“Over the years since I became ill, the drugs have cost me my home and bled my family dry. Sir, can you tell me which family doesn’t have a patient, and can you guarantee that you’ll have a lifetime free of illness?”
The words are spoken by an elderly Chinese leukemia patient to a policeman confiscating her smuggled cancer drugs in the movie Dying to Survive, which opens nationwide in mainland China today (July 5). It already looks set to be a major hit, having won acclaim when it debuted at the Shanghai Film Festival last month and racked up thousands of raves on Chinese film portal Douban after preview screenings. At a show in Beijing this week, the audience stood for a standing ovation as the credits rolled.
Based on the true story of a businessman who became a savior for hundreds of leukemia patients struggling to pay for expensive imported drugs, it’s a rare example of a domestic movie that dares to tackle the cruel realities of middle-class life in China—in this case, the extraordinary lengths families go to in order to obtain life-saving medicines.
Dying to Survive tells the story of Cheng Yong, a peddler of oils intended to cure erectile dysfunction, who is approached for help by a leukemia patient who can’t afford the fictional Geliening, a Swedish drug that costs some 40,000 yuan ($6,032) a bottle. The patient asks Cheng to procure the generic version from India, which costs just a fraction of the price.
After realizing the enormous profits to be made, Cheng puts together an unlikely team of smugglers—including a mom who’s stripping to pay for her daughter’s leukemia treatments, and a priest. The film draws its lighter moments from Cheng’s irate reactions to his encounters in India, where he travels to buy the medicine. Cheng is played by Xu Zheng, a well-known Chinese comedic actor who co-produced the film with Ning Hao, a director known for making low-budget comedy films.
Cheng’s character is based on the true story of Lu Yong, a textile trader who was diagnosed with leukemia, and spent more than $80,000 (link in Chinese) on Gleevec, a very effective treatment that wasn’t covered at the time under national health insurance. Manufactured by Swiss pharmaceutical firm Novartis, it cost the equivalent of $32 for a single pill. Lu located a generic substitute in India—and then helped get it to at least 1,000 other leukemia sufferers in China.
The unapproved drug was considered counterfeit under Chinese law, and in 2014, Lu was arrested and charged with selling fake drugs. During his more than four months (link in Chinese) in detention, some 300 leukemia patients petitioned for his release. Lu was freed in 2015, with the prosecutor noting that he had never personally profited from the sales. After his story came to light, many drew parallels with Dallas Buyers Club—the 2013 film about a man who sells unregulated AIDS drugs to fellow HIV sufferers.
In the Chinese movie, Cheng starts off looking to make money but gradually develops compassion for the patients. At one point (link in Chinese), Cheng stops smuggling because of the risks involved. When a patient commits suicide because he can’t afford to pay his medical bills, Cheng resumes procuring the Indian drug for Chinese patients—but no longer profits from it.
The issue of huge out-of-pocket drug costs is one many moviegoers in China will recognize. Some 40% of the country’s healthcare spending is on drugs, a far higher share than in many countries. About a third of healthcare spending falls on individuals.
Last year, China announced plans for reforms to reduce the drug burden on patients and cover more vital drugs under national insurance. Patients taking Gleevec, which began to be covered last year, now only pay around 20% of the sticker price (link in Chinese). As of this year, China added a slew of patented drugs from multinationals to its national health insurance plan, securing massive price reductions (paywall) in exchange for covering them. And even as China exchanged threats of trade tariffs with the US this year, it scrapped tariffs on imported cancer drugs from May 1. Previously import taxes varied from 3% to 6%.
It’s not likely the pipeline between India and China will immediately dry up though—apart from price, because of a lengthy approval process it can take a long time for foreign drugs to become available in China. Many Chinese people also travel to countries like Japan to scoop up basic, over-the-counter drugs, since drugs sold overseas are often perceived to be safer than those available in China.
On Douban, Dying to Survive has a rating of 9/10 (link in Chinese) from over 100,000 users. In addition to applauding its heart-wrenching depiction of life for China’s cancer patients, viewers admired the film for its courage to go beyond the commercially-driven blockbuster fare that fills China’s big screens. That’s a bold move in a country where authorities have low tolerance for movies that touch on topics that pose a threat to social stability, and that directly, or indirectly, criticize the government.
“We often hear people asking why China can’t make movies that change society, like South Korea and India,” wrote Douban user Xu Ruofeng (link in Chinese). “We need more writers and film makers to confront the problems of society, and make more films with a conscience.”