The doctors of the Oncological Institute in Bucharest sound a big alarm. They say they are facing an acute shortage of vital medicines for the sick. It is about no less than 14 cytostatics that are currently missing from the hospital.
Bucharest Oncological Institute, in acute crisis of medicines. Photo source: archive
The crisis of oncological drugs has not been new for a long time, but the problem, instead of being solved, seems to be deepening even more. The reasons were explained to us by Radu Gănescu, the president of the Federation of Patients with Chronic Diseases.
The doctors of the Oncological Institute in Bucharest declared that they no longer have medicines for the treatment of hospitalized patients. It is about cheap drugs, which cost 20-30 lei, but also about very expensive drugs, which are part of the immunotherapy treatment. These drugs also cost tens of thousands of euros for a single treatment, for one patient. The doctors accuse an outrageous situation: the patients, many times, had to buy their medicines themselves, and those who did not succeed received them from the doctors. The latter formed a group to help the sick.
Unfortunately, there have also been situations where patients received their treatments incompletely or not at all, and for cancer patients, this can be extremely serious. For many of them, these treatments are vital, because they keep them alive.
“The medicine crisis is widespread. The problem is old and depends on the system, on the way the legislation was conceived, especially from the point of view of the drug policy. Because it is not only cancer patients who are missing. But, unlike others, who can interrupt or take breaks, cancer patients don’t really have an alternative. They are really in a very serious situation, because the lack of treatment puts their lives in danger”, Radu Gănescu, president of the Association of Chronic Patients in Romania, explained to Adevărul. “The treatment is done on a fixed schedule, in a fixed period that you cannot postpone. And the phenomenon of the lack of medicine is such that sometimes it is difficult for you to understand why this is happening. But generally speaking, there are three important factors that influence the presence or absence of drugs on the market”, continues Radu Gănescu.
The purchase process, very difficult
First, he explains, is the very cumbersome and bureaucratic procurement process. “Hospitals are obliged to make a purchase based on the number of patients estimated over a certain period who would need that medicine. If the number of patients fluctuates, because hospitals, especially oncology ones, do not have a fixed number of patients, about 10, 20 more come, newly diagnosed, then a syncope occurs. Because, in general, hospitals are not allowed to have stocks,” explains Radu Gănescu.
Hospitals do not hold stocks. “Buy as much as they need”
Then, the patient continues, and during the purchase it happens that no one comes to the purchase process or there is only one manufacturer who, due to the very high demand, can no longer cope: “That medicines are not made overnight. And generally, the manufacturers also make some estimates. If there are 100,000 patients who need the same product, they must have 100,000 components, if there are three manufacturers, each of them calculates the quantity differently. There are some market shares that are being made”. At the same time, because the number of patients fluctuates and hospital management has no way of predicting what will happen, at the end of the year it happens that medical units remain, some of them, out of order.
Distribution is done by regions and consumption areas
The distribution method also comes with incentives, continues Radu Gănescu. Manufacturers work with distributors, not hospitals. The drugs are with the distributors and the hospital takes possession of them after the procurement process. “The distributors bring it to the hospital pharmacy or to open circuit pharmacies. But if I have, for example, 100 thousand stocks, of boxes, how do I divide them? I divide them by regions, by areas. For example, I have 50,000 boxes of pills in Bucharest, the South area, I have 30,000 in the Transylvania area and 20,000 in the Moldova area. The most are distributed in Bucharest because this is where the most patients are. They come here from all over the country, so I have a much higher consumption than in Transylvania and Moldova. This means that there is a phenomenon where medicines have to be transferred from one part to another, from one city to another or from one region to another”.
Solutions
One of the solutions would be the centralized purchase of medicines. “This means that the central authorities make the purchases, and then distribute the respective drugs on HOSPITALS. And the purchases should be made not for one, two, three months, but for a year. And halfway through the 12 months, an estimate can be made: how much you consumed, how much you still need, whether you still need it or not.” explains Radu Gănescu. The patient stated that there are hospitals that do not have problems from this point of view. But at the Oncological Institute in Bucharest the situation is alarming”Radu Gănescu points out. .
