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February 4, 2023

The (criminal) crisis of medicines

“Poverty chokes Romania!” – this is a painful reality that, through its frequency today, became a proverb. Consecrating the expression is perfectly explainable when we know that over 70 pc of Romania’s population is affected by poverty. And, with many of these paupers living in rural areas, the Romanian village – once holder of the valuable national traditions – has become a ruin in many cases. A ruin where illiteracy and illnesses amplify each week. The general mortality, starting with that of children, place Romania on a painful top place in the EU.

Even village cemeteries are so crowded that some local priests charge today, for the first time in the history of the Romanian village, fees for each grave. The graves that remained without heirs, thus with nobody to pay the tax, will be put on sale at auction to other “solicitors.” Nobody knows what will happen with the dead buried in the respective graves, after these “modern” auctions.

Indeed, poverty chokes Romania, not just morally, as a state of mind, but mainly physically, through the increasing frequency of cardiovascular and kidney diseases, cancer, diabetes, AIDS etc. Whose treatment in hospital will be even more reduced through the recent enforcement of the co-payment. Varying between RON 5 and RON 10, the co-payment for hospital treatment is not costly, politicians assure us. Unable to understand that, with the poverty existing in Romania today, the simple enforcement of the co-payment creates a negative state of mind among the pauper population. Because hospital treatment thus becomes less accessible, as our rulers want, in favour – they believe – of ambulatory treatment.But it is precisely this superficial belief of politicians that complicates a crisis by transplanting it to an even more critical zone. Ambulatory treatment is strictly dependent on the access to the necessary medication, which is in free fall, in our country. Like the entire market of medicines in Romania, often evaluated through the exclusive lens of financial profit, rather than the general health state. Discrimination in the Health sector thus became common fact, which helps the importers and resellers of medicines to obtain maximum profits. Fueled by the errors made by Romanian politicians, who destroyed the local pharmaceutical industry through fraudulent auctions. Successively or concomitantly, one feels the absence of many medicines necessary in the treatment of cancer, diabetes, cardiovascular diseases etc. Not once, the importers and resellers of medicines act precisely in support of these crises of medicines, to the benefit of future maximal financial profits.

The strong crisis, also criminal, in the supply and use of medicines sometimes also produces a beneficial state of resurrection. An example is the recent launching on the market of the National Group of Independent Pharmacies ‘Ethica.’ The group aims at returning to the foreground the pharmacy that concentrates its attention on the patient with his real needs, rather than the excessive financial gain, so frequent and hostile to the general health state today. The ‘Ethica’ group thus admits that we live in a world where economic interests take precedence over quality and professional deontology, hence the risk of becoming a victim of the general strategies of sales and self-medication. The duty of independent pharmacists is that the pharmacy once again becomes the place where patients can be safe, where they can receive the medicines they need together with competent advice and a treatment of friendship and respect. From this perspective, one must praise the 5 fundamental objectives proposed as “strategic mission” by the ‘Ethica’ group: the adoption of an ethical attitude in all actions; the creation of a friendly environment where the patient feels safe; the promotion, by all means, of the rational use of medicines; combating self-medication and the abuse of medicines; charging correct and transparent prices that will not hide false promises.

All these objectives are positive, but achieving them does not depend on the ‘Ethica’ group alone. It is known that, on one hand, the actions will be competed – with means that are not always ethical – by those pharmacies only apparently led by professionals, while being in reality a mask for dubious business. On the other hand, achieving the objectives proposed by the ‘Ethica’ group also depends on the action of family physicians and specialised doctors from polyclinics, whose prescriptions are sometimes thus written and directed as to favour the profit of some ‘friendly’ pharmacies, which have close business connections with the family physicians and those of the specialised sections of polyclinics, hospitals etc. The recently unveiled case of the 42 physicians who signed over 800 fictive medical analyses, as “arguments” for fake medical prescriptions, represents a theft unheard of. Thus, it is natural that the high moral and professional objectives, like those of the ‘Ethica’ Group, enjoy a wider official support, precisely in order to achieve a national strategy, strictly necessary in the sectors of Health, Education and National Defence. The complementariness of efforts in view of devising a national strategy is strictly necessary in each of these three sectors of fundamental importance. And the fact that the ‘Ethica’ Group brings together 250 pharmacies from all over the country shows that a wider collaboration is possible in the Health System too.Otherwise, in the absence of this necessary strategic collaboration, discrimination in the Health sector became commonplace. A usual thing that helps the importers and resellers of medicines to “round up” their profits endlessly.

The import of medicines thus reaches immense proportions in Romania, and their price is higher than in the EU, compared to the average income per capita. Pensioners in Greece often protest because their average pension diminished from EUR 1,600 to EUR 1,200. In our country, the average pension is only EUR 250-280, and the salary of a young Romanian doctor is equivalent to about EUR 200. In our country, for many years it was ignored the truth that medicines are not just regular merchandise, as they represent the right to life as the first fundamental human right. Then, why is discrimination in the Health sector still possible? Because the RON devaluates today? But the value of the RON oscillates, like in the case of any other national currency, between ups and downs. But the increase of the value of the RON is not reflected in the price of medicines. A price that increases even when the value of the RON goes up. The debates on this issue did not lead to a salutary solution so far. The only positive aspect is the unveiling of underground schemes. Like the fact that the expensive import of medicines in Romania does not focus on their therapeutic value or the market demand. The decisive role goes to the commission fees which foreign exporters offer to Romanian importers. Hence the criminal character of the crisis of medicines in Romania.

Such practices must be fought also by the National Group of Independent Pharmacies ‘Ethica.’

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