Interview: Mehdi Zaghloul
What impact are lower prices for medicines likely to have on consumption in 2014?
MEHDI ZAGHLOUL: The price decline has been supported by the Maroc Innovation et Santé since the beginning and is an opportunity for the market to gain volume. However, lowering prices without putting in place a strategy to enable Moroccan patients greater access to health services cannot have a lasting impact on medicine consumption. Only lowered prices combined with the extension of health insurance coverage can contribute to the viability of the Moroccan pharmaceutical sector and lead to further growth.
A few years ago, the Mandatory Health Insurance Plan (l’Assurance Maladie Obligatoire, AMO) and the Medical Assistance Regime (Regime d’Assistance Medicale, RAMED) were introduced as key opportunities for market growth. The sector was already posting average growth of 10% between 2001 and 2009, so operators were expecting that the Moroccan market would progressively expand with the advent of AMO and RAMED to reach a critical size similar to Algeria and achieve growth levels of 20-25% seen in Tunisia. However, over the past few years we have only experienced declining growth levels from 5% in 2011 to 2.4% in 2013.
While we thought the RAMED programme would increase access to a wider array of medicines in hospitals, from light to heavy treatments, however, this has not been the case, with only antibiotics and anti-inflammatory drugs available in hospitals so far. At the same time, oncology has received a boost from the Lalla Salma Foundation, which guarantees access to specialised medicine. However, problems of organisation in the health system still have to be worked out and medicines available in hospitals need to be extended.
Over the past two years, no new medicine has been introduced to the list of reimbursable items within the pharmaceutical sector. However, we are still optimistic when compared to Algeria, where the market is only at 30% of its full potential. The growth of Morocco’s pharmaceutical sector is intimately connected to the AMO.
How can the certification process and clinical tests for pharmaceutical products be improved?
ZAGHLOUL: The certification process for a medicine previously validated by the EU and international institutions usually takes three years in Morocco. By comparison, it takes three months in Singapore, while the global benchmark is 12 to 18 months. The specifics of the Moroccan market have to be considered, but one year is a sufficient period to meet global norms, ensure adequate renewal of the medicine portfolio and eventually allow the sector to begin offering the item.
Singapore has become a centre of research and development, and it is key that we roll out a similar strategy to become a regional leader in medical research. Some initiatives have been implemented, including a clinical research project in Marrakech, but we are still awaiting ratification of the law allowing clinical tests, which will also boost the regulatory framework. This will enable us to secure funds for health-related projects, develop expertise and contribute to global publications. We encourage public-private partnerships, as these have been shown as a successful model when applied in South Africa and the EU.
In what way can technology transfers between international and local companies be encouraged?
ZAGHLOUL: One of the biggest existing bridges is that international companies have already outsourced some of their production to local operators. There is an automatic transfer of technologies, as local companies must comply with global standards. Current success has had a major impact on the attractiveness of local companies among international pharmaceutical groups. Morocco is already recognised by the World Health Organisation as meeting European standards for production quality. This is an opportunity for the sector to capitalise on these successes, especially as Morocco can become a regional centre for pharmaceutical production and help international companies in their expansion strategies in West and Sub-Saharan Africa.
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