- How have the ongoing global events, such as the Russian-Ukrainian war, the Covid-19 pandemic, global inflation, and the food crisis, influenced the drug prices in Kazakhstan?

‘Geopolitical upheavals have engulfed the planet. The current developments have once again confirmed that manufacturing medicines internally is one of the main pillars of national security. We at SANTO see our main goal in providing the Central Asia (Kazakhstan, Kyrgyzstan, and Uzbekistan) with affordable, efficient, and safe medications. The experience, we have accumulated while working in emergency situations during the coronavirus pandemic and handling unprecedented difficulties with procuring raw materials and consumables, has helped us reach our goals.

We did our best not to let down our partners, hospitals, pharmacies, and patients, during the severe shortage of supplies and medications from abroad. We have successfully piloted new online formats and mechanisms to ensure uninterrupted manufacture in crises and availability of medicines.

The market is experiencing certain logistical difficulties in procuring raw materials from Europe due to external circumstances, but they are temporary and caused by overall geopolitical uncertainty. Sanctions have not applied to Kazakhstan and do not apply to raw materials, required for manufacturing medications. The company has preventive measures for such situations: We have stockpiled enough finished products and additional raw materials. These have made it possible to ensure the sustainable operation of the enterprise.

The prices for active pharmaceutical ingredients (API), which we procure from abroad for foreign currency, grew globally back during the pandemic. The periodically changing exchange rates have been causing the recent price hikes for the APIs and expendables. The drug prices are certainly higher than the pre-pandemic costs. Nonetheless, we maintain availability of Kazakhstani medications: The world practices marketing many positions by prescription only during the pandemic or high demand due to political events, whereas they are available at retail in Kazakhstan (except specific super-potent substances). Hospitals account for 50% of all medicines and these are provided through public investment.’

- What prospects and possible solutions does the Kazakh pharmaceutical industry have to resolve the ongoing problems?

‘We have first revised and optimized budgets and reduced costs to keep the prices at check. I mentioned above that we have stockpiled finished products and raw materials. We also significantly expanded the range of our partners during the pandemic. If we have delivery problems with one supplier, we can swiftly turn to alternative partners.

We supply medications under state procurement in Kazakhstan and have successful sales on the retail markets of Kazakhstan, Uzbekistan, and Kyrgyzstan. Production and deliveries proceed in standard operation mode, and we will continue monitoring the situation. SANTO has never stopped manufacturing medications in crises. We are planning to fulfil our obligations to supply medicines within Statutory Free Medical Assistance (SFMA) and Compulsory Social Health Insurance (CSHI) in due time and amounts, and to supply both people of Kazakhstan and Central Asia with necessary medications.’

- How much does Kazakhstan depend on imported drugs?

‘Various expert sources report that the country remains dependent on imported drugs. But we have been hard at work to change the situation and we have been observing positive trends. The past two years are a vivid example.

The government is working on establishing a Coordination Council for Development of Medical and Pharmaceutical Industry to promptly solve the problems in the field. The council includes both government agencies and private businesses. We have taken a myriad of measures to achieve a 50% share of domestic manufacturers, such as shifting the emphasis in long-term contracts from medical articles to pharmaceutical products, setting up research and development centres designed to develop new technologies and products, producing original drugs to achieve long-term contracts, drawing up long-term contracts for expensive innovative drugs and tightening the terms for long-term contracts and their termination.

We have achieved drug safety on a state level thanks to intensifying the development of our own production in Kazakhstan and stockpiling imported products.

Even if something hypothetically happens, we will be able to provide main pharmaceuticals within the country, because our company not only imports finished products, but also produces them here in Kazakhstan. This is quite an energy-consuming and expensive process that allows us to gradually build our own industry to cover our needs and show humanitarian assistance to others. To top it all off, we have established one of the best R&D hubs in Kazakhstan, where we develop medications. Pharma companies in Kazakhstan have the necessary quantities of all vital medicines.’

- What are the most common and critical diseases in Kazakhstan?

‘The official medical statistics say that Kazakhstanis are more susceptible to diseases of the circulatory system, which account for 24.2% of all deaths. The country is the ‘leader’ in cardiovascular diseases. Seasonal respiratory ailments such as influenza, acute respiratory diseases and pneumonia are also quite spread. More Kazakhstanis have been complaining of allergic diseases. Neoplasms have also become a common cause of death in the country. 7,000 people died of malignant neoplasms in the first half of 2021 alone. The experts have also been megaphoning the dismal infant mortality statistics.’

- Has Kazakhstan built a stockpile of medications for the most common diseases? What will happen should the stock run out?

‘President Kassym-Jomart Tokayev has numerously emphasized developing domestic pharma industry. He noted that the country expects to increase the share of local pharmaceutical production to 50% by 2025. SANTO is also making a significant contribution to achieving this goal.

The pharmaceuticals market in Kazakhstan has been growing briskly. Developing domestic vaccines against COVID-19 and developing oncological and cardio segments have played a major role. Our company has earned the leading spot in production of antibiotics, cardio drugs, and other urgent medications. We are not planning to stop. Our target is to build a pharmaceutical homeland of sorts, when a business project is not confined to geographical boundaries and a company operates in several states offering uniform standards and corporate culture. For instance, the best performing aspects of a project in Kazakhstan can be successfully introduced in Uzbekistan and Kyrgyzstan, where we have offices and employees.’

- How do you provide medications for patients with orphan (rare) diseases?

‘SANTO’s profile includes over 240 generics in 12 pharmacotherapeutic groups. We expand the number of manufactured products every year based on what the market needs. The main groups are targeted at treating socially significant diseases, such as tuberculosis, diabetes, cardiological and infectious diseases, and others. The pandemic exposed the urgent need for developing our own pharmaceutical industry, as it is what population’s health and well-being depend on. We supported the national healthcare in every possible way despite all restrictions during the pandemic. Kazakhstan stopped experiencing any shortages in medications in 2021, which once again confirms the importance of having domestic pharmaceutical manufacturing, especially of sterile commodities and antibiotics.

Orphan diseases are included in the statutory free medical assistance and statutory social health insurance in Kazakhstan, which is why they are on the Kazakhstan National Drug Formulary and can be imported within medical insurance without state registration. Treatment of these diseases is quite expensive.

Kazakhstan is one of the few CIS countries that almost fully finances the treatment of patients with rare diseases at public expenses. The county has created all the conditions to provide them with all the medications they might need. The state has done a lot in the field of treating rare diseases. The country introduces and regularly updates international standards on treating orphan diseases.’

- What about the quality of generic drugs manufactured globally? Are they much in demand on the Kazakhstan market in the light of the recent global processes?

‘Generics are drugs that contain an active substance identical to the original drug and marketed after the expiration of the patent for the original molecule. They are as efficient and safe as the innovative products. They have a major role in protocols for treating numerous diseases and are trusted by both doctors and patients. We have very high-quality standards for their production.’

AzVision.az Analytical Team

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