Drop-Dead Medicine Prices in Egypt.

In a world that no longer cares, we have learnt how to survive high

food prices, high product prices, high gasoline prices and the high
prices of many other things in our lives without even protesting or
asking for how long these high prices will keep consuming us by
indulging us further and further into poverty. But what is the price of
becoming ill in our country? I say it is a lot: all from our own pockets
with some pharmaceutical companies bleeding us to death. Indeed,
who protects who? And who gets what? when high medicine prices
constitute a major barrier to access health care these days in Egypt.
Four days ago, as I was reading El Destoor newspaper, I found this
shocking observation by Hossam El Wakeel on the Pharmacists
Association in Alexandria, which has reported to Dr. Hatem El Gably,
the Minister of Health, a rapid rise in the prices of certain types of
commonly used medicines, in addition to the shrinking size of its
packaging! What is interesting is that the report confirmed, with
examples, that the price of the new pack of the medicine, Primperan ,
produced by Events Medical Company, has increased to 350 piaster
and its size has decreased to 100 mm, after it was sold at the
equivalent price of 240 piaster and the size of each pack was about
120mm. Certainly, this proves that the price of the same medicine
produced by the same company has dramatically increased up to 45%
and its size has dramatically shrunk down to 25%. Moreover, the
report also stated that this medicine doesnt have an official
prescription price, and what is worse; there are no alternatives for
these types of medicines in the Egyptian medical market.
Unfortunately, as medicines are becoming very unaffordable to the
majority of Egyptians who live below the income level of 12 L.E a day
as well as the government worker who earns a minimum wage of 10
L.E a day, many poor Egyptians have died and many others still
continue to suffer and slowly die. Indeed, this verifies that there are
many pharmaceutical companies in Egypt which are first and foremost
designed to reap money from the high prices they charge and the
extraordinary profits they enjoy from the rich who buy their medicines
on regular basis at the expense of the lives of many poor Egyptians.
On a larger scale, while interviewing Dr. Gamal Abdel Wahab, the
Chairman of the Pharmacists Association in Alexandria, about this
issue, he pointed out that these companies, referring to them as
"mafias", control the medical market in Egypt and sadly the
government is not doing anything about it. He also added, in a sigh,
that the Pharmacists Association in Alexandria presented a former
report to the Minister of Health about how the prices of some
medicines have been cut down in their country of origin, whereas

Egyptian pharmaceutical companies along with the Ministry of Health

are still selling the same medicines to the Egyptian population at the
maximum price.
"We requested the Minister of Health to bring down the prices of these
medicines, as prices should be identical to the prices in the country of
origin, and also to make prices more affordable to the Egyptian
citizen. We also requested him to keep a closer eye on what is going on
in the medical market in Egypt. But up till this moment, nothing new
has been done to stop this disaster." He asserted.
For that reason, Dr. Gamal Abdel Wahab expects new rapid raises in
the prices of medicines, the coming period, as long as the government
and the Ministry of Health are doing nothing to stop these "mafia"
companies from exploiting many Egyptians financially. "In fact, the
price of medicine in Egypt is no longer set by the Ministry of Health,"
he indicates. "These 'mafia' companies are creating incredible profits,
beyond 200% of each medicine." He adds.

On the other hand, in an interview with Business Today Egypt, that

also caught my attention, the chairman of Egypt's top exporter of
pharmaceuticals, EIPICOs (the Egyptian International Pharmaceutical
Industries Company) and Managing Director, Ahmed Borhan El-Din
Ismail, described how he is unhappy about the government's tight
regulations of pharma sector prices which made him set up
production outside Egypt! The biggest problem facing the
pharmaceutical sector, says Ismail, is that market prices are
essentially frozen by the government! He explains that with the
reforms introduced by the Prime Minister, Ahmed Nazifs government
in 2004, expectations were high that the old pharmaceutical industry
rules might bend or even change. However, as the prices of everything,
as he states, from bread to steel doubled and tripled, the cost of
medicine remained stagnant. Ismail also says that he has products
whose prices have remained the same for over 20 years.
In addition, Dr. Ismail explains that the WHO changes the GMP (Good
Manufacturing Practice) for both pharmaceuticals and pharmaceutical
companies at least once every six months. The GMP, according to the
WHO, cover all aspects of production, beginning from the starting
materials, premises and equipment, to the training and personal
hygiene of staff. Furthermore, he states that the latest addition to the
GMP just this year, concerning air purity in the entire factory, is
costing his company LE 13 million to comply with, even though
EIPICOs sterile areas are already environmentally controlled for an
almost 100% particulate-free atmosphere. Accordingly, he had to
change 36, 000 square meters and he has been doing this for 18

months and from where he would get the L.E 13 millions if he can't
raise his prices, he asks.
Actually, Ismail believes that his demands are reasonable when he
asks that the government allows him to raise prices in small
increments every couple of years, a rate which is far behind other
commodities, whose prices change in a matter of days , not to lose
money and then become unable to produce new medicines as in the
end it is the public that will be harmed.

In fact, we are not a part of this dispute and regardless of everything

which is said and done, many of us are still losing faith in our current
health care system, when billions of poor Egyptian patients, who are
being denied all forms of medical assistance, are forced everyday to
choose either between to go into debt or go without the specialty care
they need. Making poor Egyptians choose between these two
unbearable options is unjust and unacceptable. We can survive the
high prices of everything but not medicine. As a result, it is high time
we had to fix this broken system so that no more Egyptians go without
the high quality, affordable health care they deserve. Indeed, a pricing
policy which aims at reducing the high prices of essential medicines
for priority diseases must be constituted for the sake of helping the
poor and the sick to continue breathing.

By,
Rasha Adel.