Page 74 - GHES-3-3

Global Health Economics and
Sustainability
Pharmaceutical system in Iraq

A cross-sectional study has reported several challenges and Scientific Research, 2017). There is a need to upgrade
faced by the domestic pharmaceutical industry, including: the pharmacy curriculum to better equip pharmacists for
(i) lengthy bureaucratic processes for obtaining importing the responsible and effective provision of direct patient
licenses for materials, (ii) payment delays, especially care in Iraq (Al-Taie, 2020).
within the governmental sector (KIMADIA), (iii) barriers At the same time, the SIP expressed concerns about
to importing active ingredients, and (iv) resistance from the Ministry of Higher Education’s policies regarding
some physicians and pharmacists toward promoting new pharmaceutical programs, as well as the progressive
domestic pharmaceutical products (Ahmed et al., 2020). increase in the number of pharmacy graduates amid the
In addition, the scarcity of annual bioequivalence studies
limits the domestic industry’s ability to increase production limited MoH capacity to provide further training (Al-Taie,
2020; Underwood, 2020). Opportunities for graduates to
capacity (Al-Jumaili et al., 2013; Republic of Iraq Ministry practice within the public sector have become limited due
of Health, 2019a). Furthermore, policies such as the fast- to the growing supply of pharmacists, which have negatively
track medicine registration for imported medicines have
provided tremendous business opportunities for foreign impacted professional competency (Syndicate of Iraqi
companies but at the expense of domestic producers Pharmacists, 2021a). Therefore, expanding postgraduate
(United States of America Department of Commerce, training and providing clear pathways into the domestic
2018). Despite these challenges, the establishment of an pharmaceutical industry and private sector are warranted to
advanced pharmaceutical industry is crucial for improving maintain labor demands and prevent human capital flight.
health outcomes in Iraq and meeting the Sustainable 5.7. Oversight in the private sector
Development Goals (World Health Organization, 2010).
However, it has been reported that after 2003, the Iraqi The MoH has reported that the situation in the private
pharmaceutical industry faced significant underregulation pharmaceutical market is “out of control” as 60 – 70%
(Al Hilfi et al., 2013; World Health Organization, 2013a; of products in community pharmacies and wholesale
World Health Organization, 2009). pharmaceutical suppliers do not meet the requirements
of circulation, either being unregistered or not subject
Eventually, the pharmaceutical industry needs to to pricing and inspection system (many medicines lack
regain the lost momentum and enhance its contribution the SIP stickers). Less than 20% of distributors adhere
to the domestic market. The industry holds high revenue to the pricing system in the private market, and there is
potential compared to other sectors in the country’s a prevalence of irregularly practicing distributors, non-
economy (Al-Hiti, 2019). At present, the policies governing specialists supplying medicines through non-standard
the domestic pharmaceutical industry seem to be stagnant pathways, and the presence of S/F medicines (Al-Humadi
and sluggish. There are opportunities to improve the sector & Liapi, 2019; Republic of Iraq Ministry of Health, 2019a).
through strategic investment policies and regulations, These irregularities have been attributed to weak border
such as establishing complete pharmaceutical projects, inspection and control, poor monitoring and enforcement
increasing investment in domestic pharmaceutical capital, in the private health sector, and the complex procedures
upgrading factory quality and quantity, introducing new adopted by the MoH for product and company registration
manufacturing technologies, and fostering international and import licensing, all amid a sharp shortage and
cooperation in the industry.
growing demand in the country. Furthermore, medicinal
5.6. Education and training of pharmacists promotion practices of foreign pharmaceutical companies
in Iraq are largely irregular and require greater oversight to
The number of registered pharmacists with the SIP has prevent malpractice (Al-Jumaili et al., 2013).
significantly increased since 2003 (Al-Jumaili et al., 2013;
Syndicate of Iraqi Pharmacists, 2023). In May 2012, there Unlike international trends, the private sector in Iraq
were only 11,347 SIP-registered pharmacists in Iraq operates with a long distribution chain, which increases
(Al-Jumaili et al., 2013), while by October 2020, this number prices and compromises populational health by increasing
had grown to 24,282 (Syndicate of Iraqi Pharmacists, barriers to accessing healthcare services, particularly for the
2023). The increase is attributed to a steady increase in most vulnerable. The issue of equity is further exacerbated
the number of pharmacy schools and frequently modified by the use of regressive markups by private pharmaceutical
admission policies by the Ministry of Higher Education distributors, which is an uncommon practice in developed
and Scientific Research (Al-Lela et al., 2012). At present, countries (Vandoros & Stargardt, 2013). Furthermore, the
there are 60 pharmacy schools (17 public and 43 private) lack of policies and education promoting cost-effective
in Iraq, but none offer a Bachelor of PharmD program therapies contributes to high out-of-pocket expenses
(Table 1) (Republic of Iraq Ministry of Higher Education (Sharrad et al., 2008).

Volume 3 Issue 3 (2025) 66 https://doi.org/10.36922/GHES025110025