Service and Medical Treatment in Georgia

Mariam Bolokadze 79,  pensioner from Tbilisi is under medical treatment for her high arterial pressure  and she often gets prescribed medicine Enap-H. Mariam Bolokadze says that while buying that particular medicine almost always the assistants of the drug store give her “long and boring” suggestions of alternative with the same generic or in other words the same main component, though she has the prescription on that very brand.

Bolokadze is sure that the medicine she often uses is really helpful unlike another one, suggested by the chemist. In fact here are two problems, first the way prescription was written and another – the question, has the drag store assistant any right to change your mind?

Dr. Devi Khechinashvili Georgian Insurance Association (GIA) Chairman of the Board Thinks that the misunderstood and problems among chemists and consumers in such cases are mainly caused by the fact that there is wrong policy of writing prescriptions in Georgia.

Hardly anyone knows that as it follows the doctors should prescribe generics and not the brand names to the patients. This is widely spread tendency in many western countries. As Dr. Khechinashvili explains. Here also there lurks other problem according to him: “Pharmaceutical companies have some ties with the doctors, giving them commission as a profit. This is at least non ethical I think”.  He also added that in other countries such activities count as a criminal like in some way that might be even dangerous for the patient.

Still the doctors calm that there is too small and only theoretic chance for any serious side effects in case of substituting two similar medicines. 

The head of the emergency department in Tbilisi Republican Hospital Giorgi Gotsadze thinks that it is practically impossible any drug store to sell to the consumer absolutely different consistence for any marketing reasons and in all the other cases one and the same generics cannot harm consumer. He gives prescriptions with pharmacological appointment and the patients never have complained about suggesting something different from this.

Some private chemist stores are also keen on giving choices as they call to the consumers while buying the medicine. Lia Tsakadze is the owner and pharmacist of the drug store at Nutsubidze Street.  “Consumers don’t like when I suggest them some cheaper replacements. They want exactly that medicine which was prescribed to them”.

She says that there are some regular clients from her district who trust her and they take her advice into consideration. Lia Tsakadze remembers many cases when consumers were thankful to her for cheaper alternative of the prescribed medicine.

She says that still the pharmacists shouldn’t force the consumers to buy certain medicine for any marketing purpose, but if they do so, they should be very careful as a side effect isn’t the issue which can be excluded.

“The consumers mostly make substitutions in two medical analogues when they need them for small treatment and the difference among them is in price”. This is the tendency detected by Lia Tsakadze during her working experience as a pharmacist.

 According to the CRRC (Caucasus Research Resource Center) enquiry of 2008, 29 percent of Georgia’s population goes to pharmacy for small cold treatment.  The smallest number of the small cold treatment falls on the visit of doctor, which is about 5 percent in Georgia. As it appears from the data Georgians prefer to do nothing or have a hot cup of tea (34percent) when they feel the symptoms of the cold.

Devi Khechinashvili says that expenses on medicine in Georgia are 9-10%from GDP and for about 40% out of this falls on pharmaceutical service. He explains that this is not good as pharmacy merges the shares of other medical services. This is only one part of the chain which links to the monopoly of the market and uncontrolled prices on drugs.

Meanwhile the representatives of two largest drug store chain Aversi don’t want to give comments about what criteria are the medicines suggested to the consumers. The representatives of PSP Group, another market leader also don’t seem willing to speak about this issue and they even find it strange why the press got interested with such things. Yet the consumers like Maro Bolokadze are still confused in one hand because of the wrong prescription policy and on the other hand due to the lack of information about their rights as consumers.