Solutions for the “Vanishing Drug” Conundrum in Lebanon: A Change in the Subsidy System Coupled with a Digital Prescribing Platform

Abstract

The shortage of foreign currency caused by the multiple crises in Lebanon threatens the availability of pharmaceutical products, with patients experiencing shortages of many drugs despite an importation subsidy system for pharmaceuticals financed by the Central Bank’s foreign reserves. This paper describes Lebanon’s pharmaceutical supply chain and the Central Bank’s subsidy system and proposes recommendations to ensure the continuous availability of medication on pharmacy shelves.

Lebanon has been passing through multiple catastrophic crises since October 2019. The devaluation of the Lebanese pound, along with the unofficial capital control and shortage of foreign currency, continues to pose a threat to the importation and affordability of essential commodities. To ensure the availability of these commodities at affordable prices, the central bank has used its foreign currency reserves to subsidize a few essential commodities, including pharmaceutical products. Despite this, several pharmacies began to report shortages of many drugs starting in June 2020. These shortages might be caused by the smuggling of subsidized products outside the country, the stockpiling of chronically used medicines by patients and warehouses, and a possible delay in processing requests by the central bank. To make matters worse, a recent announcement by the governor of the central bank that the bank will be unable to continue subsidizing the importation of pharmaceuticals led to widespread panic, a rush to acquire medication refills, and possibly excessive stockpiling of medications by patients. While there is a need for an urgent plan to keep medication available at an affordable price, this plan has to be realistic and feasible. In this short paper, we describe the supply chain of imported medications in Lebanon in order to propose immediate solutions to the current crisis.