14ymedio, Havana, 7 June 2019 — The news is not encouraging for the more than 3 million Cubans who suffer from high blood pressure. The national pharmaceutical industry is going through a difficult time due to the drop in the import of raw materials, while the demand for anti-hypertensive drugs, such as Enalapril, continues to grow.
Hundreds of millions of tablets to address hypertension and 1 billion tablets of the painkiller Dipirona (metamizole) are produced every year on the island, but demand has doubled in the last decade. The prognosis is that this trend will continue, because more than 30% of the adult population is hypertensive.
Rita María García Almaguer, Director of Operations and Technologies for BioCubaFarma, explained on the Roundtable TV show on Thursday that there are 500,000 patients in the country who consume the anti-hypertensive drug Enalapril. In 2010, the national production reached 151 million tablets of this drug, while in 2018 the figure rose to 337 million and for this year it is expected to reach 400 million units.
A netizen, who identified herself as Dalila, appearing in a forum with an organized debate on the subject on the official website of Cubadebate, stated her concern that “in the last 5 years the demand has almost quadrupled, which means there needs to be an analysis at the national level about what the Ministry of Public Health is doing to prevent these risks. “
The state company BioCubaFarma has been at the center of the complaints of patients and relatives for several years, due to supply problems in the national network of pharmacies. The deficit has reached a point where many Cubans depend on medicines and supplements sent by their emigrated relatives.
Aspirin, band-aids, thermometers, hydration salts, alcohol to heal wounds and test strips for blood glucose measuring devices are some of the basic products that are difficult, if not impossible, to find in the pharmacies that offer their services in national currency.
The extensive informal market network includes among its offers many of these products, from personal imports, which are also more attractive to the consumer than Cuban versions, including medicines such as those to relieve the discomforts of a cold, vitamin C, vitamin supplements and some antifungal creams and antibiotics for topical use.
Another commentator said in the forum that “the last straw was the attending doctor in a consultation with a relative of mine told him in which houses there are medicines sold by private individuals, because the are not available in the pharmacies.”
But the situation is more complicated with those prescription drugs that are used by the chronically ill. Although there is also a black market where antibiotics, antidepressants, analgesics and antihypertensives are sold, it depends mainly on the diversion of resources to the state sector, which is now going through a bad time.
For example, the national industry had to increase the production of the anti-hypertensive Amlodipino from 62 million tablets last year to 87 million in the current year, and yet patients criticize the lack of availability of the drug and long lines appear in state pharmacies when does the product arrive.
The problem repeats itself with Dipirona, a non-opioid analgesic in demand in Cuban homes to relieve everything from a toothache to a cold. Belonging to the pyrazolones family, Dipirona has been renamed in popular humor as “solve everything.”
“In 2010 the production [of dipyrone] in our facilities was on the order of 450 million. In 2011 the demand increased to 500 million tablets […] which led to our having to import this medicine since that year,” explained García Almaguer. In 2018, production went up to one billion tablets, but for this year only 800 million pills of this drug will be available to pharmacies.
The “basic table” is made up of 757 medications, mostly produced on the island and 619 of them are priorities. The authorities have decided to concentrate resources on these, while decreasing the production figures of serums, dipyrone, aspirin and others, said García Almaguer.
However, last April there were 85 drugs missing from that basic table, including 16 of those sold under controls that require the patient to have a card to receive them. The drop in the arrival of raw materials and financial problems influenced this deficit, aggravated by the closure — due to environmental pollution — of several industries in China, where the Island buys the largest quantity of the inactive substances that are used in drug formularies.
The official said that in May they managed to reduce the number of missing drugs to 48, eight of which are sold under a system of control cards, such as Glimepiride, Spironolactone, Risperidone, Terazosin, Clonazepam, Dorzolamide [for the treatment of glaucoma] and Fludrocortisone.
However, García Almaguer was clear when he spoke of the future. “We can not assure that from now on there will not be specific shortages on some of the medications that today make up the basic medication framework”.
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