EHS-COVID (402) Quality (33) Overinvestigation and overtreatment of COVID-19 (2)

13 June, 2021

Thanks Neil,

Soumyadeep highlights this issue very effectively. Things are not that different, maybe worse, in Iraq.

We published a blog about this topic. I copy some paragraphs below.

You can see the link to it here

As for prevention, private retailers increased the prices of masks, gloves and other essential equipment for prevention early on in the pandemic. Several herbal medicines were promoted as effective prophylaxis against COVID-19, and their prices went up. Private pharmacies also increased the prices of Vitamins, particularly Vitamin D, Vitamin C and Zinc. These substances are promoted as preventative medicines against COVID-19, and their prices escalated.

On the investigation/examination front (i.e. tests & diagnostics), the private sector in KRI also made significant profits over the last year. In a classic example of supply-induced demand, patients with even mild symptoms of COVID-19 were referred for CT scan tests of their lungs. Private hospitals didn’t hesitate much to increase the prices of doing such tests. Meanwhile, and rather mysteriously, the few CT scan machines available in the public sector suddenly “stopped” working. To make matters worse for patients, some hospitals require patients to have CT scans before admitting them in their COVID-19 units. But the exploitation was not only limited to radiological testing, also other COVID-19- related investigations were affected. All of a sudden, tests such as CRP, D dimer and Ferritin (all nonspecific markers of inflammation) became the ‘gold standard’ for almost every patient with suspected COVID-19. And guess what, the prices of those non-specific tests also went up. Some private laboratories intentionally abused the similarity between CRP and PCR to sell the former as diagnostics for COVID-19.

Finally, treatment. The most extensive exploitation of the COVID-19 outbreak arguably happened in this area (of medicines and presumed therapeutics). The prices of many medicines promoted as ‘treatment’ for COVID-19 went up substantially, in some cases even skyrocketing. These included medicines with no evidence for their effectiveness (such as Hydroxychloroquine, Azithromycin, Famotidine, Ivermectin) and ones where the evidence base is ambiguous or still in RCTs (like Tocilizumab, Favipiravir and Remdesivir). They all became part of an informal protocol that the majority of doctors treating COVID-19 prescribed. As for the prices, well, you know the pattern by now. For example, according to receipts from a private pharmacy, a single vial of Tocilizumab was sold for $3000. Awamedeica, a local pharmaceutical company, sold one box (containing 40 tablets) of Favipiravir for $200 to the Ministry of Health. And unsurprisingly, oxygen cylinders became another “commodity” with escalating prices for those who decided to treat their family members in their own homes.

HIFA profile: Goran Zangana is a medical doctor and Associate Research Fellow with the Middle East Research Institute, Iraq. He is a HIFA country representative for Iraq and is currently based in the UK.

goran.zangana AT