Starting overseas
In May of 2020, while Covid was rapidly spreading around the world, GMP-certified drug makers Sun Ten Pharmaceutical Co. and Chuang Song Zong Pharmaceutical Co. acquired licenses to make NRICM101 and immediately began developing production processes. They converted the original decoction used in the clinical trails into an easy-to-consume soluble powders, and quickly acquired licenses to manufacture them for export.
According to Winnie Hsueh, a manager in the international trade department at Sun Ten, traditional Chinese medicines are seen as health foods or supplements overseas and regulated accordingly. In October of 2020, the company acquired the registrations and permissions it needed to sell its NRICM101 formulation, branded as “Respire Aid,” in Luxembourg, the UK, Singapore, the US and Canada. It then worked with local doctors of Western and Chinese medicine and acupuncturists in these countries to introduce the preparation to patients with confirmed diagnoses. By the time of 2021’s Delta and Omicron outbreaks, Taiwanese communities abroad were buzzing about the formulation, and you could even buy it on Amazon.
NRICM was able to get the formulation approved for sale in Europe and the US because Su excluded ingredients in the original TCM prescription that are banned overseas, such as ephedra, Manchurian wildginger, and gypsum.
Sun Ten recognized that people outside of Taiwan often have trouble taking Chinese medicines because they find them to be bitter, and the powdered forms earthy and hard to swallow. To get around these issues, foreign users often mix them with water. Hsueh says that Sun Ten improved its version’s flavor and mouthfeel by adding extra mint, and then packaged it in convenient instant packets. “The goal was to make a ‘good medicine that tastes good.’”
But NRICM101 remains a Chinese medicine, and still has that Chinese medicine taste even when you mix it with water to make a drink. On the other hand, what matters to sick patients isn’t flavor, but effectiveness. As of the end of January 2022, Sun Ten had sold 100,000 boxes of the formulation to 55 countries. While ethnic Chinese account for 60% of the purchases, many others, including even the King of Eswatini, a diplomatic ally of Taiwan, have also benefited from the preparation.
In addition, even after recovering from Covid many people in the US and Europe have continued to have difficulty breathing or struggled with exhaustion so severe that they’ve had to take sick leave or even quit their jobs. Sun Ten has therefore introduced “RestorAid,” a product aimed at the needs of these convalescent patients. Hsueh expects demand for the product to remain high for at least five years.
NRICM’s approach to its NRICM101 research provided a basis for understanding the formula’s mechanisms of action and ensuring effective quality control.
Sun Ten Pharmaceutical sells its version of NRICM101 as a water-soluble preparation, adding extra mint to make the product more palatable for non-Chinese users.