Magdalena Herrera is 69 years old and lives in the south of Bogotá.
Diagnosed with HIV and diabetes, she fell into a psychiatric emergency room due to difficulties in finding Duloxetine, an antidepressant that was prescribed to her by her EPS, the entity in charge of her health care.
“I lasted more than 15 days without that medication and I had an anxiety attack.
My hands and legs were shaking.
It was horrible.
I needed it to reassure myself”, says Herrera.
She managed to get it through the Association of High Cost Patients, a non-profit organization that defends the right to health of cancer, HIV or transplant patients.
In the town of Santa Fe, in the center of Bogotá, resides Luis Herrera, another of those affected.
The 56-year-old man had to stop a treatment to prevent prostate cancer, when he had only two of the six months it was supposed to last.
The medicine he needed was out of stock at his EPS operator.
She found it in drugstores, but she had to pay for it at a commercial price: a box of 30 pills for 180,000 pesos (36 dollars).
“Whoever has the money buys it.
Those who don't, ask God to help us because the disease continues its course.
For us it is serious not to take the medication for one or two days.
It is taking years off our lives ”, laments this pensioner with limited resources who has an older brother with schizophrenia under his care.
Magdalena was diagnosed with HIV more than 20 years ago, which has unleashed more illnesses and made her dependent on certain medications.Diego Cuevas
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Every hour of discussion about the causes of the shortage of medicines in Colombia and the absence of solutions is an hour of anguish for patients.
Barriers to finding some medicines aren't new, but shortages have become more common in recent months.
The EPS, in charge of ensuring the health of more than 34 million affiliates, are calling for government measures given the low supply of more than 1,200 active ingredients, especially for high blood pressure, mental disorders and pain.
The National Institute for Food and Drug Surveillance (Invima) specifies in an official list that there are 33 scarce medicines.
The director in charge of the entity, Francisco Rossi, denounced that some pharmaceutical companies prefer to sell directly to drugstores because they obtain more profits, and has told the EPS to restrict services to influence the health reform.
The EPS rejects this accusation.
Whatever the underlying reason, the affectation is real.
Julio César Rangel, a volunteer from the Association of High Cost Patients, narrates the odyssey of patients and their families: “they have the patient from one place to the other, from the doctor to the pharmacy and from the pharmacy to the doctor.
The doctor formulates a medicine and when the patient goes to the delivery point they tell him that he is out of stock, to go back to the doctor.
The user has to make an appointment again and sometimes days go by before the doctor finally tells him that he cannot change the prescription”.
The shortage of drugs that has been generating discussion in the country and the health system has been affecting a large number of sick people.Diego Cuevas
Changing medications is not always the solution.
In treatments for mental health disorders, for example, the answer depends on the patient's medical history.
“Some drugs can be replaced by others, but clinical evidence shows that they do not always have the same individual response.
In other words, what works for one person may not necessarily work for another.
In psychiatry, naproxen is not the same as ibuprofen to relieve pain”, explains Rafael Miranda, a psychiatrist.
Miranda emphasizes that the abrupt interruption of psychoactive drugs to treat mental disorders, as happened to Magdalena Herrera.
It can also lead to reactivation of the disease, the appearance of more serious symptoms, or crises that can end in preventable hospitalizations.
A resolution of the Ministry of Health and Social Protection of 2013 orders that the missing medicines be sent to the place of residence or work of the affiliates, in a maximum of 48 hours, when the delivery is incomplete.
The norm, however, is rather a dead letter.
The scenes of citizens anguished by the lack of medicines are repeated in different parts of the country, at different times of the day.
“Yours is there, mine is not,” a woman tells her companion after standing in a long line at one of the dispensing points in the center of the capital, one Tuesday morning.
“Many times one arrives and the medicine is not there.
Sometimes you have to go through several points and it appears in one of them, but other times it can be exhausted everywhere and then you have to wait, ”says Gloria, 49 years old.
She suffers from osteoporosis.
Her husband is sick with his kidneys.
Given the lack of some medicines, they decide to try their luck moving from to the south of the city.
Drug shortages are an aging problem.
In a December 16 communication addressed to the EPS, the pharmaceutical manager Discolmédica listed 25 drugs that "present supply novelties that hinder their acquisition and limit the ability to meet requirements."
In another letter dated January 18, the Megalabs laboratory reported to that distributor a series of brands that were not available.
"At the moment we do not have stocks of the following products because they have presented shortages by our supplier," says the text to which EL PAÍS had access.
Concern about medicines has already reached the Congress of the Republic.
In a political control debate this Thursday in the seventh commission of the House of Representatives, in charge of social security issues, Rossi declared that the Ministry of Health has rejected offers from international marketers for the sale of medicines that are out of stock.
The revelation has sharpened public discussion.
Herrera fell into a psychiatric emergency due to the difficulty in finding Duloxetine, an antidepressant that was prescribed to him in his EPS.Diego Cuevas
“The minister [Carolina Corcho] has received several visits from international drug marketers who, list in hand, tell us “this is out of stock, I will put them in a container in Bogotá in a week at a minimum price.”
It seems to us that this is the only solution that does not make sense in a country like Colombia, which wants to strengthen industrialization and is counting on the role of all the actors to solve this problem," said the official.
To the commercial reasons of the laboratories that limit the supply of certain brands to the public health network, other causes attributed by both the EPS and the Government are added.
Some of them originated from the pandemic, such as the shortage of raw materials, insufficient inventories and problems in the logistics chain.
There are also delays in the procedures of sanitary registrations before the Invima.
While the EPS, pharmaceutical companies and the Government discuss the causes, patients continue to endure the wait.
“This is only known by those who experience it.
We suffer in silence”, confesses Herrera, the man who still cannot resume his treatment.
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