Tuesday, 16 August 2022

Savings Could be Made With More Generic Drugs on Croatian Market

August the 16th, 2022 - Replacements of certain medicines are set to arrive on the Croatian market as making savings becomes extremely necessary in the enfeebled Croatian healthcare system.

As Poslovni Dnevnik/Josipa Ban writes, counting the pennies within the wider Croatian healthcare system, especially in the consumption of medicines, is now more needed than ever. We've been witnessing accumulated debts for medicines for decades now, which, after numerous rehabilitation attempts by the Ministry of Finance, are still far from reduced. In fact, they only grew enough to reach slightly more than six billion kuna at the end of April this year.

HUP - the Association of Pharmaceutical Manufacturers have been warning about some of these debts for some time, noting that they definitely can be reduced. The Croatian healthcare system's annual savings could rise from the current 300 million to as much as one billion kuna if consumption were to increase and the procedure for including generic drugs on HZZO's list of drugs for the Croatian market was finally accelerated.

There are some substitute drugs that come to the Croatian market when the patent rights to the original drug eventually expire. As their placing on the Croatian market means more competition, the price of the medicine also drops at the same time. The situation here, at least according to data from back in 2019, is that 61 percent of the volume in the consumption of prescription drugs across the Republic of Croatia is made up of generic drugs, and they only account for 5% of the total healthcare sector's budget.

"Although this percentage has been increasing over the years, it's still somewhat lower than the EU average, which stands at 67 percent. This shows us that there is still a great potential for the use of generic drugs in this country,'' they emphasised from HUP- the Association of Medicines Manufacturers, whose members, in the period from 2010 to 2020, invested a total of 5.4 billion kuna. As far as biosimilar medicines are concerned, the situation is much worse, and back in 2019 they occupied a modest 13 percent of the Croatian market.

A complicated procedure...

One of the reasons for the lower consumption of generic and biosimilar drugs, which causes higher expenditures for such medicines, is the procedure that manufacturers must go through in order to get on HZZO's drugs list.

Jerko Jaksic, president of the PharmaS Management Board and president of the HUP Association of Drug Manufacturers, explained that the process of placing a generic drug on the Croatian market takes approximately one to two years.

"The first stage is the registration of the drug with HALMED or, for biosimilar drugs, with the European Medicines Agency (EMA). After approval from HALMED or EMA, it takes up to six months for the HZZO to place the drugs on their list. Although the situation is somewhat better than it was around ten years ago, that part of HZZO could and should be accelerated. What I mean by that is that following HALMED and EMA approval, these medicines should automatically be included in the lists of medicines, without any additional administrative steps because there's no need for them. Unfortunately, here too we have an example of resistance to changes and adaptation of the system, as well as the classic slowness of the administration,'' pointed out Jaksic, adding that automatic inclusion would speed up processes and the arrival of medicines on the Croatian market, as would cheaper drug therapies for patients in three to six months.

"It would also bring savings of several tens of millions of kuna on an annual level for the entire Croatian market," said the president of the PharmaS Management Board. HUP noted that the role of generic and biosimilar drugs is extremely important for both the healthcare system and the patients themselves.

"In fact, these drugs make many key therapies available to more patients, and for the same or at a lower cost than before their introduction. For example, two to three boxes of prescription drugs issued in Croatia come from the generic industry, and the share of generic drugs in the cost of all drugs is only 27 percent. If we look at the pharmacy system, the share of generic drugs is 65 percent, and this accounts for less than 40% of the drugs budget," they explained.

Great potential

In addition to all of the aforementioned, there is no fear for the patient because prescription drugs and generic drugs are the most organised part of the healthcare system. Jerko Jaksic noted that their importance has long been recognised by GPs. However, hospital doctors are not yet following suit.

"Hospital doctors have a lower level of knowledge of generic and especially biosimilar therapies, they also lack a developed awareness of the financial savings they can enable. There's a great untapped potential there, above all in the sense of using cheaper generic and biosimilar therapies in order to reduce costs for hospitals,'' said Jaksic.

There are, therefore, several mechanisms that we must change in order to accelerate the introduction of generic and biosimilar drugs on the Croatian market, and thereby contribute to significant savings.

"It's necessary to systematically implement the existing regulations for the determination of the price of drugs, to include generic drugs on HZZO's drugs list faster, and to enable the faster penetration of generic and biosimilar drugs into the wider hospital system,'' the HUP Association of Drug Manufacturers believes.

With these measures, along with measurements of treatment outcomes, they say, savings in the healthcare system can reach up to 1 billion kuna per year. So, the ruling party has a solution. But is the will there?

For more, make sure to check out our dedicated lifestyle section.

Wednesday, 10 August 2022

These were the Key Mistakes in Treatment of Vladimir Matijanić

August 10, 2022 – On August 5, Index’s journalist Vladimir Matijanić, aged fifty-one, tragically passed away due to the negligence of the Croatian health system. With several autoimmune diseases, he tested positive for covid-19 on August 2. Both he and his girlfriend spent days trying to convince the hospital staff to take them seriously. The emergency services only ever looked at him once, refusing to take him into the hospital even when he was extremely ill. Matijanić's colleagues at Index recounted the key mistakes of the system.

For context, TCN first reported the news here, followed by the reaction of the Croatian Health Ministry who ordered an inspection into the medical assistance to the reporter. Understandably, the way the hospital staff treated the dying journalist did not go down well in Croatia, causing public outrage.

At Index, his premature death prompted many of his colleagues to examine the extent to which the poor reaction of the Croatian healthcare system was responsible for this tragic outcome.

It is simply unacceptable that Matijanić, a man with so many serious underlying diseases, which brought him at particular risk for a severe form of covid-19, despite persistent inquiries and even a trip to the hospital, did not manage, over several days, to receive thorough and adequate examination and/or hospitalisation and to receive medicine intended for the prevention of severe forms of disease meant precisely for people of his health profile, which Minister Vili Beroš stated that “we have verified it exists” in stocks in the health system.

We called ten times and begged them to admit Vlado to the hospital. They refused

Questions arise as to how much and in what ways the health care system is responsible for Matijanić's death. In cooperation with several medical experts, Index took to list the key mistakes in order.

Firstly, the main culprit for Matijanić's death, just like for the death of many other patients with covid-19 and other diseases, was a poorly managed health care system, where a part of the doctors and medical staff are its victims, along with regular citizens who need help.

The system did not properly advise Matijanić about vaccination

Matijanić claimed that doctors advised him not to get vaccinated because he had several autoimmune diseases, primarily Sjogren's syndrome and suspected sarcoidosis, as well as dermatopolymyositis, hypergammaglobulinemia and airway abnormalities, including interstitial lung disease, a condition for which sarcoidosis and Sjogren's disease are among the most common causes.

The advice is contrary to scientific conclusions, as studies have shown that people with autoimmune diseases tolerate vaccines well. For example, the Sjogren's Syndrome News page cites the recommendations of the American agency for disease control and prevention, the CDC, according to which most patients with this diagnosis are recommended not only to get vaccinated but also to get booster vaccines.

At the same time, studies have shown that people with autoimmune diseases are a risk group for several reasons, among others because they can get infected more easily, they often have lung diseases, they usually take immunosuppressive drugs, and their reaction to covid-19 can be exaggerated and misdirected, commonly referred to as a cytokine storm.

The fact is that the vaccine against covid-19 in patients with autoimmune diseases, especially in people with dermatopolymyositis, could cause more pronounced side effects, but according to the conducted studies, the risk of side effects is still much lower than from not vaccinating. The doctors who knew about his underlying diseases should have monitored his condition and, in accordance with the development of knowledge and recommendations, should have updated him with them and recommended vaccination with additional monitoring measures. People with such underlying illnesses require more than "routine procedures".

The fact that there are few of them in the population emphasizes, even more, the need for more detailed and expert care. Finally, even if someone in the system had recognised that his condition was such that vaccination was not recommended for him, they should have officially and in writing informed Matijanić about this and then followed it with special attention and updated the recommendations in accordance with the new findings and changes in Matijanić's condition.

On the contrary, it turned out that Matijanić, who went to nursing vocational school and was not an anti-vaxxer, was simply not adequately "guided" by the system in this regard.

Matijanić should have been kept in the hospital with his diagnoses

Matijanić's partner Andrea Topić says that she took him to the Emergency Infectious Disease Department on August 2 thinking that he would be kept there. It is questionable why they didn't do that when they knew about all the diseases he had, but they just let him go home. Topić believes that it is possible that Matijanić's covid-19 developed even before August 2 as his home antigen test already showed he was positive that morning, and a few days earlier he complained to the immunologist about weakness and malaise.

A person with Matijanić's diagnoses should have been admitted to the hospital if he was confirmed to have covid-19 and if he had symptoms such as elevated temperature, weakness, malaise, wheezing, and cough. On the contrary, in patients suffering from interstitial lung disease, these symptoms – no matter what caused them directly (e.g., a common cold) - are a sign that an acute deterioration (exacerbation) has occurred, and this is always an indication for detailed hospital treatment and, typically, hospitalisation.

The fact that he did not feel any better even when his temperature dropped can only be an argument in favour of the fact that something was not right.

The doctor should have taken his case much more seriously

As was reported by Index, recordings of Matijanić's calls to medical professionals show that none of them took his situation seriously enough.

Among other things, the KBC doctor on duty should have reacted urgently when Matijanić told him that he had not been vaccinated and that he had autoimmune diseases. First, he should have asked in more detail about his autoimmune diseases, because patients suffering from them belong to the risk group when it comes to covid-19. The insistence that “Matijanić was not immunocompromised” because he had only started corticosteroid therapy a day before is a result of confusing the terms “immunocompromised” and “immunosuppressed”.

The doctor who knew Matijanić's condition: He was highly immunocompromised

Matijanić’s immune system was certainly long-term compromised in the sense that it reacted unusually, attacking its own tissue, which is a consequence of autoimmune diseases. Therefore, the doctor on duty should have recommended that he come to the hospital so that his condition could be assessed and monitored. Even though Matijanić stated that he was coughing and had a lot of phlegm, the doctor said that it probably would not be serious since it was omicron, regardless of all Matijanić’s conditions, and without having asked about them in more detail. Indeed, omicron causes severe disease in fewer people in the population than some previous variants of the virus. However, due to his characteristics, Matijanić did not fit into the “general population”, but into a specific group of people in whom even a common cold is a potential trigger for life-threatening conditions (e.g., exacerbation of interstitial lung disease).

There is no doubt that in each of his contacts with the health care system, Matijanić had to be admitted or referred for a detailed diagnostic evaluation and appropriate treatment, ideally at the very beginning, but also in every further stage of the disease.

To date, it has been proven certain: 1) that drugs with an antiviral effect intended to prevent the development of a severe form of the disease and intended specifically for people like Matijanić are effective; 2) that anti-inflammatory drugs such as corticosteroids and some others are reasonably effective in those with advanced disease; 3) that supportive treatment - oxygen therapy (including the most dramatic forms such as mechanical ventilation or ECMO device), anticoagulants and possibly antibiotics where there is a basis for this due to bacterial superinfection, are effective and extremely important and that they help reduce mortality.

Overall, if Matijanić had been referred to the hospital at any stage of his condition and treated as recommended by the guidelines, it can be said with high certainty that he would have survived this covid-19 episode.

Problematic administration of corticosteroids

Due to an autoimmune disease, Matijanić took the corticosteroid Decortin, but only for a brief time. The doctor on duty at KBC Split, whom he called, knew about it but did not react, only stating that he could not be immunocompromised since he had been taking it for such a brief time. As already stated, this was wrong – though Matijanić may not have been immunosuppressed since he did not take therapy that reduces the immune response in people with autoimmune diseases, he was immunocompromised due to his underlying diseases.

When the ambulance finally came for the first time, Matijanić's partner Andrea Topić asked the team if it could be Decortin that made him sick, and the answer was no. Moreover, they also gave him an injection with a strong dose of Solumedrol, which is also a corticosteroid.

What is controversial about that? As previously reported by Index, corticosteroids are used in the treatment of covid-19, but mostly only in an advanced stage, around the 7th day of severe disease, to reduce the excessive reaction of the immune system, the so-called cytokine storm. Since they are immunosuppressants, they reduce the body's reaction to viruses, so if they are given too early, they can increase the multiplication of the virus. Due to the above, they should only be given to patients with covid-19 in a hospital, under constant medical supervision and with oxygen, and not at home.

In other words, the emergency doctor should have taken Matijanić to the hospital after the first visit if she believed that his disease had progressed so much that he needed corticosteroids. Also, she should have been aware of how serious the situation was because, unlike the doctor on duty from KBC, who did not get enough information, she had access to Matijanić's discharge letter.

At the Emergency Infectious Diseases Department, they did not even ask about underlying diseases

When on August 5 Matijanić called the emergency department at the Infectious Diseases Department, the employee on duty did not even ask him about possible underlying diseases, even though he complained of feeling extreme weakness and severe pain in his muscles and joints. The doctor simply recommended ibuprofen for pain.

They did not call him into the hospital even when it was apparent that he was very sick

Furthermore, when on August 5 Matijanić called a medical worker at the emergency department of Infectious Diseases, after his condition significantly worsened, on the recording of the conversation it can be heard that his breathing was laboured. He also pointed out that he had Sjogren's syndrome and the resulting interstitial lung disease, and that he was so weak that he could not even get up to go to the bathroom.

But that medical worker did not take him seriously enough either, and to all this, she advised him to urinate in a bed pan that one of the household members could empty.

His diagnoses and the fact that his breathing was laboured, that he was so weak that he could not get out of bed should have been sufficient reasons for the employee on duty to seriously advise him to go to the hospital in an emergency or to insist that the ambulance take him as soon as possible.

The emergency left him at home despite the diagnoses

When the ambulance finally arrived, the doctor refused to take Matijanić to the hospital even though he had serious autoimmune diseases in addition to covid-19, which she had to see based on the discharge letter.

There are certain doubts about whether the doctor who came with the ambulance was qualified for the job. It's possible she was hired even though she wasn't qualified because the hospital was understaffed, which is a chronic problem within our healthcare system.

If she was qualified, she should have known that his case needed to be referred to the hospital despite his blood oxygen saturation of 97% (a result that can change dramatically in less than an hour, as it did in the end), low blood pressure, an increased heart rate did not have to look critical. The usual practice of the ambulance is to take a patient with serious underlying diseases in combination with covid-19 and numerous complaints to the hospital to examine his condition in more detail because even minor deviations of key parameters can result in complications.

It was expected that during the summer, during the national holiday, at the height of the heat wave, the healthcare system in touristic Split was overloaded, but this cannot be an excuse for not admitting seriously ill people like Matijanić to the hospital.

In Croatia, there is a lack of necessary medicines for the seriously ill

Finally, as already reported by Index, Matijanić was told on August 2 that there are no drugs to treat the seriously ill, including Remdesivir.

Minister Vili Beroš denied this claim, with the explanation that there is enough Remdesivir or its version Veklury, and that directors must procure them from other hospitals if they lack them, and for specialist doctors to prescribe it to patients. If it is true that Remdesivir was still available on August 2 when Matijanić should have started it, it is still unclear how he never received it.  

Why didn't Matijanić get the medicine? Beroš: There is enough covid medicine in hospitals

But in this context, the Ministry's answer to the question of why there is no Paxlovid, which was approved by the American FDA at the end of 2021, and by the European EMA in January 2022, is also interesting. It is a medicine that, among others, was recently taken by US President Joe Biden and German Minister of Health Karl Lauterbach.

Since it showed excellent results in reducing hospitalisation and mortality by as much as 89%, it may have been able to save Matijanić's life, as well as that of many other patients who have died in recent days.

Many countries procured Paxlovid outside of centralised procurement

Index asked if there was a shortage of medicines in Croatia and received the interpretation from the Ministry that “the procurement of antiviral medicines Remdesivir and Paxlovid through the EC is currently being centralised” and that the department has done everything in this regard on time. However, it is known that the procurement of medicines does not necessarily have to go through the EC. States can procure medicine approved by the European agency EMA by themselves through direct contracts with manufacturers (by the way, Paxlovid was recommended as a medicine for covid-19 in the Ministry's guidelines back in February).

For example, Index received information that, in addition to centralised procurement, Paxlovid has already been procured by Austria, France, Italy, Germany, Belgium, Greece, Portugal, Ireland, and Spain, and that Slovenia will receive it at the end of August. Similarly, Croatia could have also bought the drug directly from the manufacturer, at least in some quantity, to bridge the period until central procurement is done and saved several lives, Matijanić's included.

For more, follow TCN’s dedicated News section.

Friday, 17 December 2021

Rijeka JGL Pharmaceutical Company Developing Rhinovirus Spray

December the 17th, 2021 - The well known Rijeka JGL pharmaceutical company has been busy developing an innovative cold spray which various substances targetting rhinovirus, the predominant cause of colds in humans, which haven't ever been used before.

As Poslovni Dnevnik/Marija Crnjak writes, the Rijeka JGL pharmaceutical company has teamed up in a partnership with the Centre for Proteomics of the Medical Faculty in Rijeka and with the scientific support of Biosens from Zagreb. This togetherness has resulted in the developing of an innovative ''Rino'' cold spray, with substances that have never been used in nasal sprays previously. The total value of the project stands at a massive 34.9 million kuna, and it is being co-financed by the European Regional Development Fund in the amount of 13.87 million kuna.

"This is a step forward for our company, since for the first time we're developing the product from the very beginning with substances that haven't been used in nasal sprays before, and which contribute to reducing the symptoms and progression of colds caused by rhinovirus, which is why we called it Rino spray. The project is also important because, as part of the strategy of ''smart specialisation'' of the Republic of Croatia, the thematic priority area "Health and Quality of Life" was chosen as one of the five key areas for the development of the Croatian economy.

With this project, we want to strengthen the position of our country, position ourselves as a European centre for the development and production of innovative health products through cooperation between production and research capacities of the private and public sector,'' said Masa Safundzic Kucuk, the director of research and development at the Rijeka JGL pharmaceutical company who is also the project manager. She also said that thanks to the help of the aforementioned fund, such projects don't put much pressure on the company's normal operations.

In-vitro product concept validation activities are underway to prove its safety and effectiveness, and experts from JGL and the Rijeka Medical Faculty are hoping for a roaring success in their product which will target the pesky rhinovirus, which is all too common of a bedfellow in winter.

"A team of scientists from the Centre for Proteomics of the Medical Faculty in Rijeka has been conducting scientific research in the field of immunology, virology, as well as research of new vector vaccines and immunotherapeutics, it's also participating in numerous national and international scientific projects with ambitious biotech and pharmaceutical companies like JGL. I'm convinced that the continuation of cooperation between the Faculty of Medicine and the Rijeka JGL pharmaceutical company on projects like this, as well as the expansion of cooperation in the direction of developing new immunotherapeutics will be of strategic interest to both partners.

Achieving this goal requires not only new investments through joint projects but also a vision of development based on the use of basic research results in creating new therapies or medical procedures,'' said Stipan Jonjic, head of the Department of Histology and Embryology and head of the Centre for Proteomics at the Medical Faculty of the University of Rijeka.

For more, check out our dedicated Made in Croatia section.

Wednesday, 6 October 2021

Pfizer Withdrawing Some Medication, Croatian Patients Advised to Contact GPs

October the 6th, 2021 - The name Pfizer might now be well and truly synonymous with the coronavirus vaccine, but the company is long standing and produces many medications. One of them is about to be withdrawn from the Croatian market, and as such, Croatian patients who usually take it need to contact their GPs.

As Poslovni Dnevnik writes, a very well-known drug is being withdrawn from the market, the Croatian Agency for Medicinal Products and Medical Devices reported on Monday.

Two batches of the drug Champix, produced by the American pharmaceutical giant Pfizer, are being withdrawn. The drug is used to help adults stop smoking, and given the size of the smoking issue here, Croatian patients who are using the drug should give their family doctors a call to be made aware of what they need to do to continue with their therapies.

"In the Republic of Croatia, there are no other batches of these drugs that aren't affected by this, it's the same situation with other drugs which contain the active substance varenicline. Therefore, we instruct all users of this medicine to contact their doctor sregarding the continuation of their therapy,'' the Agency stated.

As the marketing authorisation holder for Champix, Pfizer, in cooperation with the Agency, is withdrawing from the Croatian market, the following batches of the following pharmaceutical forms of this medicine are set to be no more:

- batch 00023401 of Champix 1 mg film-coated tablets

- batch 00022025 of Champix 0.5 mg and 1 mg film-coated tablets (the pack to start with this therapy).

“The withdrawal is being carried out to the wholesale level. The withdrawal procedure is being carried out due to the increased level of nitrosamine contaminants in the medicinal product compared to the acceptable levels of intake prescribed in the European Union (EU). Based on the available data, there is currently no risk for patients taking this medicine,'' the Agency concluded.

For more, make sure to check out our dedicated lifestyle section.

Tuesday, 5 October 2021

Varaždin County Gets 3 Non-Emergency Medical Transport Vehicles Worth HRK1M

ZAGREB, 5 Oct, 2021 - Varaždin County's department of emergency medicine on Tuesday was provided with three new vehicles for non-emergency patient transport, and this procurement was worth about a million kuna (€133,000).

During the vehicle takeover ceremony, County Prefect Anđelko Stričak said that emergency medicine, fire-fighters, the police, the army, the civil protection units and mountain rescue service were the essential elements of homeland security.

Stričak said that the county's department of emergency medicine had 41 vans in its fleet, and 32 of those vehicles were for non-emergency medical transport while nine were ambulances.

Annually, 65,000 patients use the services of this transport, and the vehicles in this department's fleet cover 1.3 million kilometres. The department registers about 10,500 emergency interventions and cover some 230,000 kilometres during the provision of urgent medical aid.

For more about health in Croatia, follow TCN's dedicated page.


Tuesday, 28 September 2021

MEP Says Croatia Fares Poorly in Terms of Access to Legal, Safe Abortion

ZAGREB, 28 Sept, 2021 - Compared to other countries, Croatia fares poorly in terms of access to legal and safe abortion, a Croatian member of the European Parliament, Social Democrat Predrag Matić, said on the occasion of International Safe Abortion Day and the presentation of the Abortion Atlas.

"The Abortion Atlas is a new tool that gives an overview of countries according to the availability of abortion, and more importantly, the kind of obstacles women across Europe encounter in terms of access to abortion. Croatia is in the lower section of the ladder in that regard, with the situation considered as poor. Even though abortion in Croatia is legal, we have a problem with practical obstacles to access to abortion," Matić said, as quoted by his office.

The Abortion Atlas, authored by the European Parliamentary Forum for Sexual and Reproductive Rights and the International Planned Parenthood Federation, is the first comprehensive interactive map with data on access to abortion in Europe.

It ranks 52 countries in terms of their legislative frameworks, access and availability of abortion, abortion-related medical care and available public information on abortion.

Croatia is in the lower part of the ranking, with a score of 60%, and it belongs among countries with a poor rating concerning legal and safe abortion. Of the EU member-countries, the best-ranked are Sweden and the Netherlands while Malta and Poland are worst-ranked.

"Access to abortion in the EU has been prevented due to a number of administrative and imposed medical obstacles and conditions such as compulsory counselling, compulsory additional medical tests and a compulsory waiting period," said Matić, a member of the EP's Women's Rights and Gender Equality Committee and author of an EP resolution on the state of sexual and reproductive health and rights in the EU.

The obstacles are unjustified and most citizens advocate access to abortion, Matić said, citing the latest survey on the topic in Croatia, in which 81% of the respondents supported the right to abortion while as many as 63% said that pregnancy termination must be free of charge, which makes abortion truly available regardless of one's geographical and socioeconomic status, Matić's office said.

Matić also recalled an extremely dangerous trend among gynecologists in Croatia, with 186 or 60% of the 322 gynecologists employed in hospitals across the country refusing to perform abortion.

For more about politics in Croatia, follow TCN's dedicated page.

Tuesday, 28 September 2021

Croatian Chamber of Nurses Distances Itself From Unscientific Views on Vaccination

ZAGREB, 28 Sept, 2021 - The Croatian Chamber of Nurses (HKMS) has distanced itself from unscientific and unprofessional views on vaccination against COVID-19, spread by some of the nurses.

"A large number of nurses have been vaccinated, notably 72 percent of them, and the Chamber once again calls on all nurses to get vaccinated and thus protect their health and the health of their patients," the HKMS said in a statement on Tuesday.

The dissemination of untrue and scientifically uncorroborated information, especially when it comes from nurses, makes the fight against the epidemic and efforts to increase the vaccination rate difficult and undermines trust in the healthcare system, it added.

The HKMS stressed the importance of vaccination as the only effective way to overcome the epidemic and get life back to normal.

Many of our nurse colleagues treat hospitalised patients for serious forms of COVID-19 and many of them see their patients, most of whom have not been vaccinated, die, the HKMS said, reminding nurses that "nursing is a medical profession and our public discourse must be based on the results of medical science."

For more about COVID-19 in Croatia, follow TCN's dedicated page.

Monday, 20 September 2021

VetHealth is Croatian Dermocosmetic Product for Animals Without THC

September the 20th, 2021 - Back during the very warm final days of August this year, oil with CBD (cannabidiol) and CBG (cannabigerol) intended for the treatment of animals was presented. Meet an interesting Croatian dermocosmetic product - VetHealth.

As Poslovni Dnevnik/Marta Duic writes, the producers are the Istrian veterinarian Igor Bencic and the company Canna Trade from Porec, led by Karlo Kovacic. This oil is a registered Croatian dermocosmetic product, is vegan, laboratory tested, free of gluten and other allergens, and it's even free of THC (psychoactive substance from hemp).

"Given that we've been following research in the field of cannabis and cannabinoids for years now, and we cooperate with companies that engage in that research, it wasn't difficult to determine the direction in which we wanted to go in,'' said project manager Andrea Gudac.

While all are concentrated on the so-called ''full spectrum oil'' whose products contain a hemp extract which then dissolves in the base of another oil (such as that from olives), they opted for what's known as broad spectrum.

“VetHealth is broad spectrum where the exact amount of certain cannabinoids is put into the base to make the composition of the product as reliable as possible. While full spectrum contains up to 0.2 percent THC, vroad spectrum lacks it, meaning that it's actually THC free. VetHealth is currently the only broad spectrum in Croatia, with 8, 16 and 24 percent cannabidiol and cannabigerol.

Igor Bencic participated in the formulation of the product, and he has also participated in the VetHealth project from the very beginning and understood the benefits of cannabinoids properly. Thus, he is the first veterinarian in all of Croatia to introduce broad spectrum into complete therapy in animals,'' explained Gudac.

VetHealth as a product in the distribution part was taken over by Phoenix Pharmacy, one of the largest veterinary wholesalers, and in cooperation with them, they're also educating veterinarians on how best to determine therapies.

Oil n More is a cosmetic part of the story of the manufacturer Canna Trade, more precisely oil with CBD intended for the beauty world. After several well-known brands introduced creams, lotions, toothpastes with hemp, they realised that something that really contains CBD is missing.

“If we need something for an animal's claws, and we need to prevent a problem, then we'll put something out onto the market which does actually help, and not just nurture. In addition to nourishing the claws, it's great for massaging the paws and is effective in combating fungus. Our oil contains exclusively organic and raw materials, and it is produced according to the GMP standard, which means that it is completely safe for human use as well,'' explained Gudac.

They are present here on the Croatian market, and are in negotiations to expand further to Europe - Switzerland, Austria, the Czech Republic and Poland. Both products are made in Croatia, and the raw material is procured exclusively organic and certified by an authorised distributor.

"So far, we aren't able to buy raw materials in Croatia, but we hope that the new regulations will soon allow us to do something like that. The VetHealth project already required a large investment, and the process itself took a year and a half. Oil n More is a newer project and has just seen the light of day, but that doesn’t mean we don’t have big plans for it. That's followed by additional facial care products after eyebrow and eyelash treatment, followed by a nourishing cream.

Work on the new line is an investment that will run through 2021 and 2022, and in addition to product placement, we want to focus on education, and this includes lectures, but also congresses for the veterinary profession,'' stated Andrea Gudac.

For more, follow Made in Croatia.

Thursday, 16 September 2021

Certain Medication to be Withdrawn from Croatian Pharmacies

September the 16th, 2021 - Croatian pharmacies are set to be without a certain medication following a German pharmaceutical giant announcing that all of it is set to be withdrawn, leaving some unfortunate Croatian patients without their prescribed therapies.

As Poslovni Dnevnik writes, the German pharmaceutical giant Sandoz has announced that it is withdrawing all batches of the drug Bromergon 2.5 mg tablets with the active substance bromocriptine from the Republic of Croatia, the Agency for Medicines and Medical Devices reported recently.

The withdrawal of this medication, which is used by many, is being carried out to the level of pharmacies, according to Sandoz, the world’s largest generic pharmaceutical company that is part of the well known Swiss giant Novartis.

After the withdrawal, bromocriptine drugs will unfortunately not be available on the Croatian market at all, so the Agency has invited all patients who were obtaining this medicine from Croatian pharmacies to please contact their doctors/general practitioners immediately regarding the continuation of the therapy they need for their illnesses.

Those batches of medicinal products are being withdrawn for regulatory reasons which prescribe that a particular medicinal product may be placed on the market for a maximum of eighteen months after their expiry or the revocation of their marketing authorisation, if the product doesn't expire of its own accord at an earlier date than that.

''No other drugs with the active substance bromocriptine in them are available on the market in the Republic of Croatia at all. Therefore, we're instructing all users of this medicine to contact their doctors regarding the continuation of their therapy,'' they pointed out from the Medicines Agency.

For more, make sure to check out our dedicated lifestyle section.

Tuesday, 15 June 2021

Dijana Zadravec Presents Her Evidence of Corruption in a Zagreb Hospital

ZAGREB, 15 June, 2021 - The National Anti-Corruption Council on Tuesday interviewed the dismissed head of the radiology ward of Zagreb's Sisters of Charity Hospital, Dijana Zadravec, who presented her evidence of criminal activities used to siphon money from the hospital.

Zadravec, who has been on sick leave since May, told members of that parliamentary body that she learned yesterday from the media that acting hospital director Zoran Vatavuk had given her a warning before dismissal for harming the hospital's reputation, noting that the hospital's reputation was harmed by corruption and those who committed and covered it up.

Zadravec said that her fight against corruption started in 2016, when her persecution and harassment started as well.

She said that as the deputy hospital head she reported in 2016 the charging of fictitious overtime work which the then director Mario Zovak had covered up, adding that she had reported this to the prosecutorial authorities and the Health Ministry.

Zadravec said that in late 2020 she discovered a criminal network at the hospital, with public money being siphoned by doctors, which was why she reported them for abuse of office.

The doctor, who claims to have extensive documentation proving her allegations, says that offers to suppliers with whom the hospital did business without public tenders, since the last public tender was conducted in 2019, were signed by doctors Vladimir Kalousek and Branimir Čule, and that the offers exceeded HRK 30 million.

She also cited cases when less material was used for operations than the quantity ordered from suppliers.

Commenting on Zadravec's allegations, the State Secretary and chair of the Sisters of Charity Hospital Steering Board, Tomislav Dulibić, said that hospital documentation was being checked by inspectors from the health and finance ministries and the HZZO health insurance agency.

"According to preliminary information, no significant departures have been found, except for some minor irregularities. Eleven inspectors are working on this, invite them to testify," Dulibić told the Anti-Corruption Council.

He said that the decision to carry out the inspection at the hospital was made a couple of weeks ago, noting that the relevant proceedings were underway.

The chair of the Anti-Corruption Council, Nikola Grmoja, asked if anyone had responded to Zadravec's claims, to which Zadravec said that after she reported the false charging of overtime work, Health Ministry inspectors were called in and concluded that the matter should be investigated by the hospital director.

Allegations should be investigated as soon as possible 

After conducting the interviews today, the Anti-Corruption Council adopted a conclusion asking the ministries of health, finances and economy as well as the prosecutorial authorities and the USKOK anti-corruption office to determine facts related to the case as soon as possible.

Zadravec was told to submit copies of the reports she had sent to the competent authorities as well as the text message in which, she claims, Parliament Speaker Gordan Jandroković lobbied for Zovak's reappointment as the hospital head.

The Anti-Corruption Council will send the audio recording of today's hearing to the prosecutorial authorities, and it will ask the Health Ministry to submit all documents on inspections conducted at the hospital since 2016 or explain why no inspections were conducted.

The Council will also ask the government to secure additional conditions for the employment of financial investigators at courts in four big cities.

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