© AP
RUSSIA-LACK OF MEDICINES
Warnings came first, in messages between friends and family and on social media, for people to stock up on crucial drugs from Russia before supplies were hit by harsh Western sanctions over the invasion of Ukraine.
Later, indeed, some drugs became more difficult to obtain in pharmacies of Moscow and other cities.
“He no longer has a single pharmacy in the city,” he told The Associated Press a resident of Kazan at the end of March, about a blood thinner her father needs.
Experts and health authorities in Russia say that the shortage of medicines is temporary, due to panic buying and the logistical difficulties of suppliers associated with sanctions. But some remain concerned that high-quality drugs continue to disappear from the Russian market.
“Surely there will be shortages. How catastrophic it will be, I don’t know,” said Dr. Alexey Erlikh, head of the cardiac intensive care unit at the Hospital number 29 of Moscow, and professor at the Medical University of Pirogov, in Moscow.
Reports of Russians not getting some drugs at pharmacies surfaced in early March, shortly after Moscow launched a war in Ukraine and harsh sanctions left Russia increasingly isolated from the rest of the world.
Patient’s Monitor, a patient rights group in Russia’s Caspian region of Dagestan, began receiving complaints in the second week of March.
Ziyautdin Uvaysov, director of the group, told AP that he had personally checked several state pharmacies in the region for the stock of 10 specially requested drugs and “they did not have a large number of them”.
Uvaysov added that when he asked when the stock would be replenished, the pharmacies replied that “there weren’t, and it wasn’t clear when there would be.”
Despite guarantees from the authorities that the empty shelves were due to hoarding, reports of shortages persisted during the month of March.
Vrachi.Rf, one of the largest online communities of medical workers in Russia, surveyed more than 3,000 doctors in mid-March and said they had found stockouts of more than 80 medications: anti-inflammatory, gastrointestinal, antiepileptic and anticonvulsant drugs, as well as antidepressants and antipsychotics.
About a dozen people AP contacted in different cities in late March said they had spent days searching for specific thyroid drugs, types of insulin or even a popular children’s pain-relieving syrup. Some said they had not been found.
“The patients I see have lost some blood pressure medication,” Erlikh said. “And some doctors I know report problems with some very expensive, very important medications (used in) some surgical procedures.”
The Russian Minister of HealthMikhail Murashko has reiterated that the availability of medicines is not a problem in the country and attributed any shortage to panic buying. He said demand for some drugs has increased tenfold in recent weeks and urged Russians not to hoard.
Experts agree that panic buying has played a role in creating the shortage.
“People rushed to stockpile, and in some cases, supplies that were supposed to last a year or a year and a half had been sold in a month,” said Nikolay Bespalov, company development director, director of development at the firm. of analysis RNC Pharma.
Bespalov also pointed to logistical problems that occurred early in the crisis. Although big Western pharmaceutical companies have promised not to withdraw vital drugs from the Russian market, the sanctions have blocked major Russian banks from the international SWIFT system, complicating international payments. Dozens of countries have cut off their air traffic with Russia, affecting supply chains.
Experts stressed that logistical issues have largely been resolved, but panic buying, triggered by fears that companies will stop deliveries, could continue to cause shortages for some time.
“Clearly, until things calm down, it will continue,” Bespalov said.
Local media in places from Vladimir, on the eastern outskirts of Moscow, to the Kemerovo region of Siberia, reported shortages of several medicines in the last days of March, as panic buying continued.
However, the Russian health regulatory agency, Roszdravnadzor, said in a statement on Friday that “the situation in the drug market is gradually returning to normal, panic buying of pharmaceuticals is subsiding.”
Erlikh, the cardiologist, noted that there were previous problems with drug quality in Russia, which according to some estimates imports up to 40% of its drugs.
Some imported medicines have become scarce since the authorities adopted an import substitution policy to offset sanctions for Crimea’s annexation in 2014 and promote their own medicines over foreign-made ones.
The policy gave a long list of preferences to Russian companies and ultimately made it unprofitable for foreign pharmaceutical companies to sell some of their expensive high-end drugs to Russia.
In 2015, state-funded purchases of medicines for hospitals and clinics, which account for up to 80% of the Russian pharmaceutical market, were made subject to the “three is a crowd” rule, which excluded foreign firms when at least two companies Russians were fighting for a contract.
The government has also been expanding its list of vital medicines, a registry of some 800 essential drugs for which mandatory and relatively low prices have been set. Companies can request a price change per year, but the process is long, very bureaucratic and without guaranteed results.
“We have already been gradually losing one important original medication after another. Generics take their place, and while there are some pretty good ones made in Europe, there are also some questionable ones made in Russia,” Erlikh said.
“Of course, when there is no original medication, a generic is better than nothing. But it is a situation of lowering the bar (deliberately), it is not a good way to live, ”he added.