MEO had the pleasure to interview Dr. Mohamed Fateen, Assistant Professor of
Hematology Clinical Pathology Department Cairo University, to investigate the major
challenges of the pharmaceutical sector in Egypt.
How you would evaluate, the price of drugs and medication, internationally and locally?
Well, first if we compare the price of medications here in Egypt to the price of drugs outside
Egypt, we will find that prices in Egypt are relatively not high comparing to abroad.
This could be the result of a subsidizing system, or maybe because we have really high
demand for medication as a result of the increasing population number.
However, the relatively high price of medication is yet present because not all the Egyptian
population, has an insurance system that will cover up for them; as well, the income of the
Egyptian citizen is for sure low comparing to the income of citizens in other countries, so it is
normal that the price of medication, must be affordable.
What are the elements that interfere in setting the price for medication in Egypt?
I believe that the Ministry of Health and population, has got its hands on setting the prices of
medication; however, with what we are witnessing these days with the fluctuation of prices in
some medications, I believe that there must be a strict application of the law and close
monitoring of prices. As well, there should be close follow up to check if all pharmacies are
regularly, paying their taxes!.
Do you think that the financial pressure that the typical Egyptian patient (B and C class)
experiences nowadays is taking into consideration while setting the price of medication?
Well the B and C class, are struggling for sure. As patients whose source of living is
governmental pensions, some medications are really expensive for these classes. I would say
they need, an entity to help them! Medical Insurance is a must; a type of insurance that can
cover up for drugs and medications and apply a good discount on scans and medical tests is
needed.
What are the challenges that the Egyptian patient experiences in order to buy the medication
that he/she needs?
We have talked about the escalating price of medications and the high prices that the B and C
class can’t afford; another critical problem is the unavailability of some drugs and
medications; sometimes the patient go for alternatives that are less in quality and efficacy.
Drugs that are needed for chemotherapy, are not always available and it is hard to find them,
as well as drugs for hemophilia that are expensive as well.
Furthermore, some medications need to be taken only in hospitals, so this add a financial
burden on the patient who can’t afford paying the expenses of the hospital.
What rules need to be set in order to regulate the changing/ escalating prices of drugs?
Recently, for sure the prices of drugs are increasing like many other goods in Egypt,
especially that as a country, we are exporting many drugs; however, a good solution that can
help is try to manufacture drugs locally, yet prices might still be a bit high because the raw
materials for manufacturing drugs, would still be imported. I believe this is sure a burden that
the government should be trying to take it over. Let me add as well, there must be strict
governmental monitoring and regulations set over prices! it must be closely monitored so that
drugs are sold with the exact set price, it is not up to the pharmacist to set his or her price!
In your point of view, are there any concerns in the relation that exists between some doctors
and drug companies? as well, do some doctors fall in the trap of recommending medications
marketed by certain drug companies which sponsor events for staff within the medical field?
If yes, please explain more
Well each field has got its own challenges and problems. I would say the first concern, is that
there are some drug companies that afford several privileges to doctors and unfortunately
there are doctors who accept; they offer them to travel abroad to attend conferences, enjoy
their times in sightseeing and make touristic tours on the expenses of the drug company! As
well, yes some companies, ask certain doctors to speak about the effectiveness of a drug as a
marketing tool for this drug, and inappropriately some doctors accept, and here there is a
point to explain.
As a doctor, if I do this because I see that the drug is effective and it deserves to be marketed
that is acceptable, however, if as a doctor I do this just because the drug company will pay
me, here is the issue! It is a conflict of interest; abroad, in many European countries, this is
forbidden and because the medical system is also different, it is not the doctor who provides
the drug to the patient, it is the hospital which acts as a middle agent between the patient and the doctor; however I don’t mean that the Egyptian medical system is bad comparing to the
European system; yet it is just the system that is distinct. Abroad as I mentioned the doctor
belongs to an institute through which he gets his patients, it is not like here in Egypt, the
doctor needs to “advertise” for himself/herself to make his/her own clinic and get more
patients.
Regarding what you mentioned in the previous question, does this problem exists only in
Egypt and underdeveloped countries, or is it a worldwide problem?
Well, this problem exists worldwide, however, in undeveloped countries, it persists more, as
the regulations are not strict enough; strict new regulations and laws must be passed in order
to regulate this complicated relationship in some countries, including Egypt. It should be the
law that counts what is acceptable within the medical filed and what is not.
As well, code of medical ethics must be applied; taking medicine solely as a business that
generates money here in Egypt is a fatal problem; for instance certain gynecologists might
take some actions that violates medicine code of ethics, for instance the doctor might tell a
patient that she needs to do a c-section (Cesarean section), for delivery, while she medically
doesn’t need to; the doctor might tell her that just for the sake of generating more money
from the C-section, comparing to the money he will gain from normal delivery! Which
certainly violates the medical code of ethics. As well, certain doctors might take commissions
from medical labs or scan centers, which is also a serious problem.
What are you recommending as a solution, for the doctor/drug companies relation!?
I would say, that a full governmental medical insurance for Egyptian citizens might be a
considerable part of the solution; as the insurance institute will revise the prescriptions of
doctors and would evaluate it before executing it. It is not an easy step, however it is crucial.
Furthermore, I believe the school of medicine should not accept a big number of applicants,
there must be a criteria for choosing who is admitted as a student in the school of medicine
and who is not; and more courses about code of ethics must be given within the curriculum.
As well, what are you recommending as a solution for setting a relatively reasonable price for
drugs, so that Egyptian patients can afford to buy it?
I would say close monitoring and applying strict regulations is a must; and a good idea could
be initiating and establishing a new insurance system just for drugs and medications.