Prescription drugs without a prescription: A deep dive into Uzbekistan's pharmacies

"In our country, selling prescription medications without a prescription has become the norm. We once took strict measures to regulate this, but people complained to the agency, saying, 'I’m used to buying this drug without a prescription; I don’t have time to visit a doctor,'" Azizov explained.

He also compared the situation with other countries: “For example, when I lived in Denmark, if you went to a pharmacy without a prescription, they wouldn’t sell you any drugs. You had to see a doctor first.”

According to Azizov, the situation will improve once the country transitions to electronic prescriptions.

“There is a systematic solution to this. The process of dispensing prescription drugs based on an electronic prescription will work effectively only when all hospitals, clinics, and even private medical centers are connected to a unified electronic prescription system. Once this is established, people will no longer ask for prescription drugs directly at pharmacies. They will be required to visit a doctor first. Patients with chronic conditions can receive long-term prescriptions.

I can’t provide an exact timeline, but I know the Ministry of Health has prioritized this task, and significant progress is being made. I hope that we’ll implement electronic prescriptions soon.”

However, he emphasized that simply introducing the electronic prescription system is not enough. "This is a multifaceted process. It involves not just the implementation of the system, but also ensuring strict monitoring and fostering a culture around it. If we fail to develop this culture, even the best information system won’t resolve the issue.

For example, if an ordinary person argues with a pharmacist, saying: 'I don’t feel well, why aren’t you giving me the medication?' and responds with 'I don’t have time to see a doctor,' that issue will also need to be addressed."

He added that shaping the right cultural norms, re-educating doctors, integrating the private sector into the system, and ensuring pharmacies are part of the process are all key elements. “This is a large and complex task. While it may seem simple on the surface, it is much bigger than it appears,” Azizov said.

He also mentioned that during discussions with German partners, they shared that it took Germany two years to implement electronic prescriptions. Before that, prescriptions were written on paper, but the system still functioned effectively. In Denmark, the electronic prescription system was implemented in 2005.

"Our biggest priority this year is to implement reference pricing controls and strengthen public oversight. A labeling system should be introduced for all imported and locally produced medications. Currently, only 6-7% of medications are processed through online control systems in pharmacies, but we will intensify monitoring in this area as well," Azizov concluded.