Health care reform aims to bring ‘appropriate and quality medicines’ to patients

Georgia’s Ministry of Health has launched a large-scale reform aimed at making Georgia’s pharmaceutical sector transparent and accessible, and providing high-quality medicines to citizens. Changes include patient prescriptions – which from this week can only be dispensed for medicines under generic or international titles, to allow patients to choose specific branded products when purchasing.

Eka Adamia, head of the Department of Health’s policy department, spoke to agenda.ge about the reform, explaining that the reform was primarily aimed at ensuring that “the benefits of each component are felt first and foremost by patients”. Adamia said the process would help create a competitive environment in the pharmaceutical market and ultimately reduce the cost of drugs.

The Georgian pharmaceutical market has been characterized by a lack of regulation as well as a less competitive environment, high product prices, polypharmacy, self-medication and drug abuse by patients, Adamia said in the interview for explain the need for the department’s initiative. . The reform also includes the recent launch of imports of medicines manufactured in Turkey following an initiative by the Prime Minister of Georgia – with the aim of effecting a price reduction in the Georgian market – which, according to the ministry official, has showed a “very serious result”. in the early stages through price reductions of up to 60-80% for some drugs.

Under the new regulations, doctors will not be allowed to dispense prescriptions for products under their trade name, while pharmacists will be required to offer customers the equivalent of three high-quality, cheapest drugs in the world. prescribed generic type.

The patient now has the opportunity to make a choice, and choose the desired drug from the list of offered equivalent products, based on manufacturer, price or other property,” Adamia said.

In order to ensure the high quality of medicines, a “positive list” of medicines has been developed to ensure that patients will receive equivalent pharmaceuticals of high quality. Adamia said the “positive list” title did not imply any restrictions on the sale of drugs that were not on the list. Photo: Ministry of Health.

The official from the Ministry of Health also explained a novelty in the definition of another group of pharmaceutical products. “This group includes drugs that should not be used without a doctor’s prescription because their uncontrolled or untargeted use may harm the patient. These include antibiotics, anti-inflammatory and antihypertensive types,” noted Adamia.

Also as part of the reform, from April 1, pharmacists are required to sell drugs only on the basis of digital prescriptions, with the first group of psychotropic drugs being added to the requirement from April 11.

“This change will significantly regulate the misuse of non-therapeutic doses of psychotropic drugs, which poses a great threat to human health,” Adamia said, adding that digital prescriptions would be able to monitor both pharmaceutical companies over-the-counter and prescribing physicians. .

“Our goal is to provide the patient with the right, appropriate and quality medicine, because the main thing is his health. Naturally, the availability – or the price – of these medicines is no less important. Therefore, after putting implementation of all the components of the reform, it will ultimately have a positive impact on both the health of citizens and their financial situation,” added Adamia.

We also asked the ministry official about the challenges doctors face in adapting to digital changes in their work. Adamia said the ministry started communicating with doctors early about the changes. “Trainings were held with clinics, family doctors, insurance companies, the pharmaceutical sector” to ensure that they would be ready to work in the updated regulations “without any problem”, we were told. she said.

The head of the policy department also explained that “if a doctor does not have information about the generic drug for a specific use, he can use the name of a familiar brand to search for results in a single list and then dispense a prescription for the generic product concerned.”

Photo: Ministry of Health.

Adamia said it was “important” that the ministry drew up the reform and its action plan based on recommendations from the Competition Agency and a study by the World Health Organization. The ministry consulted Georgian and international experts and studied the experience of other countries before approving the changes, she said.

“We cooperated with WHO expert Luka Vončina [in the process]. One of the recommendations was to introduce a mandatory national e-prescribing system, which would link all prescribing doctors and pharmacies, as well as provide the cheapest generic equivalent instead of the brand name drug. We have adapted the experience of the countries and the challenges that we have,” noted the health official.

Asked whether there is now a risk that the practice of polypharmacy will be transferred from a family doctor to a pharmacy, the ministry representative replied that the risk was covered by the digital prescription system. The unified list used there displays the type of drug, as well as the purpose of its prescription, with the risk of lobbying for specific products by doctors and pharmacies also assured. “If we see a consumer consistently buying the same drug, regardless of the drugs offered, this may indicate a case of lobbying for a particular drug by the pharmacy,” Adamia told us.

As part of the reform, it is planned to digitize the entire operating cycle of the pharmaceutical sector in order to contribute to market transparency. The Ministry of Health believes that the reform will have a “really serious scale” which will ultimately lead to a “very significant result” in terms of the highest possible access to high-quality pharmaceuticals, the official said.

Among the comments on the reform of health professionals, therapist Ketevan Tsertsvadze shared her opinion on the decision taken by the ministry on generic drugs.

Photo: Commersant.ge

The expansion of the generic segment is important to increase access to medicines. Competitive pricing will regulate drug prices and increase the availability of quality drugs. The relationship between doctor, pharmacist and patient will be regulated,” Tsertsvadze said.

Eka Burdzenidze, Director of Aversi Pharmacy Network, noted that patients would be able to choose the desired products from the manufacturer and price options and based on generic prescriptions, adding “on our side, the process is technically [already] fully operational.

We also spoke to Nana Motsonelidze, a resident of Tbilisi who suffers from a chronic illness and has to take medication frequently. The 64-year-old is retired and believes the health ministry reform was “necessary” for her and others who spend a large part of their finances on drugs. She said she would “definitely” take the opportunity to buy generic products. It’s very good that [now] I can choose drugs according to my budget. I often have to take medicine to regulate my blood pressure, I have chronic thromboembolism, and I constantly need to buy medicine, which is quite expensive. Now I can choose which one to buy, and as far as I know, that price doesn’t affect the quality,” she said.