it is hard to find a seedling in the community, and the online ＂yellow cattle＂ price increase is rampant.
HPV (human papillomavirus vaccine) vaccine reservation market "yellow cattle" is active. Recently, Qing Liu (pseudonym), a citizen of Guangzhou, also saw relevant news in the circle of friends, "There are still a few 9-valent HPV vaccine appointments this week. Inoculation community: XX Community Hospital, Panyu District; Vaccine: 1331/ needle ×3 needles, paid at the community hospital, with an appointment service fee of 3,000 yuan, and paid at Noah’s clinic. "
In fact, there is no need to pay extra fees for booking vaccination through the official platform. However, due to the long-term shortage of nine-valent HPV vaccine, it is often "second light" after the number is released, and the huge market has also spawned a large number of "vaccine scalpers".
Recently, the reporter of national business daily called the Noah Medical Public Telephone Consultation mentioned above as a consumer. The other party said that the supply of 9-valent HPV vaccine in Guangzhou is tight at present, and only Panyu District has seedlings for the time being, but individuals can’t go to community hospitals. The secret lies in the "service fee". "If we make an appointment here, the community will also charge a certain fee, which is included in the reservation price of 3,000 yuan."
The reporter also noticed that the "vaccine scalpers" who provide the booking service are rampant on different social platforms. How can they use invisible hands to make profits in the state of "no seedlings" in community medical institutions? How does this gray interest chain around the nine-valent HPV vaccine move the rights and interests of the general public? Who should be responsible for the repeated violations of scalpers?
Some private hospitals call it "channel fee", which can be inoculated in community hospitals.
Qing Liu hasn’t grabbed the 9-valent HPV vaccine, but she is dubious about the "scalpers" in her circle of friends. According to the picture information sent by the intermediary in the circle of friends, Noah Medical can provide the "Zhenai Women’s Health Management Package" with 2 outpatient visits by gynecologists, 1 ultrasound examination and 1 tooth cleaning maintenance, and give an additional HPV9-valent vaccine (three needles) to make an appointment.
On February 23rd, the reporter of national business daily called the contact number on Noah’s medical publicity picture as a consumer, and the other party clearly stated that the supply of 9-valent HPV vaccine in Guangzhou is tight at present, and only Panyu District has seedlings for the time being. Noah’s medical can make an appointment in the community hospital on behalf of the consumer, and the corresponding appointment fee is 3,000 yuan, including three items with a total price of 2,000 yuan. If the appointment is successful, the consumer needs to pay the vaccine fee of 1,331 yuan/needle to the community hospital separately, and the total cost of 3 needles is 3,993 yuan.
In the introduction of employees, this service has no "gift" nature — — "In the past, the service fee for our 9-valent HPV vaccine was 3,000 yuan, but some customers felt that the price was more expensive before adjusting it to give away the rest of the items."
As if afraid that the reporter didn’t understand, the employee said again, "That is, we will help you to get vaccinated in a community hospital, and you have to pay the (vaccine) fee to the community hospital." When the reporter further asked which community he could go to for vaccination, the other party’s answer was vague, only revealing that one of the community health service centers had a relatively large supply.
However, when the reporter inquired about Guangdong official vaccine platform "Yuemiao" and WeChat official account, a community health service center in Panyu District, Guangzhou, he found that it was impossible to make an appointment. After the reporter called, he was told that the application qualification is free and the injection will be charged.
Since the community is "seedless", how do private hospitals make appointments? The aforementioned Noah medical staff said that there are very few nine-valent HPV vaccines now, and too many people make appointments. "I can’t make an appointment in a community hospital. If we make an appointment here, the community will have to charge a certain fee, which is included in the appointment price of 3,000 yuan."
When the reporter showed that the price was too high, the person said that if you want to enjoy the 9-priced HPV vaccine reservation service at a cheaper price, you can choose another package with a price of 2,500 yuan. The difference from the 3,000-yuan package lies in the different inspection items, but it is still very cost-effective compared with other options in the market.
What is the "channel fee" and whose pocket does it fall into? The person did not give a more detailed explanation, only reminded reporters, "Now you go to many institutions outside to make an appointment, and they say that you can get 3 shots, but you can’t guarantee that all 3 shots will be made on time, but we can guarantee it." It also asked reporters when they want to vaccinate, and they can choose the vaccination time relatively freely.
On the afternoon of February 24th, national business daily tried to interview Noah Medical, but as of press time, he didn’t get a reply.
On February 25th, the reporter called Noah’s medical consultation telephone again as a consumer, and the wiring staff also said that the reason why Noah could help make an appointment for customers was "to operate through institutional channels" and "to cooperate with community hospitals". "If some customers don’t want to pay the appointment fee, they can only queue up slowly by themselves, and there is no such priority (vaccination) service".
Alternative "intermediary": bundling medical examination packages
In addition to the "intermediary" like Noah Medical, some private medical institutions regard HPV vaccine as a "cash cow" for drainage.
In public medical institutions, the price of 9-valent HPV vaccine is 1,318 yuan/piece, and a total of 3,954 yuan is required for three doses. However, in many private hospitals, the vaccination of 9-valent HPV vaccine requires a medical examination package, and the total cost needs 5,000-6,000 yuan.
At the beginning of February, the chaos of bundling the "medical examination package" when private hospitals inoculated with the nine-valent HPV vaccine appeared on the hot search. On February 6th, the reporter of national business daily called Beijing Jiahe Women and Children Hospital (hereinafter referred to as "Jiahe Women and Children") for consultation as a consumer, and obtained the link of the nine-valent HPV vaccine medical examination package sent by employees.
At that time, the package price was 5680 yuan, of which only two were clearly marked, namely the price of 9-valent HPV vaccine was 3894 yuan (3 needles), and the vaccination fee was 75 yuan; The rest of the price comes from blood routine, urine routine, four items of kidney function, five items of blood lipid, eight items of liver function and four items of virus, and the service fee of gynecologists.
On February 6 th, Jiahe women and children 9-valent HPV vaccine physical examination package Image source: Jiahe women and children employees
When the reporter asked if the 9-price HPV vaccination service could be purchased separately, Jiahe women and children employees said that "the cost of three shots of vaccination alone (vaccine+vaccination fee+service fee) is 5469 yuan", which is not much different from the price of the bundled medical examination package.
On the same day, the reporter also randomly called Beijing Mingde Hospital, Beijing Wuzhou Women and Children Hospital and many other private hospitals that provided 9-priced HPV vaccination services on public comments, and found that these private hospitals can be roughly divided into two categories, one is represented by Jiahe women and children, and the package provided includes a number of medical examination items, and some said that "(other items) can be abandoned, but no refund can be made"; The other category, represented by Beijing Mingde Hospital, clearly indicates that the package price only includes the cost of 9-valent HPV vaccine, vaccination and service fees, and does not include other testing services.
In addition, some hospitals are similar to Noah Medical, and the package fee includes the appointment fee. The difference is that they also provide vaccination directly.
On February 23rd, the reporter of national business daily clicked on the package link of Jiahe women and children again. The original package content was replaced by the cost of 3 shots of vaccine, vaccination fee and doctor service fee. The total package price was 5369 yuan, but the items were not clearly marked.
The reporter’s search for "9-valent HPV vaccine" in the public comment also found that no longer merchants package and sell 9-valent HPV vaccine with other physical examination items, but the price of 3-needle vaccination is still between 5,000 yuan and 6,000 yuan, which is 50% more expensive than that of public hospitals.
Cracking the "yellow cattle" needs to start from two aspects: open source and supervision.
The contradiction between supply and demand of HPV vaccine has a long history. The data shows that the 9-valent HPV vaccine supplied by Merck to China is increasing every year. According to the semi-annual report of Zhifei Bio in 2022, in the first six months of last year, the number of 9-valent HPV vaccines issued by Merck was 9,298,700, a year-on-year increase of 379.34%.
However, according to the age range from 9 to 45, the number of women with HPV vaccine in China may exceed 300 million, and the gap between the vaccine that can be put on the market and the vaccination demand is very wide, and the number of people who can be vaccinated is less than 1% of the total. In addition, the production process of 9-valent HPV vaccine is complicated, and the production cycle takes four years, so it is difficult to keep up with the huge demand in China in a short time.
Earlier, some media reported that some citizens in Shanghai made an appointment for a 9-valent HPV vaccine and were told to wait for 3 to 5 years.
"It is a situation where there are not enough porridge, and there are less than 10 million in total. Some communities may have 10 branches and 8 branches a month, but the reservation platform is for the whole province, even if there is no ‘ Cattle ’ It is also a second light. " An industry insider familiar with the vaccine distribution mechanism told national business daily that the high demand for 9-valent HPV vaccine is just like the train ticket in Spring Festival travel rush, mainly due to the imbalance between supply and demand. As for why private hospitals seem to have more stocks, it is mainly because the price is expensive and there are relatively few people to vaccinate.
Because of this, some school-age women will choose high-priced services. According to the data of the first hour of the pre-sale of Tmall double 11 in 2022, the pre-sale amount of HPV vaccine reservation increased by over 600% year-on-year.
It is also the huge demand of young women for nine-valent vaccine that provides huge profit space for cattle. This situation has been reported in recent years, but why is it repeatedly banned? Where did the scalper exploit the loophole?
"Now I use the ID card to make an appointment with the APP, and the data is in the CDC. It is estimated that it is to prevent related households and scalpers." A doctor from a basic medical institution told the reporter of national business daily that the supply and demand of nine-valent vaccine in his area are relatively balanced, and all the people who want to fight can basically grab the number. The "yellow cattle" still exist in some places where vaccines are difficult to grab. The "channel fee" is basically the same as that of a 3-needle vaccine. The "scalper" is profitable and definitely willing to take risks. Some people don’t want to wait, but they are definitely willing to pay a high price to "go through the back door".
The doctor of another county-level hospital told reporters that the supply of 9-valent or even 4-valent vaccines in his area is in short supply. The hospital has received an appointment system before, but it has not been publicly launched because of the small number of vaccines. At present, it still continues the tradition of paper registration. The appointment only needs to leave the name and phone number. After the CDC issues the vaccine, the hospital will call the appointment person in the order of appointment to inform them to come to the hospital for vaccination.
It is not difficult to find that online data of this paper appointment and vaccination results are difficult to get through. Even if there is no appointment, as long as accurate identity information is input when vaccination, the vaccination information will also be synchronized to the vaccine platform developed by the Health and Health Commission, leaving more room for "yellow cattle".
The doctor also said that he had heard that some people were doing this business in big cities, but no one had done it in the county, "because there are too few seedlings."
The reporter of national business daily learned that many regions are exploring a more scientific, fair and open vaccine distribution mechanism. At present, most regions make an appointment to vaccinate HPV vaccine through APP, but users can only see whether each region has a number, and if they don’t grab the number, they have to wait for the next round. They don’t know how many vaccines can be grabbed or how many people are grabbing it.
At the "two sessions" in Shanghai in 2022, Chen Songju, a representative of the Municipal People’s Congress, suggested that the scientific management mechanism of HPV vaccination should be standardized, and the appointments of community vaccination clinics with various prices should be included in the "follow-the-bid" online platform, and personal review materials should be submitted online to generate an appointment demand list. At the same time, the progress can be checked, such as how many people are waiting in line and the estimated waiting time for vaccination. She also suggested that the development and investment of HPV vaccine should be increased, and the dosage and vaccination data of HPV vaccine in community clinics in this city should be regularly publicized.
Xu Tianyu from the College of Science and Technology of Jiangxi Normal University suggested that it is urgent to realize "vaccine freedom" from two aspects: "open source" and "supervision". On the one hand, the number of HPV vaccines needs to be increased. In addition to imported vaccines, the research and development of domestic HPV vaccines needs to be accelerated, so as to solve the dilemma of "one vaccine is hard to find" as soon as possible. On the other hand, the market supervision administration should standardize management, strictly investigate the source channels of vaccines and standardize the sales channels of vaccines. Only in this way can we break the interest chain of bundled sales.