BEIRUT: With pharmaceutical consumption in Lebanon tipped to rise in the next few years, domestic drug producers are calling on the government to extend support to help a sector that faces significant international competition. A 2016 Business Monitor International report on the Lebanese pharmaceutical and health care industry stated that 3.22 percent of Lebanon GDP spending was likely to be on pharmaceuticals by 2020 – the “largest” in the MENA region.
The steady increase in pharmaceutical expenditure has been credited, in part, to the Syrian refugee crisis. There are 1.01 million Syrian refugees registered with UNHCR, but the government estimates the true number to be upward of 1.5 million. With many fleeing conflict and living in impoverished conditions, health issues are widespread.
Although an increase in expenditure is theoretically good news for local pharmaceutical companies, Lebanon’s manufacturers say foreign drug producers will be the ones to cash in on growing business.
This is an issue Industry Minister Hussein Hajj Hasan has sought to address. In his recently launched “National Campaign to Support Lebanese-made Pharmaceuticals,” the minister called on the government to establish a more balanced market of international and domestic drugs while promoting sales overseas.
“Regrettably, many Arab and foreign countries make it very difficult to register Lebanese-made medication and drugs. That makes it nearly impossible to export them to these states,” Hajj Hasan said in a speech at the launch earlier this month.
“There is nothing wrong with the Lebanese-made drugs, because they are thoroughly tested in our labs before shipping them to the markets,” he added.
George Sili, president of the Lebanese Order of Pharmacists, praised the initiative and reiterated the call to enforce balance in the market. “Our total share of the market from drugs we are manufacturing in Lebanon is only 10 percent, while foreign drugs – especially from surrounding countries – are about 90 percent,” Sili told The Daily Star. “Why should we accept all the drugs coming into our market if they will not accept ours?”
Such frustrations are expressed throughout the pharmaceutical industry in Lebanon, compounded by the fact that producers say their drugs meet or surpass international standards. Sili said the situation was more complex than Lebanese products simply being discriminated against, and that countries around the world place industry protections to create a balance of imported and domestic pharmaceuticals.
Carol Abi Karam, general manager of Lebanese pharmaceutical company Pharmaline, said that this was not the case in Lebanon. She said a lack of government protection combined with challenges exporting was a heavy blow to the local industry.
Pharmaline, like all Lebanese pharmaceutical companies, exclusively produces generic alternatives to branded medication. Research and development of new drugs can cost millions and take decades, meaning Lebanese producers look to manufacture drugs under license from the developers – such as pharmaceutical giants GlaxoSmithkline or Astrazeneca.
However, the BMI report added that Lebanon was “highly dependent on high-value imported pharmaceuticals” while generic drugs were “marginalized.”
In 2014, former Health Minister Wael Abu Faour forced down the price of many drugs in Lebanon.
This also hit local producers who are required by law to offer generic drugs cheaper than branded ones.
“By law, [generic drugs] should be 30 percent cheaper than the original brand product. But lately, there has been a huge drop in the prices by original brands. Some have come down by 75 to 80 percent,” Abi Karam said.
“Everyone has to understand that quality costs. If we don’t grow our market, how can we decrease our prices further and further?”
However, Abi Karam agreed that protection had to be done carefully. “[Pharmaline] doesn’t want to put barriers because we do support our free economy,” Abi Karam said.
“I don’t want to use the term ‘protection’ because protection will not encourage the industry to develop. Instead, we want the government to creative incentive and opportunity,” she said, adding that the best way to do this would be a more-balanced domestic- to international-drug balance in the country.
In parallel Abi Karam also said the company would look to promote its brand and target doctors and pharmacists who dispense medication.
However, not all support the industry minister’s plan.
Raymond Sayegh, president of the Order of Physicians, was more critical as he told The Daily Star that the fact Lebanon only makes generic drugs means the country is reliant on foreign medications.
“The Lebanese industry is a generic industry, which means we reproduce drugs five years [after they launch] when we have the rights,” he said of the time between a drug launching and generic licenses being issued. “We will not accept being [forced] into a market that is delayed ... we need to give our patients what they need.”
While Sayegh expressed sympathy for the struggling pharmaceutical industry in Lebanon, he also noted that the Order of Physicians could not support the demands of the pharmaceutical industry that he said was creating a “careless market.” “The market may be unbalanced and I know they have economic issues,” Sayegh said. “[However,] we, as the doctors and the Lebanese Order of Physicians, [prioritize] our patients.”