In Uzbekistan, pharmacies often sell medications without requiring a prescription, even for drugs with serious side effects or potential risks. In contrast, in developed countries, purchasing medication without a doctor’s prescription is nearly impossible. To investigate the situation, a reporter from Kun.uz visited over ten pharmacies in Tashkent and spoke with the head of the Pharmaceutical Industry Development Agency to explore potential solutions.

As of December 2024, Uzbekistan has 1,491 over-the-counter drugs and 7,121 prescription-only medications registered. However, in most cases, people have become accustomed to buying prescription drugs without a prescription.

When a customer requests a medication, pharmacy staff usually provide it without question.

The Kun.uz reporter investigated about 15 pharmacies in the Chilanzar and Uchtepa districts, where prescriptions were not required for drugs that should only be sold with one. For example, in tests, several pharmacy staff members in Chilanzar provided drugs like Normodipin, Mezaton, Yantasol, Feksonik, Omeprazol, and Pentoksim without asking for a prescription.

When the reporter inquired about medications for kidney and heart pain, some pharmacists suggested prescription-only drugs, while others recommended over-the-counter medications.

Only two pharmacy staff members complied with the regulations, refusing to sell prescription drugs without a prescription.

For instance, when asking for a kidney medication at a pharmacy on Qatortol Street in Chilanzar, the staff member explained they couldn’t provide the medication without a prescription, citing legal obligations. Another pharmacist emphasized that it was not permissible to recommend medications for heart and kidney pain or high blood pressure without a prescription.

According to the Center for Pharmaceutical Products Safety under the Ministry of Health, violating the rules for dispensing prescription drugs can result in fines ranging from five to ten times the base calculation unit. If the drugs contain potent substances, the fine can be between 50 to 100 times the base calculation unit.

Abdulla Azizov, the Chairman of the Pharmaceutical Industry Development Agency, stated that combating the sale of prescription drugs without a prescription is not an easy task.

"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.