When the house supplier is “licked” by UKC Ljubljana

For several years, there have been warnings that suppliers of medicines and medical devices are making profits in the millions of euros at the expense of public healthcare. Friendly relations with doctors and other decision-makers in medical institutions also enable them to do this. The latest example of coupling between public clients and private suppliers is what is happening at the University Clinical Center (UKC) Ljubljana, the largest hospital in the country.

At the heart of the story are transactions involving the purchase of a contrast agent. It is a solution that medical personnel inject into the patient’s body during a computed tomography (CT) scan. It enables a better and more reliable display of veins and organs in the body, and thus also a more accurate diagnosis. For the past 20 years, three different contrast agents have been purchased at UKC Ljubljana. One of these, visipaque, has been supplied since 2018 by Apta Medica, a company run by Aljoša Rojecformer director general of the Oncology Institute.

Researchgate

The company Apta Medica sold several hundred thousand euros worth of visipaque contrast agent to UKC Ljubljana. It got complicated when it lost its dealership and suddenly could no longer supply it. But in UKC Ljubljana, the problem was not solved by signing the supply contract with a new representative. They preferred to remain loyal to the old supplier – even if it meant that they had to start buying another, more expensive contrast medium. The head of the clinical radiology department, Dimitrij Kuhelj, is said to have played a key role in this.

For more than 200 thousand euros of annual deliveries

It is clear from publicly available data that the company Apta Medica is one of the major suppliers of medicines on our market. Among other things, he has a license to sell the sedative persen, an over-the-counter drug.

In 2021, according to data from Ebonitete.si, the company generated a record 17 million euros in revenue. His important client is also UKC Ljubljana. Every year, he sells more than one million euros worth of drugs, including visipaque contrast media. In 2020, the largest hospital in Slovenia sold:

– 498 bottles of contrast agent of 500 ml each,

– 1320 bottles of 200 ml and

– 1280 bottles of 100 ml each.

A year later, the volumes sold increased slightly. It is not known how much traffic Apta Medica generated with these deliveries. According to the data of the Public Agency for Medicines and Medical Devices (JAZMP), the highest regulated price of this contrast agent is 356.38 euros. That’s how much a box with ten 100 ml bottles costs. This means that in 2020 the company sold a maximum of 228 thousand euros, and in 2021 for 258 thousand euros of visipaque contrast agent bottles. It is not known what the final price was.

ebonitete.si

Why did UKC not buy from another supplier

In December 2021, deliveries stopped. Before that, the company Apta Medica informed UKC Ljubljana about the “unavailability of visipaque”. Not because this contrast agent could not be purchased on the market, but because the manufacturer has chosen a new representative.

The company Apta Medica did not answer the questions of necenzurirano.si. As they learned, the company lost representation for visipaque already in September 2020. At that time, the American company GE Healthcare chose Swixx Biopharma as the supplier of its products.

So why didn’t UKC Ljubljana start working with a new supplier of contrast medium with which they already had good experience? As they explained, they also tried to do it, but they did not succeed. “We also tried to order visipaque from the supplier Swixx Biopharma, but the order was not fulfilled,” replied the Clinical Institute of Radiology.

But these statements are not true. Director of Swixx Biopharma Martina Bergant namely, she confirmed to us that ever since taking over the agency, they “have ensured a smooth supply of the visipaque product, without any interruptions in the supply, being aware of the importance of access to contrast agents”. This means that UKC Ljubljana could easily change suppliers and continue to buy the same contrast agent. Instead, they opted for a replacement.

They preferred to choose a contrast medium that was a quarter more expensive

In the UKC Ljubljana, such a large part of the deliveries last year was replaced with the xenetix contrast agent, which is supplied by the company Apta Medica – i.e. the company that was previously left without a representative for visipaque. The supervisor should play a key role in this Dimitrij Kuhelj. As they justified in UKC Ljubljana, they used contrast agents that were available. “Because they proved to be adequate in clinical work, we still use them today,” said the public institute that he runs Marko Jug.

But according to sources, the xenetix contrast agent is of inferior quality to visipaque. This is said to be the key reason why it was not used in UKC Ljubljana before. At the same time, it is also more expensive. The highest regulated price of a box of xenetix with five bottles of 100 ml is 221.42 euros, which is almost a quarter more than that of visipaque.

Primož Lavra

According to necenzurirano.si, UKC Ljubljana already signed an agreement on the supply of medicines with the company Apta Medica in October 2021. Among them, there is no more visipaque, but a smaller amount of xenetix. Less than a year later, they concluded an agreement on the supply of xenetix worth 130,000 euros. Last year, the company Apta Medica delivered to UKC Ljubljana:

– 100 bottles of contrast agent of 500 ml each,

– 740 bottles of 200 ml and

– 730 bottles of 100 ml each.

In the first five months of this year, the total amount of deliveries of xenetix contrast agent increased slightly.

Due to a delivery complication, the patients were left without chemotherapy

At the end of 2019, the company Apta Medica attracted public attention with an incident at the Oncology Institute in Ljubljana. At the time, the basic drug carboplatin ran out, leaving 30 cancer patients without much-needed chemotherapy.

At the time, the Oncology Institute placed the blame entirely on Apta Medica, which did not supply the medicine. This is not kept in the hospital, but is ordered before each new therapy. According to them, the company did not warn them in advance that the drug was not available, which would have given them time to find another supplier. At the time, Apta Medici defended itself that they really had problems with the supply, but they warned the client accordingly. In addition, they urgently provided a replacement drug at the same price.

All this did not harm their cooperation. In the last two years, Apta Medica signed contracts with the Oncology Institute worth a total of 3.7 million euros. Last year alone, he transferred more than one million euros to her.