
The Commission has been ignoring the obligation to review medical records for more than five years: patients with epidermolysis bullosa remain hostage to the monopoly
Kyiv • UNN
For more than 5 years, the Commission has been ignoring the obligation to review medical documentation for the treatment of epidermolysis bullosa. Because of this, Swedish Molnlycke Health Care maintains a monopoly on the medical bandage market in Ukraine.
The situation with the provision of care for patients with the rare genetic disease epidermolysis bullosa raises serious questions. The adapted clinical guideline, approved in 2016, provided for a mandatory review in 2019, but this has not yet happened. The documentation lists only one company that manufactures butterfly wound care products - the Swedish company Molnlycke Health Care. This creates an artificial monopoly, excluding other manufacturers from public tenders, UNN writes.
According to international standards and norms, medical documentation should be regularly updated to reflect new developments, the availability of alternative products, and changing market conditions. However, the situation with the supply of wound dressings for patients with epidermolysis bullosa shows that there are cases when patients become hostages to the desire of a large company to monopolize the market for the sake of super-profits.
The UNN launched an investigation into the situation on the Ukrainian market and found that an artificial monopoly has been created for the Swedish company Molnlycke Health Care. In 2016, a multidisciplinary working group developed an adaptive clinical guideline for the treatment and care of wounds in patients with epidermolysis bullosa. This document was based on recommendations from 2012.
It was in the guidelines that the working group specified that only Molnlycke Health Care dressings could be used for wounds. No analogues were offered to patients. Based on this document, the Ministry of Health approved a protocol for the treatment of butterfly people, which also states that only Swedish dressings can be used to treat their wounds.
At the same time, the guideline contains an important point, according to which the commission was to review this document no later than 2019.
"The presented adapted clinical guideline should be reviewed no later than 2019 by a multidisciplinary working group with the participation of the chief freelance specialist of the Ministry of Health of Ukraine, practitioners providing primary and secondary health care, scientists, health care organizers, representatives of NGOs interested in improving the quality of health care, etc.", the guideline says.
In this way, the members of the working group were probably trying to prevent the creation of a monopoly position for Molnlycke Health Care, as they understood that analogs of Swedish dressings would definitely appear on the market by 2019, which is exactly what happened.
However, the Commission has not revised the relevant guideline for more than 5 years, which suggests corruption in this matter. It turns out that while the Commission is delaying the review of medical documentation, no other manufacturers can participate in public tenders except Molnlycke Health Care.
This situation has a negative impact not only on patients who cannot choose other products, but also on the state budget. Due to the monopoly on the market, procurement of wound care products is carried out at inflated prices.
Add
Earlier, UNN received information indicating that the Swedish company Molnlycke Health Care, which holds a monopoly position in the Ukrainian market of medical dressings for patients with epidermolysis bullosa, may be involved in financing the public union "Orphan Diseases of Ukraine", headed by Tetiana Kulesha. The union has actually become the mouthpiece of the company, helping to maintain Molnlycke's monopoly on the medical dressings market in Ukraine and lobbying for its interests.
In his public speeches, Kulesha constantly emphasizes that there is no alternative to Swedish bandages and defends Molnlycke products, despite the availability of high-quality and cheaper analogues that are successfully used in other countries.
Experts interviewed by UNN note that the situation around Molnlycke Health Care has clear signs of a conflict of interest and corruption component. At the same time, attempts by other manufacturers to offer alternative dressings for public tenders are blocked due to the influence of Orphan Diseases of Ukraine and its leader.
Former Minister of Health Zoryana Skaletska emphasizedthat the Ministry of Health must look into the situation and do everything necessary to ensure the interests of patients. She emphasized that orphan diseases require special attention, because due to the rarity of these diseases, government agencies may not have enough information to respond quickly.
Recall
UNN launched an investigation to find out how Molnlycke Health Care, a Swedish company specializing in the production of dressings, managed to create a monopoly in the Ukrainian market. After all, the manufacturer has secured absolute dominance in public tenders for the purchase of wound care products for patients with epidermolysis bullosa. For example, they are trying to prevent a Ukrainian manufacturer from entering the market, which offers the same super-thin dressings, but at four times the price. A previous analysis revealed a possible conflict of interest in tender procurement through the public association headed by Tetiana Kulesha. In particular, there are reasonable suspicions that Molnlycke Health Care uses Kulesha to lobby for its own bandages.
For reference: Epidermolysis bullosa is a rare genetic disorder that makes the skin extremely fragile. Such patients are also called butterfly people. Even a slight mechanical impact can cause blisters, open wounds and scars on their skin. This disorder affects not only the skin but also the nails, hair, and mucous membranes. Treatment includes special wound care, the use of protective dressings, drug therapy, and surgery in severe cases. Due to the significant impact on the quality of life of patients, ensuring access to the necessary care is critical. Currently, there are more than 300 such patients in Ukraine.