The Vetting Show, News24

In August 2023, the Supreme State Audit published a report revealing an alarming situation at the Oncology Hospital at the “Mother Teresa” University Hospital Center. More than two years have passed since this report, but the Albanian government and the Ministry of Health and Social Protection have not taken any measures to change the problem.

"It's my third year of chemotherapy, I continued for two years in Durrës, I bought it, the doctor in Durrës says: "Nazmi, we have nothing to do, you buy it", he says, we have nothing to do. We have been buying it for two years, week after week, but 5 thousand lek is not a little", Nazmi Picirri, a patient at the Oncology Department, tells "Vetting". Nazmi Picirri is not the only one who experiences this situation, but he is among the few who comes out publicly and tells about it.

More than two years have passed since the "Vetting" editorial team denounced the situation at Onkologiku, but the same situation continues. According to public health expert Dr. Erion Dasho, this is a very serious situation.

"This is a problem that directly affects patient safety, up to the safety of life," expert Dasho told "Vetting." Nazmi's story calls into question not only the Oncology hospital, but the entire health system. When there is a lack of medicines and funds for patients, why are concession contracts paid even when they are under investigation? According to pharmaceutical expert Ilir Pecnikaj, it is rare for patients to leave the Oncology and receive full treatment. "This is not a problem of the doctor, the hospital, but of the way the government treats this problem," expert Pecnikaj told "Vetting."

From "Vetting"'s research and the evidence collected, it results that the problem is also related to the way in which funds are distributed in healthcare.

A significant portion of the investments go to concession contracts, some of which are under investigation for corruption. These contracts are even one of the main reasons that patients with tumor diseases do not undergo tests to monitor their health parameters. The situation becomes even more serious when drug shortages also affect children in pediatric oncology.

"After two years, they told me to buy it in Tirana, even here when we had the tests done here at the entrance to Durrës, we had the tests done once at the hospital, once at a private one, because they didn't have it, "the date is past the 20th, it's not there" the hospital says, go do it at a private one", Nazmiu recounts, unmasking the health concession for the test laboratory.

The change in the law distorted the pharmaceutical market

The lack of drugs in Oncology is not just a supply problem in a hospital.

This situation is also related to the way the drug system functions, from the laws that regulate the Albanian market to the institutions that must guarantee their quality and safety. Drugs are the main tool with which the health system treats patients and without drugs there is no therapy for chronic, tumoral, infectious and cardiac diseases. For this reason, the way drugs are controlled and introduced into the market has a direct impact on the quality of treatment.

The changes in the drug law in 2014, 2015 and then in 2021 have affected the conditions for the entry of drugs into the Albanian market, price control and the role of institutions that guarantee quality. “Today we are after drugs that have the cheapest cost and of course the quality leaves something to be desired,” says pharmaceutical expert Ilir Pecnikaj. The 2014 law imposed a stronger filter for drugs coming from Balkan countries. To enter the Albanian market, they had to be registered not only in the country of origin, but also circulate in a country of the European Union.

In 2015, this condition was removed at the proposal of former Minister of Health Ilir Beqaj. After this change, a drug produced in a Balkan country could be marketed in Albania as long as it was authorized in its home country.

Officially, this was justified by the CEFTA agreement and the free movement of goods. In practice, a security filter that served as an additional control over the quality of medicines was removed.

“It is a problem where the gap between the quality of medicines and the patients who seek treatment is widening,” says expert Pecnikaj. At the same time, the concept of direct price negotiation with pharmaceutical companies was also removed and the composition of the Medicines Price Commission was changed, excluding some independent representatives such as the Order of Pharmacists and patient organizations.

This has concentrated decision-making more in the administration and reduced professional and citizen control over drug prices and selection. But experts warn that this requires a very strong control system to guarantee patient safety.

"If we talk about the quality of medicines, it's scary to say. We know that we don't have the right quality of medicines," says expert Ilir Pecnikaj. Problems in the medicine control system have even more serious consequences when it comes to children.

A State Police operation, carried out by order of the Tirana Prosecutor's Office, uncovered drug smuggling, a large part of which were pediatric oncology drugs.

"The biggest tragedy is that a large part of the smuggled drugs were for children with cancer," says expert Pecnikaj. In the first episode of the show "Vetting", on February 8, 2024, the alarm would be raised about the lack of drugs in oncopediatrics or, in other words, drugs for children with tumor diseases, specifically for "Actinomycin D".

In the documentary, "Vetting" would raise questions about the authorization, which the Supreme State Audit would confirm in the last report published in 2025. It was found that the drug Actinomycin D did not have a contract or marketing authorization and that measures were not taken to ensure its regular supply, making it impossible to treat patients at the "Mother Teresa" University Hospital Center.

The report even criticizes the Ministry of Health and the Mandatory Health Insurance Fund for the 4 lengthy authorization procedures and the lack of contracts with importers, which indicates a lack of planning. For the audit period, Actinomycin D was obtained through donation (24 vials from a hospital in Israel), which according to the audit does not guarantee full security for the storage and effect of the drug, especially since no clear record of receipt and entry into the inventory has been recorded.

From the verification of the cards for the period 2020-2024, it turns out that 12 children needed this drug according to medical protocols. Of these, four did not receive the treatment at all, five provided the drug themselves, one was treated abroad and in two cases an alternative therapy was used. "To carry out a real control of drugs, it starts from registration by performing a physical check and its documentary control, to its traceability. Is this done today? It is not done," said pharmaceutical expert Pecnikaj.

The report emphasizes that although after January 20, 2020, there was no stock of this medication in the hospital and in some cases it was used after being found privately or through donations.