Drug shortages caused by profiteering

The shortages of Euthyrox and Siofor, two important drugs used by patients with thyroid disorders and diabetes will soon be resolved, the head of the Health Ministry, Vlad Voiculescu announced recently. However, pharmacists say that there’s been a drug shortage  for years, and just increasing imports will not be enough to solve the problem; lawmakers need to prevent profiteering companies from exporting these drugs out of the country.

As Voiculescu stated the other day, he has already signed the ministerial decree allowing for sufficient quantities of Euthyrox and Siofor to be imported into Romania, the Székelyhon.ro news portal wrote. The health minister referred to the amendment of the ministerial decree regulating the wholesale prices of medicines that can be marketed under a parallel import or parallel distribution license, among them Euthyrox in 25, 50 and 100 micrograms and Siofor in 1,000 milligrams.

There has been a problem with pharmaceutical supplies in Romania for quite a few years, ever since the health ministry put a cap on drug prices. For instance, Romania’s price for Euthyrox, which is produced in Germany, is the lowest within the entire European Union. That’s why this drug has arrived for years in scarce quantities. Moreover, pharmacists say that some “slick” companies export a part of the imported Euthyrox stocks because they can market it abroad for a greater profit, the Székelyhon.ro wrote.

The cap on medicine prices has not really helped patients. For instance, the price of a pack of Euthyrox has fallen by less than RON 1 (EUR 0.21), and in return, patients have to walk from pharmacy to pharmacy to find enough medicine for one month, or at least for a few weeks, a pharmacist from Székelyudvarhely (Odorheiu Secuiesc) told Székelyhon. The chemist believes that the price-policy decision the Health Ministry took years ago was nothing but a populist political ploy. The pharmacy he runs at the moment has Euthyrox 125 micrograms and a substitute, the Accu-Thyrox syrup, in stock, but this is not a day-to-day situation at all. As the chemist told Székelyhon, “he has evenings and weekends when he has to think about what he will tell patients because even he doesn’t know when he will get new supplies of the drug.”

“However, the situation is somewhat better now than it was a half a year ago, when Euthyrox was nowhere to be found. It helped when the Accu-Thyrox syrup came out and that in the past two months, Euthyrox in 75 and 125 micrograms was available from time to time,” the pharmacist noted.

He also added that the situation varies from pharmacy to pharmacy, as it greatly depends on which distributor they have a contractual agreement with. At times, a drugstore can get a few boxes of the medicine it’s in short supply of if the order is big enough, at least RON 10,000 -20, 000 (EUR 2,050-4,100). Furthermore, some patients are reluctant to accept a substitute medicine with the same active ingredient; even though Accu-Thyrox, for example, can be administered more correctly than Euthyrow pills, which might not contain the proper amount of active ingredient the patient needs, the chemist added.

Incidentally, the situation with Siofor, used to treat patients with type 2 diabetes is the same as with Euthyrox. Furthermore, at times there are smaller or bigger problems with supplying drugs needed for the treatment of other types of illnesses as well.

“People are more restless and frustrated due to the pandemic situation; at times, patients lash out at pharmacists because they are desperate because of the lack of medicines,” the president of the Harghita County Chamber of Pharmacists, Melinda Melles, told Székelyhon. She also said that there is a growing shortage of more and more categories of medicines, for instance, of a drug used to treat cancer patients as well as a blood thinner used in post-coronavirus treatment. Melles also believes that the main cause of supply problems is the imposed lowering of drug prices.

Manufacturers are reluctant to import more of these products into the country than was agreed, and on top of that, parts of the drug stocks imported will not remain in Romania. “Skillful” companies buy the drugs, re-label them and transport them to Germany overnight, as they make a profit of EUR 300,000-400,000 on the sale of a truckload of medicines, explained Melles. While a box of Euthyrox tablets costs RON 10 in Romania, in Germany it costs EUR 14.

According to the president of the Hargita County Chamber of Pharmacists, the lasting solution to the medicine shortage can only be if the ministry raises the maximum price of the drugs. “Ensuring the right amount of imports will not solve the situation; there should be legislation to prevent the export of medicines that entered the country, as this is currently perfectly legal if one has the right permits,” she said. “We ration drugs the way sugar and oil were rationed in the past (editor’s note: during the communist regime). It is very unpleasant for us, we are terribly frustrated because the situation is not our fault,” said the pharmacist.

Title image: Because of certain drug shortages, chronically ill people have to go from pharmacy to pharmacy to get just part of their monthly prescription. The image is an illustration.

Source: capital.ro

Author: Éva Zay