Greece faces shrinking drug supply

By Peter O'Donnell

No crisis yet, but the next few days are critical.

The threat of medicine shortages hangs over Greece, the latest worry for a nation of frightened bank-account holders unable to access their savings.
Pharmacists and wholesalers that supply pharmaceuticals to patients and hospitals say they are hoping for a compromise soon, as Greek leaders and their creditors continue emergency talks. If the banks do not open soon, they will not be able to supply medicines to meet local needs, they say.
The situation on the ground is shaky, as it has been for some time with the cash crunch, and there are spot shortages with some pharmacies reporting supply interruptions already.
It is not an emergency yet,  according to Apostolos Veizis, director of medical operations at Doctors Without Borders, in Athens.
“So far it doesn’t seem there is an SOS,” he said.
The group Doctors of the World said it had no hard data on drug shortages but noted that since the start of the crisis, access to health care in Greece has become measurably worse.
Wholesalers are continuing to function, but are deeply worried.
A spokesperson for Greek pharmaceutical wholesaler Prosyfape, which distributes medicines to pharmacies across the country,  told POLITICO the situation is “difficult but not at present hopeless, because there are still some medicines in stock – for a few days, like the banks.”
As with the banks, “the next few days will reveal just how acute the problems are,” he added.
The Pan-Hellenic Association of Greek Wholesalers has written to the president of the Greek national health organization, EOF, reaffirming that “wholesalers will rise to the occasion and keep the promise we gave to the Minister of Health, as we consider it our duty as Greeks to supply our clients in a constant and usual way.”
But Irene Markaki, president of the wholesalers’ organization, told POLITICO: “I really do not know (and this is my greatest fear) whether the medicines which I supply to the pharmacies will be paid in euro, drachmas or will never be paid if the economy collapses.”
For pharmacists, who have front-line contact with patients and are in constant need of re-supply from wholesalers, the situation is already acute, according to Dimitrios Karageorgiou, a pharmacist and member of the Panhellenic Pharmaceutical Association.
“They are still coping, but the situation becomes worse every second,” He told POLITICO. “They have a big problem with shortages.”
“The main problem is the lack of cash flow,” he says. “The wholesalers request payment in cash from pharmacists, who are not able to make those payments.”
There are also problems upstream with manufacturers. Karageorgiou says: “Some pharma companies are not supplying medicines to the Greek market.”
European drugmakers, for their part, say they have committed to keep supplies flowing, for the time being, though they have warned of a looming public health crisis.
The supply problems are likely to exacerbated because none of the major pan-European pharmaceutical wholesalers have a presence in Greece.
There are about 130 wholesalers in Greece, almost all of them national.
But big chains such as Celesio, PHOENIX and WalgreensBootsAlliance have stayed out of the market, partly because of local restrictions on operations.
For national wholesalers that run out of cash to buy medicines because pharmacies cannot pay them, there is little prospect of any temporary cushioning from a benevolent headquarters elsewhere in Europe.
And in the event of continued exchange controls in Greece, the absence of foreign wholesalers will leave the market still more vulnerable.
So far, the government committee responsible for capital controls has been accepting many requests for medical supply imports, say wholesalers.
But tighter controls will leave national wholesalers increasingly limited in the supplies they can acquire from abroad, warn sources in the wholesale sector.