Reem Leila reports on the latest battle between local pharmacists and multinational drug companies The Egyptian Pharmacists' Syndicate (EPS) has told its members to boycott five multinational drug companies after it emerged that retail pharmacies were to be charged higher prices for some drugs than the Health Insurance Organisation (HIO). The EPS has issued a list comprising 36 drugs which it says members should no longer buy. The board of the EPS has threatened it will issue a similar list on a monthly basis until the drug companies involved agree to sell its members the designated medicines at the same price that they are being offered to the IHO. The EPS board met on 26 April to implement recommendations passed by an extraordinary general meeting held the day before, among them the setting up of a Supreme Pharmaceutical Council with President Hosni Mubarak as its chair. The role of the proposed council, says the syndicate, will be to set drug prices and production policies that recognise medicines as a vital commodity that impact on the health security of all citizens. The EPS warned against what it claims are attempts by multinational drug companies to manipulate prices. Next month's list, says the syndicate, will include up to 107 medicines and details of the price discounts which the five multinational drug companies have offered to the HIO. Mohamed Abdel-Gawad, deputy president of the EPS, said the aim of the action was to protect local drug producers against international companies that had offered the HIO credit facilities and an unlimited refund and return policy in addition to wholesale discounts. Pricing, argued EPS spokesman Ahmed Rami, should be determined by a neutral body outside Health Ministry control. HIO head Said Rateb believes the EPS is motivated less by the desire to protect local producers, let alone consumers, than from sour grapes. "They failed in negotiating a similar deal for themselves and now they are just jealous. If they wanted a similar offer they would need to exert more effort instead of attacking people and seeking to impose bans." The drugs offered to the HIO at a discount, says Rateb, account for just 0.07 per cent of the organisation's total orders. Abdel-Gawad, however, sees the discounts as part of a wider conspiracy, the opening shot in a campaign by multinationals to dominate the local market. "Patients will not be affected by the implementation of the syndicate's decision in any way," he says. "The basic drugs will still be available since there are at least five or six alternatives readily available for each one locally." Abdel-Gawad describes the syndicate's position as "logical" though its success will depend on the stand taken by the owners of individual pharmacies and the support of the general public opinion. Even Hatem El-Gabali, the minister of health and population, he says, is on record as saying the pharmacists can do as they like. "Convince the companies and if they agree I don't mind at all," El-Gabali is supposed to have said. Given that HIO purchases account for just over 10 per cent of the total drug market, which is valued at LE6 billion, Abdel-Gawad is convinced the multinationals will not be able to resist the boycott for long. Drug companies, though, say they are unwilling to cave in to such pressure, arguing that the EPS has no authority to issue lists of prices at which its members are allowed to purchase drugs. The only party authorised to price drugs in Egypt is the Policies Committee of the Ministry of Health and Population, points out Osama El-Saadi, a member of the board of directors of one international company's Egyptian operation. El-Saadi stresses that his company will not yield to such pressure. "We will do our job and distribute the drugs to pharmacies. Whoever does not want to buy from us needn't," he says. "Our job is to help eradicate disease and save lives. It is our business to bring breakthrough medicines to patients throughout the Middle East as quickly as possible. Besides, we have a policy to make drugs available for everyone. While some pharmacists have indicated they will not take part in the boycott others argue that they must support the position of their syndicate if they are to force foreign companies to retreat from selling brand-name drugs to the HIO at a lower price than they have to pay.
