Issue 5, 2014. October-November


Irakli Margvelashvili: New Prescription Rules Will Usher in Higher Standards for Medicine

On September 1, the Georgian government launched a new policy on pharmaceutical purchases, which limited the type of medications that can be obtained without a prescription at PHARMACIES. The policy has been heavily politicized over the past several weeks but, according to THE Association of Pharmaceutical Companies Representatives in Georgia Executive Director Irakli Margvelashvili, the new regulations will be good for patients and pharmaceutical companies alike.

The new rules, which reorganized the way the government categorizes drugs and restricted access to more types of medications, were met with public outcry.

But Dr. Irakli Margvelashvili told the decision to return to prescriptions will ultimately help society - and the pharmaceutical industry.

"The pharmaceutical sector is not like other sectors... there are some rules, some kind of standards which are created in the countries that went through the stages that we are going through now," he said, noting that the new rules will help curb abuse of over-the-counter drugs and overuse of medicines.

Obstacles for addicts

One of the main goals of the change is to restrict access to medicines that addicts use to make drugs at home.

Prescriptions, which have been on the law books for years but fell into disuse, are a "defensive mechanism" that protects the public from abusing and misusing medicine, Margvelashvili said.

Ending a culture of overconsumption

Another issue is overmedication - and improper medication.

Over the past two decades, Georgians have grown accustomed to self-medication and the power to buy nearly any medication over the counter without a doctor's prescription.

A blood pressure pill that helped someone's aunt may be quickly purchased to help a neighbor's mother-in-law.

Ditto for the antibiotic that worked wonders on someone's cousin's child. The result: a population that buys too many unnecessary drugs.

In a 2012 study of the pharmaceutical industry based on 2010 figures, Transparency International Georgia reported that the average Georgian household spends 34 percent of its income on healthcare.

The Health Utilization and Expenditure Survey of the World Bank found that, in 2010, Georgia spent four percent of its GDP on medicine - double what is spent in the US.

The culture of over-medicating - and self-medicating - needs to change, Margvelashvili noted.

"This local behavior is not correct," he said, adding a one-size-fits-all attitude to medicine consumption is dangerous.

Adapting for the Georgian market

Change is difficult, however.

Margvelashvili noted that while "as a doctor" "any time was time" to reinstate the policy of prescriptions, for Georgian society the first month under the new rules has been challenging.

"The negative reaction of the Georgian population was due to two main reasons. Number one was, whch always happens when you put new restrictions, is that it takes more time. [Before], I could go and buy whatever. But that is not for me an option; that is not acceptable for me" he said.

"The second one was 'how can I go to a doctor and get a prescription?' Some people were complaining that it costs money.

Now all of Georgia has the state insurance and you can go to the doctor and get this consultation, but of course it takes time."

The association worked with the health ministry to help create a prescription form that enables patients to purchase their dose in smaller portions to minimalize cost as well, he noted.

Margvelashvili added that a more "active" awareness campaign could have eased some fears about access to commonly used medication and other concerns.

But the ministry has been open to society's complaints and has already tweaked the categories to meet some public demands.

The changes has also affected pharmacies and pharmaceutical manufacturers, he said.

But he added: "For the industry itself, we do not complain about it. Of course there could be some temporary issues but...for the companies that really care about the ethical way of marketing...for us it is only positive. Medicine should be used for what it was created for."