Drug shortage affects more chronic disease patients

During the second four-month period of the year, the shortage and non-supply of medicines reported in the online platform cerodesabasto.org affects more patients with chronic diseases and the highest prevalence in the country: diabetes (23%), hypertension (15%) and arthritis (3%), as well as those facing high-cost diseases such as cancer (31%) and HIV (15 percent).

If the complaints on that site for the period January-April 2020 are compared with May-August of the same year, it is observed that the cases reported by cancer patients increased 188 percent.

Of the registries of this organization, about 40% correspond to women with breast cancer who have not received their medications and chemotherapies in a timely manner (mainly fulvestrant, denosumab and cyclophosphamide), followed by cases of patients with Leukemia, Acute Lymphoblastic Disease and Myeloma Multiple (lack of Vinicristina and polonosetron, respectively).

According to the second quarterly report 2020 “Mapping the shortage in Mexico”, prepared by the collective “#CeroDesabasto”, promoted by the organization Nosotrxs, in collaboration with Fundar, the Mexican Association for the Fight Against Cancer and the Mexican Association of Fibrosis Quística, from February 18, 2019 to August 31, 2020, 3,309 reports were registered on the aforementioned platform that denounced the lack of supply of medicines and medical supplies in different health centers in the country.

49.3% of cases correspond to patients from the IMSS (which is the institution that, by far, serves the most people), 34.9% from the ISSSTE, 9.7% from the Ministry of Health and 6.2% others.

Compared to the first four months of 2020, the proportion of IMSS reports in May – August 2020 decreased significantly: 33 percentage points. In fact, it is striking how the position of the institution with the most shortage reports is interspersed each period of analysis since the start of the Zero Shortage initiative in February 2019.

In the second four-month period 2020, the ISSSTE retakes its position as the institution with the most reports with 45%, followed by the IMSS with 39%, INSABI with 11%, the same position that the Institute held in the May-August four-month period 2019.

Nosotrxs highlights the trends of worsening of shortages between subsystems, where the ISSSTE takes the first position this May-August four-month period (replicating the trend of last year).

In addition, three out of ten people who report on the platform consider that there were acts of corruption involved in their case.

It also points out that the shortage of drugs in cancer patients has had a dramatic rebound in cases of 188% during the period analyzed.

Andrés Castañeda Prado, coordinator of the Health and Welfare area of ​​the civil organization Nosotrxs, said that it must be taken into account that so far in 2020 the number of care or consultations for non-covid patients has been considerably reduced. “That means that the shortage is very likely much greater, but there are less attention and therefore fewer reports.”

The activist stressed that, no matter how minimal the shortage, what is really important is that these are people who are running out of their treatment. In addition, the opportunity in which they are given is critical to your health. A person who is missing his medicine is a case in which the right to health is not being respected.

It was striking that the country receives a million visits a day. If 99% of prescriptions were filled someone could say that it is not bad, but also that 10,000 people a day run out of their medicine, which is brutal.

A persistent problem

The shortage of medicines in public institutions is a problem that persists intermittently in Mexico and mainly affects patients with chronic diseases.

According to the 2020-2024 Health Sector Program of the federal government, until before the Covid-19 pandemic began, in the country, three out of 10 prescriptions (69.97%) were not fully filled.

The government of President Andrés Manuel López Obrador set the goal that, by 2024, all prescriptions issued in the public health sector are filled in a timely manner.

By 2020, the “intermediate goal” had been set for 8 out of 10 prescriptions to be filled.

While this is happening, the “out-of-pocket expense” of patients who cannot find the drugs prescribed by their doctors in their health center pharmacies is 41.4%, according to estimates by the IMCO public policy research center.

That means that, once their food needs are satisfied, they allocate four out of every 10 pesos of their family spending through direct disbursements to meet the different requirements of health care.

Ministry of health: until October only six medicines were missing

In this sense, according to the Secretary of Health, Jorge Alcocer Varela reported that, until last October 22, of the 31 medications that in recent months have been in what he said is a supply situation, shortage or shortage path. Only six were absent and were bleomicidal, two presentations of epirubicin, etoposide and two of methotrexate.

However, by that date the orders had already been made to laboratories in the United Kingdom, Germany and Spain, to ensure that they were achieved.

For his part, the director of the IMSS, Zoé Robledo Aburto raised with senators that there is an international situation that has caused the shortage of medicines, but it is not the only factor.

He commented that a study by the World Health Organization indicates that treatments for diseases such as cancer and some cardiovascular diseases and diabetes have been affected by the Covid-19 pandemic.

The official said that to face the shortage problem, the IMSS resorted to consolidated purchases; authorized purchases from its state delegations and complementary purchases via the Ministry of Health.

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