Tashkent, Uzbekistan (UzDaily.com) — The pharmaceutical market in Uzbekistan is rapidly developing today, attracting more and more international players. Market participants discuss the great potential of the pharmaceutical industry in Uzbekistan in the coming years, provided there is proper regulation, particularly through intensified efforts to combat counterfeiting and the smuggling of pharmaceuticals.

What changes have already taken place this year, and what can the market and healthcare system expect in 2025? Aleksey Tetryuk, Government Relations and Market Access Manager at AstraZeneca, shared his insights with UzDaily.

— Aleksey, summarizing 2024, could you tell us what changes have occurred in Uzbekistan regarding the fight against counterfeiting and ensuring the quality of pharmaceuticals?

The issue of smuggling and the distribution of counterfeit drugs in Uzbekistan still persists, but we can see that the government has taken notice and is taking certain actions to address it.

First, a pharmacovigilance system was introduced, with a relevant decree signed by the President of Uzbekistan in January 2024. This document aims to implement a set of measures to improve the detection and response to potential threats related to the use of medications. The goal is to create a state system for receiving and processing reports of adverse events that occur in patients after taking medications. It can be said that Uzbekistan is establishing a legal foundation for the implementation of the international GVP standard (Good Pharmacovigilance Practice), which is a quality standard for monitoring drug safety and, if necessary, taking measures to reduce risks and enhance the benefits of medications.

Additionally, this year the authorities granted pharmacies the status of organizations responsible for providing consumers with safe and quality medications. Pharmacies are now required to notify the authorized body under Uzbekistan’s Ministry of Health about compliance with medication quality requirements. These are significant steps for controlling pharmaceutical products and preventing tragedies that Uzbekistan has, unfortunately, seen before.

Moreover, in October, the Cabinet of Ministers adopted a regulation on post-marketing surveillance of pharmaceuticals. This means that periodically, regulators will conduct controlled purchases of drugs available in the civilian market to check product quality and compliance with technical standards. This new control mechanism will begin operating on January 1, 2025.

— But are there still risks of counterfeit and smuggled drugs reaching pharmacies? How can these risks be prevented?

AstraZeneca has been operating in Uzbekistan since 2021, and despite the uninterrupted supply of our medications to the country, we regularly encounter cases of smuggling: batches of drugs are brought into Uzbekistan in violation of customs laws and transportation and storage requirements. For example, AstraZeneca medications may be sold in pharmacies in packaging with languages from countries where there is no official import through regular channels. Furthermore, these drugs are often brought in suitcases without maintaining the required temperature conditions, which leads to the spoilage of medications, making them less effective or completely ineffective for treating diseases.

What is dangerous about counterfeit or smuggled drugs for people? The main risk is the lack of guarantees regarding the authenticity of the drug. People are not protected from purchasing counterfeit medicines with unknown ingredients, which may not only fail to provide therapeutic effects but also worsen health conditions, depending on what the counterfeit product contains.

It is essential to strengthen penalties for the import and sale of smuggled and counterfeit drugs in Uzbekistan, including revoking the licenses of pharmacies violating legislation. This will significantly reduce the size of the gray market for pharmaceuticals and reduce risks for patients.

— A mandatory drug labeling system has been in place in Uzbekistan for over two years. How do market participants assess its performance?

The development of the drug labeling system in Uzbekistan is an important measure to protect citizens from dangerous products. Labeling confirms the authenticity of medications and indicates that they were properly manufactured and imported. However, it works only when the drug is dispensed by a pharmacy with the issuance of a receipt. Therefore, it is very important to ensure that the barcode on the drug packaging is scanned in the system when the drug is dispensed.

Of course, launching and setting up a product tracking system is always a complex, multi-level process involving the entire industry. Clearly, it is somewhat stressful for businesses and regulators, but it has been successfully managed. We see that the adjustment of all labeling processes has already been completed.

However, the digital labeling system is only one of the measures to create an honest and safe pharmaceutical market. A comprehensive approach is needed: stricter legislation regarding counterfeit imports, regulation of "parallel imports," and the development of a patent protection system, which I mentioned earlier.

— In September, the authorities of Uzbekistan and Russia agreed to mutually recognize the drug labeling codes for pharmaceuticals. How will this document impact the pharmaceutical market in Uzbekistan?

This decision could potentially expand Uzbek patients' access to modern medications already available in Russia. After determining the operating mechanism, companies will have the opportunity to ship to Uzbekistan goods that are produced and labeled in Russia according to Russian regulatory requirements, but only if the products are registered in Uzbekistan. At the same time, the labeling codes applied in Russia will also be valid in the Uzbek ASL Belgisi labeling system.

This will increase the supply volume to Uzbekistan’s pharmaceutical market. The integration of systems will make cross-border shipments seamless. Thus, patients in Uzbekistan will have access to the necessary medications.

— What growth opportunities do you see for the pharmaceutical market and the healthcare system in Uzbekistan?

First and foremost, we see new opportunities in the public healthcare sector. Although there is an increasing number of innovative drugs available on the Uzbek market, their accessibility for patients remains relatively limited. The problem lies in the underfunding of healthcare. For example, according to the state budget document for 2024, 151 billion soums were allocated for the purchase of medications for cancer treatment, and just over 121 billion soums for medications to treat hematological diseases. Unfortunately, these funds are insufficient to provide necessary therapy for all patients. Providing medications to patients is a pressing and socially significant issue, where active state participation is crucial to expanding access to modern therapies.

However, it is important to note that the government is trying to improve the situation by increasing healthcare funding. According to the adopted Uzbekistan State Budget Law for 2025, this amount will be 10.4% higher than in 2024, totaling 5.1 trillion soums. Thus, 166.4 billion soums will be allocated to improve cancer care and develop oncology services. Moreover, a new expenditure item has been introduced for medical care for children with oncological, hematological, and immunological diseases — 135 billion soums.

The republic is paying more and more attention to issues such as drug supply and the development of effective medical care. This is clearly a positive trend that will only strengthen in 2025. It is essential to consolidate the efforts of the government, the medical community, and drug manufacturers to accelerate the development of both the healthcare system and the pharmaceutical market in Uzbekistan. This will enhance the effectiveness of medical care, particularly in identifying diseases at earlier stages and achieving better treatment outcomes through innovative therapies, ultimately extending people’s lives.