Five pharmacy groups led by the Bulgarian Pharmaceutical Union (BPU) want the illegal making and selling of medicines to be a crime under the Criminal Code, not just an administrative offence. They asked for this in a joint letter on Wednesday, 14 October, to the prime minister, the speaker of parliament and the health and justice ministers.

The Association of Research-Based Pharmaceutical Manufacturers in Bulgaria, the Bulgarian Association for the Development of Parallel Trade in Medicines, the Bulgarian Association of Wholesalers and Retailers of Medicines and the Bulgarian Generic Pharmaceutical Association also signed the letter, as did the BPU.

Where it began: Pharma industry wants illegal drug trade made a crime

The groups want criminal liability for people and firms that are not wholesale or retail medicine traders but make medicines or put them on the market outside the legal rules. They say this would limit the supply and use of dangerous products.

They expect the authorities to set up a working group that includes their representatives, and to bring a bill amending the Criminal Code to parliament soon.

The groups say fines under the Law on Medicinal Products in Human Medicine do not deter offenders. Online sales are most often run by unknown people or firms with no assets, so no fine can be collected from them. The groups say finding and punishing them takes every tool of criminal law.

BPU chair Dimitar Marinov said that today even an offender who is caught gets only a fine. The regional health inspectorates, which impose the fines, do not have the capacity to deal with online trade. Many of the websites sit on domains outside Bulgaria and the EU and are hard to block, and a site that is taken down reappears at a new address within hours. But the medicines still reach buyers physically, so those involved in the deliveries can be identified, Marinov said.

He said the most worrying products are injectable weight-loss drugs, which are sometimes sold as food supplements. Supplements fall under different rules and by law cannot contain medicinal substances. Medicines are a special kind of goods, Marinov explained: a doctor prescribes them and a pharmacist dispenses them. The legal chain is strictly checked for origin, quality and storage conditions, while the illegal one offers no such guarantees.

Health minister Katya Ivkova said a few days ago that 73 online platforms selling medicines illegally have been found, more than 30 of them mainly selling peptides. She said the Criminal Code has gaps, and she will ask the head of the Bulgarian Drug Agency for proposals on changes that would make this trade a crime. The ministry has also published a list of about 70 websites where people should not order medicines.

The BPU also proposes that vaccines be given in pharmacies by pharmacists with a master's degree and extra training. Marinov said this is the case in a number of European countries and makes vaccination easier to get.

At present, a patient first sees a doctor, then buys the vaccine at a pharmacy, carries it alone at a temperature usually between 2 and 8 degrees, and goes back to the doctor to have it given. Marinov thinks this is inconvenient and risks improper storage. He also backs free vaccines for all risk groups if funding is available, because prevention costs far less than treatment. For now, the ministry's free vaccination programmes go through family doctors.

Injectable flu vaccines are expected in Bulgaria between 9 and 13 November and will reach pharmacies a day or two later. Two companies have confirmed quantities for the ministry's free programmes. Only one manufacturer will supply the open market, because the other has said it will not provide quantities for it.