Today, on March 26, at the parliamentary hearings on prescription medication in the National Assembly, the Armenian Lawyers’ Association and the Armenian Association of Young Doctors, which cooperate in the scope of the EU funded “Commitment to Constructive Dialogue” Project, discussed the decision on prescribed drugs.
With this regard the organizations had issued a statement condemning the behavior of the Ministry of Health, submitted a joint letter to the RA National Assembly, the heads of all factions and the head of the Standing Committee on Health Care and Social Affairs with request to hold parliamentary hearings. Further the representatives of both organizations held meetings with the head of the Standing Committee on Health Care and Social Affairs and the representative of “Tsarukyan” Faction. As a result of these activities at 12:00 on 26 March, on the initiative of “Tsarukyan” Faction, Parliamentary hearings on “Forms of Prescription, Writing Prescriptions, Ordering Drugs (Including Electronic Forms) and on the Procedure for Registering Medicines and Medicinal Substances” were held in the NA Session Hall.
Miss Mariam Zadoyan, the lawyer-expert of the Armenian Lawyers Association in her speech touched upon the 2 groups of the main problems regarding the regulations related to prescriptions.
The first group of problems refer to the process of developing a public policy on prescriptions, which was unfounded, non-participatory and incomplete.
According to her, it is incomprehensible how and on what reasoning the proposed solutions have been determined. In particular, there is no reference related to prescriptions in the substantiation of the RA Draft Law “On Drugs”. At the same time the justification of the issue under the question – Decision N 1402-N of the RA Government includes only a few sentences, which does not generally refer to any successful international experience related to prescriptions or any other grounds for the development of public policies.
“Public opinion was not taken into account in the process of public policy-making which refers to the entire society, public discussions, and hearings were not held and, in general, the society was not informed adequately about such regulations.
Notably, the first shortcoming is that as of March 1, when the decision under the discussion entered into force, the website of the official bulletin, the two decisions of the RA Health Minister dated 2005 and 2007 “On the Approval of the List of Medicines provided without a Prescription in the Republic of Armenia” were still in force. The lists provided in these decisions did not correspond with the list posted in the official website of the RA Health Ministry. In fact, we face a situation when the Ministry of Health of the Republic of Armenia simply forgot to recognize the abovementioned acts ineffective. The vivid evidence of which is that after the above-mentioned concerns publicly voiced by both organizations in connection with these shortcomings, the RA Minister of Health recently revoked these two orders,” she said.
Mariam Zadoyan mentions that the second shortcoming was that it was not possible to find out what legal act regulated the transition phases of passing to prescription regulations which is voiced in the press so much. The reason was that legislative norms for step-by-step transition were published some days later after the decision came into force.
“The third disadvantage is that the law does not provide authority to carry out secret purchases yet to the health inspection body, but in practice such checks take place without proper legislative basis. These secret purchases are similar in their nature to the verification procedure of providing cash register devices but in this case, the RA State Revenue Committee is legally entitled to carry out operative-authorized activities,” she said.
The second group problems concern to the existence of a number of gaps and shortcomings in these legal regulations that create fertile ground for corruption risks.
According to the law expert, the analysis of international experience shows that such strict and precise regulation leads to the increase in corruption risks, in particular, the volume of shady turnover. For example, in Moldova, in 2012, about 80 titles of medicines were required to be provide by prescriptions, which led to the increase in drug smuggling in the country: the drugs were brought from Ukraine, Romania and other countries. In neighboring Georgia, more than 3000 names of medicines are being provided by prescription since 2014. However, it is not a secret for us that even a foreigner can buy medicines in Georgia without a prescription.
In addition, according to the RA Law on Drugs, the medicines are written out in the prescribed form according to the general name of the drug. In other words, this regulation is aimed at preventing corruption among healthcare providers and pharmaceutical companies when a physician has no right to guide the patient, mentioning the brand name of the drug. However, research shows that in a number of countries, for example, in Spain, Estonia, doctors continue to provide prescriptions according to a brand name rather than the universal names, although the latter is banned by law,” Mariam Zadoyan said.
Moreover, with the above-mentioned legal regulations, a greater range of corruption risks is created between pharmacy and pharmaceutical companies because even though the decision prohibits and imposes liability upon the pharmacist to lead the patient by the brand name of the drug, however there are no sufficient control mechanisms provided for by law.
In conclusion, she noted that the Armenian Lawyers’ Association of is for the idea of drug prescribing, which regulates for example, self-medication, so-called “drug addiction” and so on, but there is a need to revise the relevant legal regulations, adapt them to the reality in the RA and introduction of existing mechanism to curb corruption risks.
