Lack of medicines in Colombia: what is happening?

In recent years, there has been a crisis of drug shortages in various countries around the world. This has caused a lack of essential medicines for the treatment of multiple diseases. Thus, health systems have been affected and, above all, the integrity of people. Several factors have contributed to this drug crisis, such as insufficient regulations, logistical problems in the supply chain, and the lack of incentives for the production of certain drugs, for example, those that treat rare diseases.

At this moment, Colombia is one of the countries that is suffering the most from the lack of medicines in full debates on the approval of a health reform. Earlier this month, the Colombian Association of Comprehensive Medicine Companies (Acemi), which brings together 11 EPS, denounced that the country is experiencing a shortage of more than 1,200 active ingredients. "Several EPS members of Acemi, which are in charge of managing the risk of nearly 34 million affiliated people, reported at the end of this February news of shortages in at least 1,242 active ingredients," says its official statement.

Cases such as the lack of psychiatric medications, antibiotics, analgesics, or the change in formulas for patients with dermatological diseases stand out, which has been denounced by the Foundation for the Support of Patients with Psoriasis and other Skin Diseases FUNDAPSO.

What do the authorities say about the lack of medicines in Colombia?

Although the situation is worrisome, there is no agreement on who is responsible for what is happening. There are multiple voices surrounding the reasons for the drug shortage and its possible solution. The Colombian national government has accused the EPS and these, in turn, have pointed out negligence by the Ministry of Health. However, it is most likely that there is a shared responsibility and there are multiple reasons that caused this drug crisis.

Factors such as complications in contracting between EPS and health managers, delays in deliveries by pharmaceutical companies or delays in procedures before INVIMA are some factors that account for what is happening. However, there are also global problems with raw materials and the pharmaceutical industry. Behind this industry there are many economic interests and this is reflected in the scarcity of drugs with low profitability for pharmaceutical companies, which also have no regulatory or financing plans from the States.

In response to the situation, on March 21 the Office of the Attorney General of the Nation (PGN) began an investigation against the National Institute for Food and Drug Surveillance (INVIMA) and the Ministry of Health. Various voices, such as that of the former Minister of Health Fernando Ruiz, point out that the government has not acted as it should and that the Minister has not carried out an effective management. Although it is true that when Minister Carolina Corcho received the portfolio there were already signs of this scarcity crisis, the situation has gotten worse.

For his part, the Superintendent of Health, Ulahí Bletrán, pointed out that from the entity "we have initiated an investigation of the insurance agents of both the contributory regime and the subsidized regime and special regimes." Thus, the EPS will also have to render accounts of their responsibility in the matter. In fact, in this crossover of accusations it has also come to light that it could be a strategy to influence the Health Reform by the EPS, as well as by the government.

For its part, the ACEMI has issued a series of recommendations in the framework of a political control debate in the Seventh Committee of the House of Representatives. Among its key points are the need to make extraordinary imports, update regulated prices, "Acemi considers that it is possible to mitigate the problem if the Ministry of Health, Invima, scientific societies, IPS, the pharmaceutical industry, pharmaceutical managers, drugstores, and even the companies themselves EPS adopt concrete measures in a coordinated manner", they point out in their recommendations.

On the other hand, the University of Antioquia announced that it could be a key agent in solving the issue. "The UdeA Essential Medicines Production Plant was not only included as a strategic project in the National Development Plan 2023 – 2026, it is also prepared to produce 5 medicines that currently present shortages in Colombia." Thus, it made its capacities available to mitigate the shortage.

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And the patients?

Those who today depend on painkillers or medicines to control HIV, high blood pressure, depression, cancer or many other conditions, today face a very complex situation. In addition to not being able to treat their symptoms, they are being sent back and forth between pharmacies, doctors, and EPS. Faced with these situations, the medical community is making a call not to self-medicate and to consult the specialists on the procedure to follow. In fact, various EPS or health service providers have enabled channels to consult the case. Likewise, it is essential that patients report their situation to the Health Superintendency, which also indicated that patients must receive their medications from the EPS and that if they do not comply they will be penalized.