How Molnlycke Monopolized the Bandage Market for Patients with Bullous Epidermolysis in Ukraine

UNN continues its investigation and this time decided to find out how the Swedish company Molnlycke Health Care, which specializes in the production of bandages, managed to create a monopoly on the Ukrainian market. After all, the manufacturer has secured an unequivocal dominance in government tenders for the procurement of wound care products for patients with epidermolysis bullosa.

In 2016, the Ministry of Health of Ukraine approved an adapted clinical guideline for the treatment of epidermolysis bullosa. A multidisciplinary working group that was engaged in the development of medical and technological documents for the standardization of medical care based on evidence-based medicine for orphan patients worked on it. The working group included representatives of the State Expert Center of the Ministry of Health, the Association of Dermatovenerologists and Cosmetologists of Ukraine, the international public organization "Dermatologists - Children", the "Debra - Ukraine" center, as well as doctors from the National Children's Specialized Hospital "Okhmatdyt". Among them, for example, was Inna Gedeon - the head of the epidermolysis bullosa office at "Okhmatdyt".

The fifth section of the clinical guideline, which deals with wound care, states that doctors should inform patients about new products that appear on the market.

"Careful discussion usually provides an opportunity to identify which products are used by patients in certain cases, and the doctor must be prepared to accept this. In addition, doctors should teach patients wound care and provide information about new products as soon as they appear on the market," the document states.

The working group that prepared the clinical guideline directly indicated that bandages from the Swedish manufacturer Molnlycke Health Care should be used for the care of patients. The very fact that a specific company is mentioned in the medical documentation indicates corruption and bias of the working group, and possibly its financial interest.

Currently, these bandages are supplied to Ukraine by the company "Ekomet", which the Center for Public Monitoring and Research previously suspected of collusion with another distributor to win tender purchases.

The global and Ukrainian markets also feature other manufacturers that produce bandages for epidermolysis bullosa that are not inferior in quality to Molnlycke's products. Some of them offer them at a much lower price. However, since the MOH clinical guidelines only indicate Molnlycke, the products of other manufacturers are automatically considered "not recommended". That is, due to corruption and monopoly, the state is forced to spend funds that could go to equipping the army or other patients.

It is important that the clinical guideline has not been reviewed for almost nine years, despite the development of technologies and the emergence of new players in the market. So the question arises, don't doctors know about the existence of high-quality and cheaper analogues? Why then don't they recommend them to patients?

In fact, by prescribing a specific manufacturer in the official guideline, unlimited opportunities were created on the Ukrainian market for the Swedish company, and all others were eliminated. After all, government procurement is still focused exclusively on the products of this manufacturer, and patients receive recommendations from doctors to use these bandages, despite their high cost. What is this if not corruption?

This also affects government tenders: tender documentation is often written with a focus on characteristics that perfectly match Molnlycke's products. Other manufacturers simply cannot meet such specific requirements and therefore are not allowed to participate in procurement.

Due to Molnlycke's monopoly, patients and the state are forced to pay inflated prices for bandages, while alternative manufacturers could provide the necessary quality at a lower cost. This is especially critical in wartime, when every hryvnia of the state budget must be used as efficiently as possible. Law enforcement agencies should pay attention to the situation with the Swedish manufacturer and prevent the misuse of public funds.

Moreover, the created monopoly limits patients' access to choice. They are forced to trust the products of only one manufacturer, even if analogues may be more convenient or economically advantageous. Why should patients, including children, suffer while one pharmaceutical giant earns money from Ukrainian patients?

The need to review the MOH clinical guidelines is becoming increasingly relevant. The world has long since moved away from the practice of specifying specific brands in official recommendations, as this creates discrimination in the market. Ukraine also needs to adapt its standards to modern realities, ensuring equal opportunities for all manufacturers and access to quality treatment for patients.

In addition, the practice of doctors prescribing patients drugs or medical devices of certain manufacturers for certain percentages or financial rewards should be abandoned long ago.

To be continued...

Reminder

Earlier, UNN reported that the state procures bandages for patients with epidermolysis bullosa only from one Swedish manufacturer. The investigation revealed a possible conflict of interest in tender purchases through a public association.