It is no secret that for several months now in Latvia medicines have been in acutely short supply both on the shelves of pharmacies and in hospitals. Why is this? Despite the fact that the Latvian pharmaceutical industry has a lot to offer - an outstanding scientific base, valuable traditions, genuinely high-quality and competitive products, 95% of the pharmaceutical market is comprised of imported products. Challenges involving supply chains and the availability of raw materials globally have a direct impact on foreign manufacturers and inevitably the Latvian public. Better synergy between the medical community and the public, education, science and manufacturers is necessary for quality of life and in order for vitally important medicines to be available both in times of peace and at X Hour.
Choosing local products benefits the health of both the public and the country
In relation to the pharmaceutical industry as a whole, Latvia really does have accomplishments to be proud of. We are the only one of the Baltic States to have such a powerful and competitive pharmaceutical industry. However, in comparison to companies of a similar level and structure in European countries in which local manufacturers' market share comprises over 40% of the entire range of medicines, in Latvia they make up only around 5%. Of course, illnesses in all European countries are pretty much the same, medicines for their treatment are also similar, and it is no wonder that an extensive range of products is available in pharmacies to treat every malady. However, just like in all industries, there would be greater value in supporting local pharmaceutical manufacturers, which would be of significant benefit to the national economy. So why is it that we are still looking in the direction of foreign medicines? There is no clear answer. Perhaps this is due to a historically ingrained belief that foreign is superior to local, which one can still observe in certain realms. A case in point being the pharmaceutical industry in Latvia, which is unique in the Baltics, and was established during the Soviet era, when medicines produced in the West were in short supply, and it came to be believed that they were the best, because everyone wanted them. At present, the local offering is much broader, in addition to which, in terms of safety, quality and efficiency indicators, medicines made in Latvia are equal to the alternatives made in Western countries. If doctors and the public were to opt for local products, this would benefit the health of both the public and the country. Moreover, by expanding the share of local medicines, the pharmaceutical industry has the potential to become one of the Latvian economy's driving forces. Developing a market for local medicines is also a matter of national security, so that when X Hour arrives, and supply chains are disrupted, the public is not left without vitally important medicines. The health system's stability in crisis conditions will not only depend on medicines made in Latvia and flexible local manufacturers who can meet government "orders", but also on strategic stocks of medicines, which the system has yet to establish in Latvia, through the construction cooperation of the state with Latvian private pharmaceutical companies.
The scientific base is outstanding, but collaboration should be encouraged
From a global perspective, Latvia's advantage is outstanding science. We have the Institute of Organic Synthesis, Biomedical Research Centre, Rīga Stradiņš University, University of Latvia, Riga Technical University, along with a high-quality scientific base with rich traditions. Pharmaceutical companies in Latvia are continually striving to expand their product portfolios, constantly researching trends and needs, and what the medicines of the future will be like. They are also working to develop original medicines, which is the highest level of pharmacy. At present, however, there is insufficient funding to create original preparations, because these entail comprehensive and expensive research. Nevertheless, we can develop ideas, seek cooperation partners and together bring ideas through to fruition. Pharmacy is an industry with immense added value, which is confirmed by a number of the Ministry of Economics' benchmarks, and we can be proud of the fact that the industry in Latvia is developing in conditions of inadequate state support.
At the same time, the pool of specialists is limited, because there are a lot of drug manufacturers and accordingly specialists are in high demand. Luring specialists away from competitors is not a good solution, because even if one manufacturer temporarily benefits, the others lose, as a result of which sooner or later problems are bound to arise in the industry. There have been instances in which leading companies intensively outbid one another for their respective specialists, but this is not the best path for development. Therefore, it is vital to train specialists of a certain level in-house. For example, Olainfarm resolves this by offering internships, scholarships, collaborations with universities, which in turn provide assistance at certain stages in the development of products. It is always tough for a Latvian to admit that he does not know how to do something, and to look for help. The industry needs powerful cooperation partners, because this provides the opportunity for learning and the attainment of much better results. The ability to swallow one's pride and engage partners who have advanced further down the line in certain stages of development would at least partially compensate for the shortage of niche specialists.
What the pharmaceutical sector learned from the Covid-19 crisis
In both Latvia and elsewhere in the world, pharmacy is among the most stringently regulated sectors with exacting requirements and endless laws, rules and regulations. If it were necessary to re-register medicines registered 10 years ago in Europe today, it could not be done without additional research and evidence. However, there is also room for new players in the market, in particular if they can offer something competitive that everybody needs.
The Covid-19 crisis demonstrated that conditions can change very quickly, and that therefore scientists and manufacturers must be able to respond fast to offer new medicines to a great number of people. And, even more importantly, the trust of both medical specialists and the public must be patiently nurtured. Many people questioned the reliability of Covid-19 vaccines because they were developed in a very short space of time and registered at high speed, ostensibly without a sufficient body of evidence. One the one hand, the pharmaceutical industry faced enormous demand, and on the other - a deal of mistrust on the part of the public, which was understandable and only to be expected, because people cannot be blamed for not trusting that which they do not know. If patients cannot get answers to their questions from specialists, they search for them themselves. However, these days a lot of information is available, and the insights that patients find and choose themselves are no longer dependent on industry specialists. In relation to the sudden and dramatic advent of Covid-19 on the global stage, this was the biggest error - insufficient public information. The lesson from this is that not only should trust be strengthened between doctors and patients, but also between industry specialists, in order to together build a flourishing industry and expand the local market, where numerous outstanding products can find their niche.
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