“Instead of quality medicines, there will be cheap analogues: the patient organization of cancer patients is concerned about the new rules on the pharmaceutical marketThe director of the Charity Foundation “KRAPLYA KROVI” warns about the risks of the new regulation of drug prices. Harsh
administrative intervention can lead to the disappearance of high-quality European drugs and their replacement with cheap Indian
counterparts.”, — write: unn.ua
- How do you think the new price regulation will affect the availability of medicines for patients? Do you see a risk that manufacturers will reduce supply or withdraw certain drugs from the market due to the restrictions?
This is a very risky bill. In general, if we have a market economy in the country, and the state starts to interfere in the market by introducing additional regulations, this is not very good. Some drugs may, on the contrary, become more expensive rather than cheaper, and some drugs may disappear from the market altogether. That is, it will become unprofitable for them to sell their products in Ukraine, and they will leave.
- Will the innovations affect the implementation of treatment protocols, since they contain certain drugs, including imported ones, which, according to the professional community, may disappear?
I can comment on my field, oncology. Basic molecules are purchased through the public procurement nomenclature. It’s more or less normal there, there are long-term contracts and the risk is low.
The risk is in the pharmacy segment and in retail. In retail, each drug competes with each other on the shelf.
- Will the innovations affect the physical availability of medicines, including imported ones? After all, associations such as the European Business Association have already expressed concerns from foreign companies.
They are right. In fact, we have a history in our country: the market can be divided into three parts. One part is European manufacturers, either generic or original. Another part is our Ukrainian producers, we have quite powerful pharmacology. And the third part is Indian manufacturers, which, unfortunately, we are letting into our market very much. And they put a lot of pressure with their low prices on our producers, especially on Europeans. That’s why this law risks causing Europeans to leave and Indians to survive. And it will hit our producers hard. And there are problems with Indian manufacturers. Firstly, because of the quality, and secondly, they may not deliver the drug on time.
Therefore, I share the concerns of the European Business Association.
- Is there a danger that some patients will be forced to switch to less effective or cheaper analogues? Could this worsen the quality of treatment and cause additional health risks?
Yes, it is possible. That is, if brands leave the market and only cheaper options remain, there is always a risk that the cheaper options will be of poor quality. This is how it works with everything. It’s one thing to buy a branded car, and another to buy a fake. It’s the same with medicines.
- What other risks do you see in the new regulation of the pharmaceutical market for patients? What changes, in your opinion, can make the situation more balanced so that those who need constant treatment do not suffer?
The first thing I would do is to ban cheap Indian manufacturers from our market. That is, we cannot completely abandon Indians. Good Indians, those who are registered in Europe, should be kept. All others should be removed from the market. Moreover, we are now working very closely with Europe. Sooner or later, we will get into the European Union. And Europe does not allow cheap and low-quality Indians to enter its market.
Second, we need to expand the Affordable Medicines program as much as possible and cover the main areas of treatment for Ukrainian patients with it. In this way, we will preserve the market and allow patients to choose whether to take a cheap option for free or pay extra and take an expensive option. This is how European markets work.
Reimbursement is a chance to avoid a shortage of drugs that actually treat. Because if any hepatoprotectors, neuroprotectors, or antivirals disappear from the market, no one will die from it. This is a fake medicine. Ukrainians actually buy fake medicine. If they disappear, nothing terrible will happen. But if the original antibiotics disappear, it will be a serious shock.
We still need to look at that collusion, of course. I understand that this bill is intended to break up the collusion between the two distributors. It’s not to say that it doesn’t exist, but it was formed, most likely, historically, not because of collusion. In other words, everyone else was simply doing a worse job, and as a result, these two distributors – Optima and BaDM – survived in a competitive market. So they survived, and the smaller ones died. Perhaps, we should let two or three more distributors work in this market. But these are very delicate tools. Americans know how to do it somehow. And here they stupidly hit the law, made this 20%, and it’s not a very good story.
- Has your foundation addressed the government or specialized authorities with proposals for more balanced regulation of drug prices?
We are now thinking about a petition to the President to veto this law. But we don’t have a unified opinion yet.
We are now advocating, first of all, the law on parallel imports, because it will not solve the problem fundamentally, but it will give the market a little more air. It will be possible to import medicines from Europe through parallel imports, and not only from Europe. And secondly, we suggest that the Ministry of Health expand the reimbursement program. We, from the oncology community, have proposed several molecules that should be included in the reimbursement program, and thus prevent them from disappearing from the market, and vice versa, to keep competition in the market.