The persistence of the thalassemia drug crisis is not a measure of the country’s pharmaceutical supply
Dr. Rouhani’s government is facing a budget deficit that remains from the previous government, with much of the budget being spent on services and services are the most important issues in the country, including health care. They are heavily indebted to hospitals and insurance companies. There have also been problems with financial resources from banks and problems with foreign exchange resources. These large management problems have also caused the tenth government to have a lack of thought in the administration of the Ministry of Health. If our reserves were sufficient, We haven’t had this amount of drug shortage problems right now. In fact, a combination of these factors has come together to make the drug problem worse than anything else.
Upcoming Social Service :In the early days of last month, during the early days of the drug crisis, about the thalassemia patients and their problems with the supply of medicines and the bad news that had arisen, Future Site had a conversation with Dr. Majid Arasteh, President of the Iranian Thalassemia Society, about the shortcomings and lack of some medications and What happens if the same trend continues. For some days now, scarcity and scarcity of drugs for thalassemia patients have been reported, and bad news is that the patients’ hearts are being watered and their blood iron levels are too high to cause infection. The person gets sick and gets the infection into the bloodstream and more unfortunate things happen Ray will create, story. After a year and a half and going through that critical period created by the tenth government’s ineptitude and the country’s financial and banking sanctions and the changing government and management policies in the field of health care and partial clearance of drugs In February 2013, we again had a conversation with Dr. Arasteh. It seems as though nothing special has happened during this time, and the cross-cutting issues that have been raised about drug problems have had little effect on changing the status of thalassemia patients. He says there is still a huge problem with the supply of drugs to these patients, with some injectable drugs not available in the market, which means that thalassemia patients are getting closer to more serious illnesses and a step ahead. to death.
What changes have been made in this shortage since the second half of the year when drug problems and deficiencies increased, especially for specific patients, and what is the status of drugs for thalassemia patients now?
With the eleventh government activity, some of the medication status for thalassemia patients improved. Thalassemia patients have two proprietary medications. Medications used to reduce blood iron loads to lower the amount of iron found in the body due to repeated blood transfusions. The other is conventional medicine. Drugs that reduce blood iron include oral and injectable drugs. These drugs are offered in our country in both foreign and domestic production. One of the drugs available in the country is one called “desferal”, which comes directly from abroad and is heavily deficient in the market. If thalassemia patients need between 100 and 120 units a month, now between They take 30 to 40 units of desferal, which is much less than what they need. In fact, they get about a quarter of their consumption, which is by no means accountable. has it. In the last three, four months, the drug was distributed to thalassemia patients in two of the three phases, but not as much as the patients actually needed. They were forced to procure raw material from other sources, because of the low levels of these substances, the quality of the medicines was poor and not effective for patients and caused other problems for them. And made them unhappy. In fact, they have been problematic in terms of injectable drugs, severe shortage of foreign medicines, lack of in-house medicines, as well as a decrease in the quality of in-home medicines in all three cases. There are no problems for patients when using our own in-house medicines. But when the raw materials are imported from overseas and packaged by Iran only, the problems become even greater. For the past six months, these medicines that needed raw materials were virtually unavailable to patients. But two weeks ago, oral medications were available to patients in this area, and the situation was slightly better, with no price changes. It has been shown to reduce the price of oral medications to aid thalassemia patients. But we still have a shortage of imported injectable drugs.
What about the “pneumococcal” vaccine?
About this vaccine and its shortcomings, it is about people who have their spleen removed and should be vaccinated every 3 to 5 years in order not to get infected. The infection gets worse. Iron chelating drugs cause heart problems and this problem will last until the end of one’s life. The vaccine is currently in severe shortage and is not available in many parts of the country. It is limited in some places, and recently in some places, which were previously sold for 15,000 bucks, are now priced at 70 It costs up to 80,000 bucks. But in some places, it costs 160 to 170 bucks for free, which is not covered by insurance, and the patient has to pay for it because of the cost. Their high medical costs put a lot of pressure on them.
Dr! From the last month until the first half of this year, drug problems became critical and we saw a severe shortage of different medicines for specific patients. Now, after a year and a half, you have mentioned the same problems with the same critical condition for thalassemia patients. So there has been no positive change in the status of drugs for thalassemia patients during this period, especially during the last six months when Dr. Rouhani’s government came out with changes.
We are reflecting on this and talking about it. But the problem is that managerial changes have taken place across the country and ministries, and all of these changes have been going on for the past six months, and whether or not these changes are occurring, processes that speed up these processes are slow and even possible. It has to stop for a while until new managers and deputies from different sectors are deployed and continue to operate. Another problem is that of banking problems at the level of currency exchange with the world. It is and cannot provide the amount of money needed by pharmaceutical companies to different banks around the world His twin. In fact, this money transfer cycle puts a lot of pressure on companies that produce or import drugs. While the United Nations and the European Union have publicly stated that sanctions will not affect medicines and food, it has had an indirect impact on our banks due to the boycott of our banks and the difficult turnover around the world. On the other hand, many companies Foreign airlines were hampered by the lack of fuel to fly to Iran. In addition, sanctions have indirectly caused some imported drugs to enter the country in multiple rounds over several phases. Problems with foreign drug supply increase. According to the UN Charter which includes human rights and the protection of human lives, but with the resolutions and sanctions imposed by the world on our country, there were difficulties in securing medicine for the country, and the long and long cycle had to be taken to provide the drugs needed. Hopefully, with the steps taken, the problems in the field of medicine will be lessened. We have been promised in a meeting with the officials of the Ministry of Health that with the implementation of the nuclear agreements, it will be easier to dispatch and transport drugs to Iran. Hopefully, with some measures taken in the past few months to alleviate drug problems, the government will be able to address both the funding problem of medicine and the issue of international communication for the year 93 to address some of the suffering of specific patients. Decrease.
You have noted that some steps have been taken in the past few months to alleviate drug problems. Dr. Rouhani’s 100-day report referred to the clearance of much of the medication left behind and better access for patients to certain drugs. But according to your current explanation, thalassemia patients now have both short and severe injections of their two injectable drugs and the conditions are still very difficult for them.
Medications were discharged, but not to the extent required by all specific patients. For example, only one thalassemia patient needs one million doses of medication per month, while total customs clearance for thalassemia patients was 1 and a half million doses. The same amount of drug was distributed in three stages of 500,000 doses. Has been. For example, if 100 doses of medicine were needed, we would be given 30 doses. Drugs were among the drugs that were lower than the actual needs of thalassemia patients. While we need about 4 million doses of the drug for the last three months, we have not actually received the drug, and hopefully the next year’s contract will supply all the drugs needed for thalassemia patients.
Given that you have said that much of the problem is not resolved because of continued central bank sanctions and the difficulty of cash flow, could the government have taken or taken any further action to further alleviate drug shortage problems?
What we were told at the meetings of the Ministry of Health used different approaches. Including giving money to pharmaceutical companies to go to sanctioning countries like China and India during the boycott, collecting their money there, converting it into dollars or making money. Or get help from people involved in money transfers. Of course, all of these solutions had their own issues and problems, and at times they faced particular difficulties. The government provided facilities to move to these two countries. They were all working together to take steps to lift restrictions on the import of drugs into the country, leading to increased drug problems for patients. In general, we can say that the government has made efforts to eliminate the restrictions, but we have not yet achieved the results that patients need and want. The reason is that there are many reasons for the problems to be resolved. There is also a discussion of the resources and budget needed to allow pharmaceutical companies to import medicines. However, there should be sufficient funding when planning to buy large quantities of medicines. We cannot say to foreign companies that we will pay you back later. Dr. Rouhani’s government faces a budget deficit left over from the previous government, with the bulk of that deficit being in service matters and services being the most important. There are issues in the country that also include health care. Many hospitals and insurance companies now have heavy debt. There have been problems with banks’ finances and problems with foreign exchange resources.
Are all thalassemia patients covered by the Thalassemia Patient Support Association?
More than 95% of patients are covered by the association, but there are exceptions. 1) Cases where people develop thalassemia at an early age have had significant anemia from the beginning, but later become thalassemia over time and, because of the delay in receiving the card, are later than the benefit of community service. 2) Foreign extinguishers who cannot be issued cards under the Ministry of the Interior and are not covered by insurance. 3) Patients who do not have a valid ID due to some past problems are in consultation with the authorities.
Do all patients covered by the association have health insurance? Because some patients, even with insurance, cannot easily afford the drugs they need, and insurance seems to play no role for them .
Almost all thalassemia patients are insured. But the point is that some insurers have even 100% coverage and some have poor coverage. In fact, the quality of their services is different. For example, social security insurance in some cases takes away the price of a medicine from the amount of insurance it receives from the patient, and some drugs are not covered at all. Sometimes we have problems in the private sector and in private hospitals. Our villagers also have problems with insurance.
Given the different types of insurance coverage you mentioned, how much does the issue of insurance in general affect thalassemia patients?
The issue of insurance is the most important pillar for thalassemia patients. Without insurance, none of our expensive drugs can provide, and if they are out of insurance coverage and the government does not provide subsidies or subsidies for their medicines, none of our patients will be able to afford treatment. They also have many problems and lack of resources. On the other hand, social security and health insuranceDue to various problems, some thalassemia patients are excluded from coverage and this allows non-private insurance booklets to be given to our community patients and increases our patients’ problems. Unfortunately, people in insurance companies tend to pay more attention to the economic side of their business and try to maintain their finances, not to mention that if they remove an insured person from their insurance coverage and insure their insurance book. May be life-threatening for a lifetime because, for example, he has not been injected with blood for three months. These are issues that are not addressed much. In a word, the health economy in our country is very poor. The managers of this sector should think seriously and not think they are paying a heavy price for the health sector. Rather, this long-term cost will be very high for the healthcare system. But everyone is looking at their resources and thinking that if they set a high cost for the country’s health system today, tomorrow they will face a deficit tomorrow. However, if they act with caution, they will see a profit in the next two to three years.
Why do the Social Security and Health Service exclude thalassemia patients from their insurance coverage?
There are laws in place that specifically exclude thalassemia patients from insurance coverage. In fact, the lack of insurance funds has led to stricter laws. Three specific insurance policies for thalassemia patients have been removed. 1) Individuals have special insurance policies as long as they are workers and have compulsory insurance. Unfortunately, when a person becomes unemployed or has insurance, he or she and his / her family member do not receive a special sickness insurance booklet. 2) Sometimes, some thalassemia patients develop a condition that should not be injected for 3 to 5 months as prescribed by a physician. During this time, they are prescribed medications that may be used instead of blood transfusions to ease their blood pressure and sensitivity. Accordingly, if the patient expires during the course of non-injection treatment, her insurance booklet expires, or she wishes to renew or obtain a booklet, she will not be eligible for specific patient insurance. They also have thalassemia and “dart-like anemia”. But by law they cannot have a special insurance booklet while their problem is exactly the same as that of thalassemia patients. But insurers do not consider these people to be thalassemia patients and do not belong to the insurance booklet. They only consider having blood problems and blood transfusions as a sign of thalassemia. We have all corresponded separately with the Minister of Labor and Welfare and the Director of Social Security, but have not received any response so far.
How does your community support all patients in the country? Do they have government resources to cover all thalassemic patients and to help the patient in times of stress?
It has been almost 10 years since the Thalassemia Patient Support Association received no funding from the government, and because the associations were non-governmental organizations, their funding was cut and all resources and funding provided through public assistance. Fortunately, many humanitarian people in the country are rushing to our aid and we are trying to solve some of the patients’ problems by using the same aid. People pay for us and we also spend the same money for patients. we do. Talk about medical equipment and medicine as much as we can to help patients. But sometimes the numbers get too big, and for example, a prescription for a hepatitis problem for one of our thalassemic patients comes in at $ 80 million, which we have to pay. If a society that is going to make a living for one penny and one penny to pay for all this big money is too heavy and out of power. We just hope that people will pay more attention to these problems and that government officials will take action to discuss subsidizing expensive drugs. Not only thalassemia patients, but all patients in this country are entitled to the best medical care at the lowest cost. There are more problems with thalassemia patients because they are more vulnerable than any other specific patient. Provide the best for patients. We just hope that people will pay more attention to these problems and that government officials will take action to discuss subsidizing expensive drugs. Not only thalassemia patients, but all patients in this country are entitled to the best medical care at the lowest cost. There are more problems with thalassemia patients because they are more vulnerable than any other specific patient. Provide the best for patients. We just hope that people will pay more attention to these problems and that government officials will take action to discuss subsidizing expensive drugs. Not only thalassemia patients, but all patients in this country are entitled to the best medical care at the lowest cost. There are more problems with thalassemia patients because they are more vulnerable than any other specific patient. Provide the best for patients.
Do you want to get funding from the government or you can’t fund it?
The point is that according to the laws and regulations they have adopted in this area, NGOs are being aided by non-governmental organizations, and governments should not be criticized by government organizations or processes The government has oversight, is legally direct financial linkage. Sometimes assistance is provided to the associations in the form of work, but the amounts are small enough to just drive a program or lecture. A figure that can solve patients’ problems. . In fact, such a figure has not been met yet