Cancel the “NS” or raise the medicine’s royalty

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Rajana Diet wrote in the newspaper “Al-Akhbar”:

About a month ago, Minister of Health Hamad Hassan was decisive in talking about new drug pricing, as required by the circumstances of the financial economic crisis hitting the country. On that day, after a meeting with the Council of Pharmacists Syndicate, he refused to “bargain over the citizen”, on the grounds that the current circumstance does not allow the ministry “merely to think about prejudicing the price of medicine.” On the other hand, the union council was understanding, albeit grudgingly, of what Hassan had issued, relying at the same time on the discussion sessions taking place within a joint committee (from the ministry and the union) formed to search for solutions to the pharmacy sector. Until now, the discussions did not rise to the level of solutions, as they are still within the framework of brainstorming from the two parties, without there being any agreement on a specific thing, according to the Pharmacists Syndicate Leader Ghassan Al-Amin. However, at a time when deliberations continue, the syndicate “pharmacists” came out of a group of pharmacists demanding to amend the medicine’s royalty from 1500 pounds, according to the official exchange rate of the dollar, to 3900 pounds, according to the exchange rate approved in the banks. Their justifications are that the incomes that come from selling medicines are much lower than the expenses they incur, which drives many towards the option of closure, and this – by the way – is what many pharmacists unanimously agree on, from this group and from outside. They list the expense list whose value exceeds “five times the revenues”, according to one of the pharmacists, from the cost of renting the pharmacy to electricity subscription, maintenance of inkwells, air conditioners, the price of paper and ink … to living. However, paying these costs without the consequences for citizens. Adjusting the royalty in proportion to the exchange rate approved in banks will lead to an increase in the prices of medicines. This is what the union understands well, although today it fluctuates between two things: collecting these costs from people’s pockets or closing more pharmacies (in less than a year, the number of pharmacies that closed their doors exceeded 200, and the Secretary asserted in an earlier interview with Al-Akhbar that “ About 1,000 out of 3,400 pharmacies are threatened with meeting the same fate.

Therefore, the union prefers today to wait for the outcome of the negotiations, and does not support the pharmacists’ movements in “this particular timing of the crisis”, according to what the Secretary says, even if in substance it supports those demands that are “pushed to us by the wrong policies that began decades ago.” The Secretary explains that reaching here was the result of accumulations that took place years ago, “specifically 4 years ago, with the decision that former Minister of Health Ghassan Al-Hasbani came out regarding re-pricing the medicine every 3 years instead of five”, on the basis of a “pricing” of 14 countries that he considers Lebanon is its reference in this regard, 7 of which are European and 7 Arab. And the worst is the other decision of Hasbani, which requires the adoption of the lowest price between these countries, in contrast to what was previously taking place from the middle rate. Thus, “the price of medicine in Lebanon has become the lowest among these countries.”

Pharmacists confirm that the income from selling medicines is much lower than the expenses they incur

This aspect would have been fine-tuned had it not been for the financial crisis and not for a “but essential” detail, which was the policy of dealing with drugs “Brand and Generic”. If adjusting prices is difficult at this time, pharmacists demand that the solution be “to increase profits on generic medication that is similar to the original in its composition, but its price is lower”. This requires an amendment of the established mechanism, so that the pharmacist is given the authority to replace the original drug with another from the same formula but at a reduced price, which is not what can be obtained today. This pharmacist, whom the pharmacist cannot tire of, returns to the prescription that granted the doctor the privilege of imposing “exclusive” medication through the prescription through the phrase “NS” (Non substitution), which prevents the pharmacist from presenting to the patient a drug bearing the same combination of the drug. The original bill is still stuck in the parliamentary committees that have not yet released what allows for the reduction of the value of the medical bill, as is the case in many countries.



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