A new Health Ministry project that will be put into practice in 2009 to combat the selling of fake medicine has already created controversy in the sector.
The new �Medicine Monitoring System� will replace the current system in which medicine boxes are stamped with an identification number and price, and instead medicine will be monitored using barcodes.
However, pharmacists say the new implementation may cause new problems. Head of the All Pharmacists' Federation of Employers' Organization, or TEİS, Nurten Saydan claimed that defects in the provision system, worries about future availability of medicines in pharmacies and the establishment of technical infrastructure have rendered the new system inoperable.
Turkish Pharmacists Association, or TEB, President Erdoğan Çolak said the ministry promised to grant a transition period for consumption of old packaged medicines in 2009 and to exchange the rest with new ones at the end of the year. Due to the cost of the new system, the ministry has undergone extensive negotiations with pharmaceutical companies. Companies expect a transition period, while medicine distributors are waiting for a quick establishment of the system that will not interrupt their work.
Speaking to daily Referans, Saydan claimed that pharmacists would be negatively affected by the new system. She cited disagreements on discounts for public institutions between pharmacists and the Social Security Institution, or SGK, which lasted for months. �We do not think that companies that raised difficulties to pharmacists during the application of discount for public institutions will exchange available medicines with new bar coded medicines. We will be aggrieved by this.�
Pointing at the new system's lack of an established infrastructure, Saydan argued that new problems would occur when the new �provision� system, in which products are registered onto a computer and the state determines the amount paid to the purchaser, was implemented. �Monday is the last day for our value added tax (VAT) declarations. However we still invoice prescriptions of July due to defects of provision system. We both make out an invoice and the system cannot overcome system cannot both print invoice and correcting it. Only after 6 o'clock in the evening, we can work on these invoices,� she added.
Under the current system, provision works of the medicines can be made after patients take their medicines. �However, medicine monitoring system will give different identity numbers for each medicine so provision system should work regularly,� Saydan said. She also asked why such a system was not applied in other countries. �If the target is to find fake medicine boxes, medicine depots put their own signs on them. In this way we know which depot the medicine belongs to,� she stressed.

A fake label cancels a contract
Meanwhile TEB head Çolak claimed that given that 90 to 95 percent of medicine is purchased by the state, the system is already well established in Turkey. �Thus not fake medicine but package forgery exists,� he noted.
Due to only one fake label, hundreds of pharmacists' contracts with the state have to be cancelled. �Fake labels worth YTL 2 cause cancellation of contracts with the state for six months to a year. We want to remove unjust treatment against our colleagues. We support medicine monitoring system to remove both fake medicine and package forgery,� he said.
The new system aims to prevent fake medicines for entering the system by warning professionals when they register them. A medicine depot or pharmacist will then return medicines about which the system has sent a warning,� according to Çolak.

How will the new system work?
Besides the stamped part of the medicine box, a second two-dimensional barcode called a �karekod� will be placed on the box as part of the medicine monitoring system. Karekod will transfer information about the medicine to the center and allow for it to be tracked.
Except for medical equipment, consumables and cosmetics, the system will include all food supplements, prescription and over-the-counter drugs. Price labels on the boxes will be replaced by barcodes. Through the barcodes, reimbursing institutions will pay for the medicine. Karekod application came into force in February. The system requires �karekod� on all medicines beginning Jan. 1. Products without karekod will only be sold until 2010.
According to the latest research of the European Alliance for Access to Safe Medicines, 62 percent of over-the-counter drugs sold via the Internet are fake, while 16 percent of the rest are imported illegally.