Georgia throws out Hepatitis C medications worth $200 mln

Medicine for the treatment of Hepatitis C worth more than half a billion lari [about $200 million] were disposed of in Georgia because of their expiration date.

This message from the Georgian State Audit Office has caused public uproar.

The opposition accused the authorities of failing to properly implement the Hepatitis C programme and called on the prosecutor’s office to begin an inquiry into the case.

The medications in question were donated to Georgia as part of a free Hepatitis C treatment program.

Georgia is the only country in the world where the treatment of Hepatitis C is completely and free of charge for everyone.

The government of Georgia began this programme in 2015 in partnership with the World Health Organization and the US Center for Disease Prevention and Control. Its goal is the complete eradication of Hepatitis C in Georgia.

Gilead Sciences, an American company, provides the country with the expensive medicines needed to treat this disease.

Georgia was not chosen by chance for this unique programme. Hepatitis C is a serious problem for the country. In 2015, up to 150,000 people, that is, 5.4 percent of the entire adult population, were carriers of the virus in Georgia. For comparison, this indicator in Europe does not exceed 0.5-1 percent.

It is these alarming figures that caused the project to eradicate Hepatitis C, which had no equivalent in the world, to be started in Georgia.

For four years now, everyone included in the programme has been receiving free medication. According to the Georgian Ministry of Health, 60 percent of the adult population was examined during this period.

Of these, 65,000 people are being treated at this stage; 58,000 have completed treatment already. 

98.7 percent of those who underwent treatment fully recovered.

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Why did the expensive medications end up in the trash?

The Ministry of Health’s Social Services Agency names several reasons for the situation with the expired drugs.

The first and main reason is a significant reduction in the beneficiaries of the programme since July 2017. Another reason is a change in the treatment regimen:

“At the first stage of the programme, Sofosbuvir, along with Interferon and Ribavirin, was the main treatment. Since February 2016, these drugs have been replaced with a new generation of medicines, Harvoni, and the consumption of the drugs used in the first phase has dropped sharply,” the Ministry of Health explained in an official statement.

According to the State Audit Office, thanks to the medication worth 560,645,083 GEL (194.5 million dollars), which have expired, more than 2.3 thousand people could have been cured of Hepatitis C.

“There should always be a certain amount of medicines in strategic stock. We treat monthly from up to 1,200 people…we try to increase our engagement rate every month. We know that there are 16,000 people with a positive antigen, but they do not come and do not receive treatment, however, if they decide to start treatment, we should have a reserve for them,” said Amiran Gamkrelidze, head of the National Center for Disease Control and Public Health of Georgia. 

However, the opposition does not trust these explanations and believes that the fact that the Ministry of Health of Georgia wrote off expired medicines may be a sign of corruption. 

“The prosecutor’s office should immediately begin studying this issue. There are suspicions of corruption. There are certain signals that these medicines were being sold. That is why the prosecutor’s office should immediately begin to study this issue,” said Roman Gotsiridze, one of the leaders of the former ruling party, the United National Movement.

The opposition also accuses the authorities of mismanagement and the failure of implementing the Hepatitis C programme.

One of the leaders of the opposition European Georgia party, MP Zurab Chiaberashvili, believes that the matter is “a most serious crime against society”.

The MP believes that the main problem, because of which the authorities could not fully carry out the campaign, is financial barriers.

“The Hepatitis C treatment itself was free for all citizens of Georgia, but a lot of money was spent on preliminary tests, which for a long time remained paid and only in August last year the authorities decided to make the tests completely free too. In the early years of the programme, in order to be tested for inclusion in the programme, initially patients had to pay up to GEL 700 (more than $240),” he says.

Hepatologist Jaba Zarkua calls on the pposition not to dramatize the situation

Hepatologist Jaba Zarkua wrote on his Facebook page: 

“the Georgian government has revealed incompetence in this area, as in all others,” however, he called on the opposition not to dramatise the situation and not to make statements about the “failure of the programme”, since such statements could negatively affect it.

“The Hepatitis C elimination programme is not considered failed, and the company that provides Georgia with medicines does not refuse to do [provide the country] in the future … Do not scare patients. Nothing special has happened except that Georgia has an incompetent government … We must criticize them so that the programme does not suffer,” Zarkua wrote.