First came the warnings in messages among friends and family and on social media to stock up on essential medicines in Russia before supplies are hit by crippling Western sanctions over Ukraine’s invasion.
Then some medicines actually became harder to find in pharmacies in Moscow and other cities.
“Not a single pharmacy in the city has it now,” a Kazan resident told The Associated Press in late March of a blood thinner her father needs.
Experts and health officials in Russia say the drug shortages are temporary – due to panic buying and logistical difficulties for suppliers due to the sanctions – but some remain concerned that high-value drugs will continue to disappear from the Russian market.
“There will probably be bottlenecks. I don’t know how catastrophic it will be,” said Dr. Alexey Erlikh, head of the cardiac intensive care unit at Moscow Hospital No. 29 and professor at Pirogov Medical University in Moscow.
Reports that Russians could not find certain drugs in pharmacies surfaced in early March, shortly after Moscow unleashed a war on Ukraine and sweeping sanctions increasingly isolated Russia from the rest of the world.
Patient’s Monitor, a patients’ rights group in Russia’s Dagestan region on the Caspian Sea, began issuing complaints in the second week of March.
Ziyautdin Uvaysov, head of the group, told AP he personally checked with several state pharmacies in the region for the availability of the top 10 most wanted drugs, and “they didn’t have many of them.”
Uvaysov added that when asked when stocks would be replenished, pharmacies replied that “there aren’t any and it’s unclear when there will be.”
Despite assurances from authorities that stockpiling was to blame for the rapidly emptying shelves, reports of shortages persisted throughout March.
Vrachi.Rf, one of Russia’s largest online communities for medical workers, surveyed more than 3,000 doctors in mid-March and they said they encountered shortages of more than 80 drugs: anti-inflammatory, gastrointestinal, antiepileptic and anticonvulsant drugs, as well as antidepressants and antipsychotics .
About a dozen people contacted by the AP in different cities in late March said they spent days looking for specific thyroid drugs, types of insulin, or even a popular children’s pain-relieving syrup. Some said they couldn’t find them at all.
“Patients I treat have lost some blood pressure medication,” Erlikh said. “And some doctors that I know report problems with certain very expensive, very important drugs[used in]certain surgical procedures.”
Russian Health Minister Mikhail Murashko has repeatedly asserted that drug availability in the country is not an issue, blaming panic buying for any shortages. He said demand for certain drugs has increased 10-fold in recent weeks, and he has urged Russians not to hoard the drugs.
Experts agree that panic buying has played a role in causing drug shortages.
“People rushed to stock up, and in some cases stocks that were supposed to last a year or a year and a half were bought up within a month,” Nikolay Bespalov, development director at analytics firm RNC Pharma, told AP.
Bespalov also pointed to logistical problems that arose at the beginning of the crisis. While major western pharmaceutical companies pledged not to withdraw any essential drugs from the Russian market, the sanctions cut Russia’s main banks from the SWIFT financial messaging system and hampered international payments. Dozens of countries stopped air traffic with Russia and disrupted supply chains.
The expert stressed that the logistical problems have largely been resolved, but panic buying prompted by fears that foreign companies will stop deliveries could fuel the shortages for some time.
“Of course it will continue until emotions calm down,” said Bespalov.
Local news sites — from Vladimir, east of Moscow, to the Kemerovo region of Siberia — reported shortages of various drugs in the final days of March amid ongoing panic buying.
However, Russia’s health watchdog Roszdravnadzor said in a statement on Friday that “the situation in the drug market is gradually returning to normal, panic buying of drugs is declining”.
Erlikh, the cardiologist, pointed to pre-existing problems with quality medicines in Russia, which is estimated to import up to 40% of its medicines.
Shortages of certain imported medicines became a problem after the authorities introduced an import substitution policy to counter sanctions over the 2014 annexation of Crimea and to promote domestic medicines over foreign-made ones.
The policy outlined a wide range of preferences for Russian companies, eventually making it unprofitable for foreign pharmaceutical companies to ship some of their expensive, high-value drugs to Russia.
In 2015, government procurement of medicines for hospitals and state-funded clinics, which account for up to 80% of Russia’s pharmaceutical market, was subjected to the “three-quantity rule,” which excluded foreign companies when at least two Russian companies bid for a contract .
The government also added increasing numbers of drugs to the “essential medicines” list — a list of over 800 essential medicines for which the authorities set mandatory — and relatively low — prices. Companies can request a fixed price change once a year, but the process is lengthy, heavily bureaucratic and does not lead to a guaranteed result.
“We are already losing one important original drug after the other. Generics are taking their place, and while some pretty good ones are made in Europe, there are also some dubious ones made in Russia,” Erlikh said.
“Of course, if there is no original drug, a generic is better than nothing. But it’s a situation where the bar is (deliberately) lowered, it’s not a good way to live,” he added.
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