On 3^rd of August at the site of the National Chamber of Entrepreneurs of the Republic of Kazakhstan was held a discussion of approaches to the introduction of state regulation of prices for pharmaceutical products. The discussion involved the Minister of Health of the Republic of Kazakhstan Elzhan Birtanov, Deputy Chairman of the Board of NCE RK "Atameken" Yuliya Yakupbaeva, representatives of the Ministry of Health of the RK, associations and the business community.

 Opening the meeting, Yuliya Yakupbaeva said that this issue was discussed at NCE with all participants of the pharmaceutical market for a long time.

Yakupbaeva noted: "On 28^th of July 28 at a meeting with the Vice Minister of Health Tsoy A., they came to an understanding on some aspects of the concept of the Draft Law.

Thus, the Ministry of Health of the Republic of Kazakhstan adopted the remarks of NCE RK regarding the exclusion of the merger of two licensing procedures (licensing and GMP standards); exclusion of the definition of an expert organization for the formation of the Kazakh national drug formulary, lists of medicines and medical products for SGBP and MSHI. Also, the proposals of NCE RK “Atameken” on the change in the deadline for the introduction of the mandatory standard for proper pharmacy GPP practice and additional introduction of the concept of technology transfer are also supported.

One of the main points in the concept of the draft law is the introduction of state regulation of prices at all levels, which today we want to discuss on our site".

In his speech Yelzhan Birtanov noted: "Today's meeting is devoted to the issue of regulation of prices for pharmaceutical products. We do not want any sharp corners, it is necessary to bypass them in advance. In this connection, we propose to discuss everything in advance. Our position is this: We do not want to apply the perfect European model in one go. We understand that we need to do it gradually".

The Minister expressed readiness to discuss a step-by-step transition to price regulation, as it was in international practice - first the prescribed medications, then, no later than two years, over-the-counter.

During the meeting, entrepreneurs delivered speeches:

Director of LLP "Aspharma" Zaure Kosherbayeva stressed that the introduction of various tools such as GPP and strict state regulation of retail prices will adversely affect pharmacies. Since they are mainly representatives of small and medium-sized businesses. The implementation of GPP especially in the countryside without state support is impossible, since private pharmaceutical companies do not have the opportunity to independently train, and constantly maintain a wide range of drugs. And the introduction of regulation of drug prices will further worsen the state of pharmacies.

The founder of LLP “Arys” in the town of Arys Alzhigit Tuygynbek noted, "It is impossible to apply prices with a clear mechanism for state regulation of prices, as this will lead to the closure of pharmacies. First, it is necessary to take control of wholesale distributors purchasing drugs from foreign companies, as well as producers. Their prices depend on the prices in pharmacies, usually pharmacies, especially in the village, make profit of no more than 15-20%. State regulation of prices is applicable to hospitals and clinics, but not to retail pharmacies. Also, entrepreneurs need support from the state, namely the allocation of financial assistance to confirm the standard of proper pharmacy practice". 

Representative of LLP "Zabota" Kostanay suggested: "It is better to introduce price regulation for certain groups of drugs, but not all prescription drugs at the same time. The prescription block of preparations is the main one in retail trade".

Independent expert of the Ministry of Health of the Republic of Kazakhstan Rakhypbekov T.K.: "As an adviser to the Prime Minister, we conducted research with the World Bank on the introduction of price regulation for medicines. And the result was the conclusion that price regulation should not be implemented. There can be various methods to adjust prices, for example, to link with taxation, that is, to control super-profits. Without this, inefficient pricing will continue. If there is a tax on super profits, no control by the Ministry of Health will be needed. There are rules and pricing methods for other products. At the same time, we will maintain market relations. And also it is necessary to work out the issue of benefits to pharmacies that serve the rural population. The introduction of regulation without digitalization will not be transparent". 

Pavel Izotov of Almaty proposed to exclude from the scheme of regulation the prices for cheap drugs worth up to 500 tenge, according to the experience of Russia. The introduction of regulation on drugs, the cost of which is below 100 rubles, led to their leaching from the market.

Vice Minister of Health Lyazzat Aktaeva noted that the Ministry of Health of the Republic of Kazakhstan is open to dialogue with business. And she suggested once a week on the site of the NCE RK to discuss current health issues.

Concluding the meeting, Yakupbaeva noted: "As a result, it is clear that many issues of entrepreneurs at the Atameken site are being resolved through joint efforts of NCE RK and the Ministry of Health of the Republic of Kazakhstan. But some questions remained that we plan to discuss in the future: we must clearly define what is the Ex works price? Mechanisms of its monitoring. How will the state body control prices that are presented by foreign entrepreneurs?

How to prevent leaching of cheap drugs? It is also necessary to keep pharmacies in the villages.

At the same time, it is necessary to introduce digitalization, starting from cities. And also to solve the problems of training pharmacists for the effective implementation of the standard of proper pharmacy practice".