Pharmacies close their doors as the lira’s rapid slide and drug shortages pile on pressure

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https://today.lorientlejour.com-L’Orient Today / By Emily Lewis

Many pharmacists closed shop Thursday morning to call attention to the dire economic problems they face. (Credit: Marc Fayad)

BEIRUT — Pharmacists across Lebanon pulled down their shutters Thursday as part of a nationwide strike to protest the economic conditions that have left them unable to provide for patients’ needs.

A group of pharmacists staged a demonstration in front of the Health Ministry in Bir Hasan with two principal demands: an increase to their profit margins and a solution to ongoing medicine shortages.

They warned that if their demands aren’t met, they may have to close their pharmacies permanently.

Unable to cover costs

The first issue facing pharmacists is profit margins that are no longer sustainable amid the collapse of the Lebanese lira.

“Pharmacists don’t have a salary,” Rita El Khoury, the owner of a pharmacy in Ballouneh, told L’Orient Today. “Profit margins are the way we make money.”

Pharmacists’ profits are calculated as a percentage of the medicine price, starting at 22.5 percent for most medicines and decreasing to 2 percent for the most expensive. These prices are set each month by the Health Ministry, and as pharmaceuticals are still subsidized by the central bank, are calculated at the official exchange rate of LL1,515 to the dollar.

Therefore, pharmacists also earn their profits at this rate, while operating costs are calculated at much higher rates.

“We are not able to continue paying any of the costs for our pharmacies,” said Hamed Minkara, the owner of a pharmacy in Tripoli.

As the value of lira has sunk as low as LL15,000 and prices of goods and services have soared, pharmacists have been left struggling to cover their bills.

“Whatever we need to buy to supply our pharmacies, like paper, ink, pens or whatever it might be, has become more expensive,” Khoury said. “Our expenses have shot up, but our income is the same, if not lower.”

Karim Gebara, the head of the pharmaceutical importers’ syndicate, said that pricing medicines at the official exchange rate was also making suppliers’ operations “unsustainable.”

“There is a major gap between the income and the real market rate of our operational costs,” he said.

This also extends to salaries, meaning pharmacy workers are taking an effective pay cut.

Diana Franjieh, who works in a pharmacy in Beirut, earns LL10,500 per hour. This used to be worth $7, but is now around 80 cents at a market rate of LL13,000 per dollar.

“All we’re asking is for our margin to be changed,” Minkara said, “We understand that we’re in a crisis and we don’t expect to make money, but we just need to be able to survive. We can’t carry on this way.”

Despite multiple meetings and proposals for revising subsidies on medicine and the decline in the central bank’s dollar supplies, no comprehensive strategy has yet been put in place.

Ghassan al-Amin, the head of the pharmacists’ syndicate, called Wednesday for the government to approve a plan to retarget subsidies to cover only the most essential medicines, including those for chronic and terminal illnesses.

Shortages

The other challenge facing pharmacists is a shortage of medicines available in the market.

“There are no medications in the country,” Frangieh said. “Even if we do get them, we are getting limited quantities — just a few boxes each month.”

There are two main causes of medicine shortages, Amin explained. The first is monthslong import delays caused by the slow processing times at the central bank, which must provide the dollars to pay foreign suppliers.

“The central bank is taking up to four months to process our invoices,” Gebara said.

The second is the stockpiling of medicines — whether in people’s homes or private warehouses — and the smuggling of subsidized medicines abroad, where they can be sold on at a higher price.

“There is high demand for medicines in the country, but the supply is low,” Gebara explained.

With stocks dwindling, many pharmacists are now only selling medicines to customers that they see regularly. For months, social media has been filled with posts seeking a particular medicine, or stories of people going from pharmacy to pharmacy in search of a drug.

“We simply cannot provide medicines for all patients,” Minkara said. “It’s hard to see someone that desperate, just for medicine.”

During the protest outside the ministry, one pharmacist said that the aim of the strike was not to cause further suffering.

“Our strike today is for every person who is no longer able to find a box of medicine to ease their pain,” he said.

Asked for a Health Ministry response to the pharmacists’ demands, Rida al-Moussawi, an advisor to the caretaker health minister, said that they would be discussed in a meeting at the Grand Serail on Friday.

“We are hoping that this meeting will produce a solution,” Amin said, “so that pharmacists can continue working.”

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