New agreements and its implications on access to medicines

By Sophiko Vasadze

The International Project Management Council, established within a long-term agreement between the international consulting group "Global Alliance” (Global Alliance for Health and Social Compact - GAHSC) and The Ministry of Labor, Health and Social Affairs of Georgia, has to define the healthcare standards in Georgia to be in line with EU requirements. High-quality medical services and affordable medicines must likewise be defined.

One of the items in 2011-2015 National Strategy of Healthcare of Georgia states:

1.4. The increase of affordability to medicines. The import stimulation of the medicines registered on EU, USA and other high regulated markets also stimulated the launch of a new and high-quality medicines in the local market. This kind of stimulation helped to increase the number of registered medicines from several hundred to several thousand; new pharmaceutical companies developed their store networks, and because of this prices have been steady and for several companies the prices have decreased 30-50%. But there are three major groups (Aversi, GPC and PSP) dominating the market in Georgia, and even some of their staffers note that prices are still high.

According to Nino Jgharkava, PSP consultant, "Prices increase day by day. Antibiotic prices have increased so much that people who have low income, can’t afford them. I hope the problem will be solved soon. If the control on medicine quality tighten in the country, then generics will gain confidence and it will help to balance prices on the market".

Global Alliance Group is responsible not only to control the prices for medicines, but to make reforms in the whole healthcare system.

On February 28, 2013, The Ministry of Labor, Health and Social Affairs of Georgia started its Universal Healthcare Program and insured all citizens of Georgia. For over two years there have been talks about the economics of the program.

Several organizations and individual experts wrote a letter to the ministry about population income differentiation and about how the program costs would increase.

The government is often late with its monthly payments to hospitals, which is hindering the work of hospitals. Many of them cannot pay the salaries of the administration, which can lead to refusal of services.

St. John's Private Clinic administrative manager Tata Prangishvili said the clinic still has not been reimbursed by the government for 60,000 GEL for August, plus arrears for the following four months.

Economic expert Nino Evgenidze said that Georgia's economy situation cannot support such a system, and it was just a populist move.

“When you have (only) 600,000 taxpayers in the country, how can they carry the burden for the rest of the population? (Georgia's total population is just under 4 million). The government's income from taxes and revenue doesn't cover its liabilities. If the liabilities exceed the ability of a person to pay, then it's a burden on us to assist them. And I, as a middle class representative, do not have the opportunity to expand and grow" - Evgenidze said.

Universal healthcare costs increased 100 million Gel in the 2016 budget. That's why the Ministry decided to hire a group that would give recommendations.

Who is the Global Alliance Group and why has the government entrusted to them not only universal healthcare, but also a whole series of reforms in the system?

Transparency International Georgia’s analyst Mikheil Kukava said that his organization foundation launched a comprehensive research about the new recommendation group and wrote an official letter to the Ministry, but the answer was unclear:

"The company does not have any experience, and I did not get a logical answer to why they were selected" - Kukava said. "They said that the company is new, but their founders have experience. We checked it, but to no avail. The only more or less experienced person is the co-founder, Jean-Charles Eli Malkin. He is a doctor with 25-year experience. The latest part of his career was in the United Nations AIDS organization where he worked as an advisor to the Executive Director and the Regional Director. He is a member of several scientific organizations.

Transparency International Georgia obtained this information and it is impossible to say that this company has enough experience. Global Alliance for Health and Social Compact, a limited liability company, registered on August 30 last year.

In our opinion, the most important task is to reform the healthcare system and it needs fundamental estimation and planning” – Kukava mentions.