One by one, 203 drugs in total have disappeared from the Greek pharmaceutical market during the last months. Of them “25 are unique and 3 are irreplaceable” state NET Tv said this morning. “The lack of three or four caused treatment problems to patients therefore they were imported by IFET, the Greek Institute for Pharmaceutical Research & Technology. IFET normally imports drugs at prices three times more expensive,” I read in medical website iatropedia.gr.
To this information given by the media I can add some more, stories I hear form relatives and friends. I can report of the epilepsy drug Epanutin, for which Pfizer halted the production since beginning of January..
Or of Exelon 6 mg, one of the main drugs for progressed forms of dementia and Alzheimer’s that Novartis distribute to pharmacies with the dropper…
A friend was telling me, she cannot find this drug. That the pharmacist told her, he had to order directly by Novartis and not through his supplier. And yet. The delivery will take some days. The pharmacist ordered 4 packages to cover customers’ needs. The company promised to deliver only one or two.
The Effect? The dementia patient will have to spend a week long without this drug. My friend is scared to death about the side effect the drug shortage will have on her father.
The drugs shortage in Greece has turned from a temporary problem, two year ago, into a permanent one. Blame the austerity imposed by the Troika that enforced sharp decreases in drugs prices. Blame the drugs speculators who now buy cheap medicine in Greece and export it to other EU countries where their are sold at higher prices. Or blame the health ministry for being unable to pay its outstanding debts to suppliers and pharmacies.
Fact is that millions of Greeks are held hostages by speculative profiting of pharma companies and the permanent conflict between public and private sector here. With fatal consequences for the patients.
Greek minister blames speculators
Deputy Health Minister Marios Salmas went on air Friday morning and denounced the practices of drugs speculators. “They sent guys with suitcases to pharmacies and buy certain kinds of medicine,” Salmas told Vima fm this morning. “The drugs shortage is artificial, the problem is not the prices but some 500 pharmacies and 5 drugs suppliers who do these practices.”
Salmas said more or less that this practice aims to collect all cheap medicine from the pharmacies and export it to countries where prices are much higher. A nice example of this so called parallel trade occurs occasionally in UK.
“The drug shortages reported on are caused by drug companies imposing quotas to stop speculators from “profiteering” from price differentials in same brand drugs in the EU. For years, the exchange rates dictated that the UK was one of the most costly countries in the EU for drugs. Thus, parallel trade saw some same brand drugs coming from EU member states at lower prices. This was sanctioned by the UK government who introduced a parallel import licensing scheme for such products. It can even be said that government action encouraged parallel trade by adjusting reimbursement to chemists to allow for such products.
Now, the exchange rate dictates that the UK is one of the cheapest countries in the EU. Therefore same brand products will often be cheaper than the equivalents in other EU member states. So, it is quite natural to expect speculators to take advantage of this situation, ie, buy at the lowest price and sell at the highest. This is normal business practice and is encouraged by the EU as representing cross border free trade activity.” (how speculators work read here)
Salmas threatened to expel the involved pharmacists from the list of National Health Care system (EOPYY), change the fines law and promised to release concrete data on the drugs in shortage. He claimed that the drugs in shortage do not create any therapeutic problem as they would be replaced by others.
Real life, real drug struggle
It is very obvious that Salmas does not have the slightest idea how the system with prescription medicine works for the real patient:
Patients gets a doctor appointment after 6 weeks.
Patient goes to the doctor who prescribes the needed medicine. Patient goes to pharmacy. Pharmacist removes the code-coupon from the package, give the drug to patient, give to EOPYY the prescription. pleased.
What if the prescribed drug is not available? Its production is halted or the pharma company does not give drugs to supplier or the pharmacy, while there is an alternative?
Patient needs to contact again the doctor to approve the alternative. Patient may wait for another 6 weeks for an appointment. In case the patient can immediately contact the doctor, he/she will have to pay the drug form his own pocket. Because the strict austerity forbids the doctor to issue more than a certain number of prescriptions per month.
So easy as Salmas or any health minister pretend to present them are things in real life not. By far, they aren’t.
Epanutin price scandal
Last week I wrote about the shortage of Epanutin. Some readers of this blog were kind enough to send me information about the distribution of Epanutin, actually a price scandal, in UK. There, producer Pfizer sold the marketing authorization of Epanutin capsules to another company Flynn Pharma. The new distribution rose the price immense: 24-fold.
In a statement issued by Flynn we read:
“Flynn Pharma Ltd recently acquired the Marketing Authorisations for Epanutin Capsules. …Phenytoin is a drug with a narrow therapeutic index (NTI) and, as such, there may be concerns amongst prescribers and patients regarding any change to the product. …Please be assured that the Flynn Pharma product is identical to Epanutin. There are no differences in formulation and the site of manufacture remains unchanged. The capsules continue to contain the same identicode markings as Epanutin, including the word ‘Epanutin’.”
Are we going to see also in Greece an old/new anti-epilepsy drug with a much juicy price?
Meanwhile, pharma companies threaten to withdraw their products from the Greek market.
PS I can’t help but ask whether pharma companies go hand in hand with the Troika that wants to get rid of sick and elderly and best of all of sick elderly, in order to cut expenditure in health in pension funds.