Rising Patient Numbers or Restricted Psychiatric Drug Imports / No Accurate Data on Drug Users

In treating mental illness, the cost should not be considered merely the price of a single medication pack. A patient may need treatment for months or even years, and if drug prices rise, the total cost of treatment for a household will become a significant sum.

According to Ambassador Arjan, the shortage of neuropsychiatric drugs continues while patients are facing serious problems in finding some anti-depressant and psychiatric drugs. The problem that now, in addition to the "lack of medicine", is associated with the increase in price and the difficulty of paying for treatment. The Food and Drug Organization has declared part of the cause of this shortage to be a disruption in the importation of psychotropic drugs, but an important question remains unanswered: does the increase in the number of people who need psychiatric treatment also contribute to the growth of demand and pressure on the drug market?

The spokesperson of the Food and Drug Organization has said that most of these drugs are in the psychotropic group or the green group under the supervision of the United Nations International Narcotics Control Board, and India is one of the important suppliers of these items in the world.

According to him, after the start of Ramadan war in March 1404 and the stoppage of direct flights from India to Iran, the transfer of these cargoes was limited. The refusal of the Indian side to send these cargoes with Iranian planes also made the supply process more difficult. Urgent imports and indirect routes have covered part of the country's needs, but it is still not enough to fully meet the needs.

How many millions of Iranians live with depression?

Meanwhile, there is an important statistical gap. Although various studies have been conducted on the prevalence of mental disorders and depression in Iran, there are no regular and clear statistics of the number of people who continuously use psychoactive drugs.

However, the dimensions of the problem are significant. A study on the trend of depression disorders in Iran, based on the data of the Health Assessment and Evaluation Institute, has shown that in 2021, about 5.2 million people in Iran were living with depression disorders. This figure has increased significantly compared to the estimate of 1990.

Therefore, it can be said that one of the reasons for the lack of drugs of this kind is the increase in the number of patients, in fact, the lack of accurate statistics can have a direct impact on the process of drug production and import.

The lack of medication for psychiatric patients in some patients can be associated with the return of symptoms or the occurrence of complications due to discontinuation of medication

Psychiatrist Farhad Mazloumi tells Ambassador Arjan about the consequences of lack, absence and high cost of neuropsychiatric drugs: the main problem in psychiatric diseases is the continuation of treatment. After reaching a stable condition, many patients control their conditions by taking medication regularly, and disruption in this process can upset the established balance.

He adds: It is not possible to advise the patient to substitute another medicine by himself just because the prescribed medicine cannot be found. Choosing an alternative drug, changing the dose or changing the interval of administration should be done with the doctor's opinion; Because psychiatric drugs are selected based on the type of illness, the patient's physical condition, concomitant medications, and the person's previous reaction.

This psychiatrist emphasizes: From this point of view, the lack of a drug does not mean more visits to the pharmacy. A patient who does not find his medicine for a few days or weeks may have to change his treatment or use it irregularly; A problem that in some patients can be associated with the return of symptoms or the occurrence of complications due to drug discontinuation.

The patient's ability to pay can directly affect the continuation of treatment / In the treatment of mental illnesses, the cost should not be considered only the price of a package of medicine.

Mazloumi continues: The second problem is the increase in drug prices. Even if the drug is found in the market through imported or alternative routes, the higher price can become a serious obstacle for a patient who needs long-term use.

He emphasizes: In the treatment of mental illnesses, the cost should not be considered only the price of a package of medicine. The patient may need treatment for months or even years, and if the cost of medicine increases, the total cost of treatment for the family will become a significant figure.

This psychiatrist warns: In such a situation, some patients may reduce the number of times they take the medicine to reduce the cost. These behaviors occur while the medication schedule must be based on the doctor's diagnosis and changing it arbitrarily can disrupt the treatment process.

Dr. Mazloumi states: The problem is not only the price of medicine; The problem is that the patient's ability to pay can directly affect the continuation of treatment.

The crisis of nerve drugs is not only a crisis of imports

This psychiatrist adds: the Food and Drug Organization's explanation about the disruption of the import route clarifies part of the cause of the current shortage, but it is not enough to solve the problem permanently. If a significant portion of certain psychiatric drugs are dependent on one or more foreign routes, any disruption in transportation, banking restrictions, changes in trade relations, or regional crisis can affect the domestic market.

He says: In addition to that, the policymaker should also pay attention to the demand process. When scientific studies report the existence of millions of people suffering from depression in the country, planning for the production and import of medicine cannot be done solely based on the consumption of previous years.

Although the disruption of India's import route could be one of the factors behind the current shortage of psychotropic drugs, the country's mental health issue is bigger than a temporary crisis in the supply chain.

In response to the question of how many people in Iran are taking neuropsychiatric drugs continuously, Mazloumi says: for an accurate answer, the statistics of registered prescriptions, the number of patients under treatment, the consumption of each effective substance, the annual consumption trend and its changes in different provinces should be published. Without such data, it is not possible to determine how much of the increase in demand is due to an increase in the number of patients and how much is due to a change in prescribing or consumption patterns.

He adds: As a result, although the disruption of India's import route could be one of the factors behind the current shortage of psychotropic drugs, the country's mental health issue is bigger than a temporary crisis in the supply chain.

Psychiatric drugs are not ordinary consumer goods

This psychiatrist emphasizes in another part of his speech: neuropsychiatric drugs are part of a long-term treatment for many patients. For this reason, their lack can have consequences beyond the drug market. A patient who can't find his medicine or can't afford it, may end his treatment and as a result need more medical services again.

Mazloumi emphasizes in the end: Therefore, the cost that is not paid today for the stable supply of medicine, may return in the future in the form of increased medical visits, loss of personal and professional performance, and higher health costs.