Turkey hit by drug shortages

Istanbul (Turkey)

From our correspondent

« Do we have any news about the medicines ordered for our patient from Yalova (city in the Marmara region of Turkey, editor’s note) ? The pharmacist couldn’t find any…? Understood… » Annoyed, Dr. Emre Kaya hangs up the phone. Oncologist in a renowned private clinic in Istanbul, the practitioner struggles to secure the care pathways of his cancer patients. “Immunotherapy treatments are indexed to the exchange rate. We’ve had shortages before, but this is the first time I’ve had a problem with these two drugs, he specifies. Before, we could replace some of them with generics, of local production. Today, even these are missing. »

To find the prescribed remedies, some patients seek family members abroad. “I started having pain after the birth of my second child. I was diagnosed with breast cancer, says Dilan Ordu, thirty years old, patient of Doctor Kaya. Impossible to find the drugs in our usual pharmacies. So my husband, who travels back and forth to Germany, bought a year’s worth of treatment there. » He also took additional boxes for patients around them.

Located opposite the clinic, Mr. Ismet’s pharmacy is renowned for its reliability. In daily contact with the establishment, he works with specialists to anticipate needs. But for the past year, he has been unable to obtain certain treatments. “Every day I spend at least two hours on the phone trying to find medicine. Despite this, I have to fire around 20 people every day… About 20% of the drugs usually on our shelves cannot be found on the market at all,” he worries.

In the pharmaceutical sector, as for other productions, Turkey suffers from a strong dependence on the outside. Painkillers, birth control pills, drugs to regulate blood pressure or diabetes, antidepressants… The shortage of drugs for chronic diseases plunges patients into situations of great precariousness. “There are allegedly drug shortages in Turkey. These statements have nothing to do with the real and concrete situation. It’s actually the lamentations (pharmaceutical companies) who complain that they cannot sell as much as they would like », declared the Minister of Health, Fahrettin Koca, at the end of 2021.

The Turkish state is the main “customer” of these laboratories via the social security system. Each year, arm wrestling begins to determine drug pricing. But the explosion in the price of currencies – the Turkish lira lost 45% of its value against the dollar in 2021 – makes the activity less and less lucrative for the big pharmaceutical companies. « Today, when the euro exchange rate exceeds 18 pounds, the rate used in drug pricing is set at 7.86 pounds,” alert Nurten Saydan, president of a union of pharmacists. Exceptionally this year, the rate was raised twice by the Ministry of Health, forced to intervene.

Turkish pharmaceutical companies are also ceasing to produce certain medicines locally, for lack of being able to finance raw materials indexed to the euro or the dollar. Even the price of packaging – now exorbitant – deters some brands from continuing to market. Like many of her colleagues, Demet Demir, a pharmacist from the Asian suburbs of Istanbul, does not hide her pessimism for the months to come: “From now on, when I call a pharmaceutical company to ask for a drug that I can no longer find in stock, they suggest that I refer my patients to equivalent drugs from other laboratories. It is a disguised way of saying that it is withdrawing from the market. »