Interview: Hubert de Ruty
What has been the impact of the price reduction policy on pharmaceutical sales?
HUBERT DE RUTY: The decree was implemented by health authorities in June 2014 after many consultations with manufacturers and distributors. It was a very ambitious step for the Ministry of Health. In less than two months, the market had to re-label more than 60m boxes of medicine. Globally speaking, the impact was negative through 2014, due to lack of communication about which products would see prices reduced, which halted orders from December 2013 to January 2014. The policy initially mandated price reductions on 800 medicines, eventually extending this to a total of 1311 products, including batching and packs. Meanwhile, to ensure that pharmacists' revenues would not be affected, the portion of sales revenues kept by retailers was adjusted in various price segments. Today, the market has not yet regained a good position, and the consumption volume increase that authorities expected to see did not occur. However, it is still too early to judge the actual impact, which can be better assessed over the next two years; it is going to take a while for doctors to change their prescription habits. For now, the market as a whole is shrinking and that all the multinationals were affected and had to restructure. On the other hand, I expect that the price reductions will allow better treatment and increase access to innovative drugs for serious pathologies such as cancer, diabetes or dyslipidaemia.
How can better access to medication be ensured?
DE RUTY: Our common goal is for patients to be able to benefit from the measures taken and that access to treatment improves. Innovative products need faster marketing authorisation. As of today, the process is haphazard and lacks transparency, but the new marketing authorisation decree – which was issued with agreement from manufacturers and health authorities and should be implemented in 2015 – will represent real progress. There is a need to improve regulations governing “biosimilars” and over-the-counter (OTC) products. Law 17-04 does not address the status of OTCs; to do so is imperative. There are also anomalies with some products’ prices following the decree, where the cost of drugs is higher than their selling price. In these cases, manufacturers have requested that prices be reviewed to make them marketable.
How can research and development (R&D) and knowledge transfer be encouraged?
DE RUTY: The market needs to become more attractive, as its size is still limited, and the coverage for medications needs to be broadened. There are also points to improve in intellectual property, without which R&D cannot happen. In this area, recent agreements between the Moroccan Office for Industrial and Commercial Property and the European Patent Office are clearing a path that could reassure multinationals. Clinical trials have been suspended, and to restart them we need to attract specialised companies with global norms.
What is the potential in Morocco for exportation of locally manufactured drugs?
DE RUTY: Out of 15 multinational pharmaceutical companies based in Morocco, 12 have chosen the country as a regional or African centre. Nonetheless, there is a protectionist tendency regarding medicines. We need measures that allow investment in factories and exportation to Africa. We are on the right track with the recent decrees, but there are still points to improve in attracting foreign investment. This industry only lives because there are multinationals. If we want to export, we need to boost the activities of these firms so that they can establish manufacturing units here and export to Africa. Also helpful would be to implement a code of best practices for promoting pharmaceuticals, and multinationals need to be able to get marketing authorisations more easily. The third essential thing to reassure foreign investors is the possibility, at any time, to recover marketing authorisation in case it is no longer met by the terms of contract with the local company.
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