Public Campaigns

Cardiovascular disease awareness
Approximately 66% of the annual deaths in Bulgaria are caused by cardiovascular disease. Despite that staggering statistic, public awareness of the problem and the significant risk factors that lead to it is relatively low. Tchaikapharma High Quality Medicines Affordable for Everyone has been conducting an extensive public campaign across communication platforms, which aims to draw the attention of the public to cardiovascular disease, as well as to offer help and information through the following channels:

• National television campaigns for acute cardiac care
• Specialized and popular printed materials for cardiac disease
• Electronic forms for doctors and patients

Blood pressure control
The regular TV videos and broadcasts raised the public awareness of the importance of blood pressure control and the need for regular measurement.

In addition, we organized free blood pressure measurements and consultations by cardiologists and volunteering medical students targeting high-risk senior citizens. Over 4,000 citizens of Sofia, Plovdiv, Varna, Veliko Tarnovo, Pleven, Burgas and the surrounding towns took the opportunity to check their cardiac health.

Chest pain and early diagnosis
Every day for two years, the Bulgarian National Television aired a prime-time educational video explaining the critical role of the first “golden hour” for lifesaving in case of infarction, sponsored by Tchaikapharma and Health Insurance Fund “DallBogg: Life and Health.” Another educational video focusing on the importance of chest pain and the early diagnosis of myocardial infarction ran at prime time on the national television 3 times a day for 1 year.

Television campaign about cardiovascular disease risk factors
An educational video about the risk factors for cardiovascular diseases ran 3 times a day at prime time on the national television for 1 year

Quality of pharmaceutical manufacturing awareness campaigns
Our public awareness campaigns were the first to inform the public of the difference between non-GMP and GMP manufacturing of pharmaceuticals. Our campaign “Know & Think First” was the first to address the quality of the pharmaceuticals during their shelf life. This quality was suboptimal due to the lack of standard operating procedures in the manufacturing process and GMP standard adherence.

Tchaikapharma High Quality Medicines showed the regulatory how the most sensitive substances were to be produced, packaged and stored, and set a higher benchmark for quality in the whole sector. The cheaply privatized pharmaceutical companies were forced to invest in the improvement of quality and thus the Bulgarian generic pharmaceuticals reached the level of their European counterparts.

National campaign for control of type II diabetes
In 2005, Tchaikapharma expanded the program for interdisciplinary innovations in medical practice and invested over BGN 800,000 to test more than 32,000 patients with type II diabetes, more than 40% of the type II diabetes patients on non-insulin treatment in Bulgaria.

Testing of glycated haemoglobin (HbA1c) was a part of the big clinical picture. This major disease can be accurately diagnosed and treated thanks to the laboratory test measuring the average blood glucose concentration over long periods of time. Monitoring of HbA1c has been shown to reduce the risk of complications.

The findings showed that more than 50% of the patients did not have their HbA1c under control. Less than 30% of the patients were treated with the latest pharmacological molecules, which provide better glycemic control and fewer side effects. The data was reported by Professor Vladimir Hristov at the World Congress in Endocrinology in South Africa (2006).

In 2006, Tchaikapharma High Quality Medicines introduced two of the most advanced molecules, gliclazide and glimepiride, at much more affordable prices than the medicines offered by the originator companies.

In 2008, more than 60% of the patients were already receiving treatment, which undoubtedly led to a much better control over the disease.

Epidemiological study of heart failure in patients over 50
Heart failure is a widespread, socially significant, and difficult to diagnose disease. It affects the heart’s left ventricle – its performance is directly connected with the heart’s pumping function. Usually the decompensated function of the left ventricle is diagnosed by means of echocardiography but in the early stages of the disease this method is insufficient.

There is a laboratory test which successfully detects early stage heart failure, namely Brain Natriuretic Peptide (NT pro-BNP). This test is not widely used in Bulgaria due to its high price and lack of government reimbursement. This is regrettable, since the NT pro-BNP test is a preventive tool and could save thousands of money for subsequent hospitalizations and treatment of complications.

Tchaikapharma High Quality Medicines wanted to contribute directly and decisively to the modernization and optimization of the medical practice in Bulgaria.

We invested in and organized a study using NT pro-BNP with 2,500 patients selected from all parts of the country. The study involved physical examinations, ECG, laboratory tests, echocardiography.

We found that 10% of the non-symptomatic patients had elevated NT pro-BNP and were in fact in the initial stages of HF without knowing it.

These patients needed treatment for their main disease – usually hypertension, but they also had to be prescribed a combination of medicines taking into account their risk of HF. One example of such a combination is ACE-inhibitor and beta blocker.

Immediately after obtaining the initial results of 500 patients, Tchaikapharma introduced the best available molecules of ACE-inhibitors and beta blockers at a truly affordable price – enalapril, lisinopril and carvedilol and nebivolol. The initial data was reported at the World Congress of Cardiology in Argentina (2008) by Professor Mladen Grigorov.

Our focus is on the manufacturing and supply of pharmaceuticals with a proven effect on life expectancy. We manufacture very few pharmaceuticals that serve only to relieve symptoms. The widespread prescription of such pharmaceuticals is a large problem in Bulgaria, which we are tackling by making sure that the most essential pharmaceuticals, the ones that have an effect on people’s health, are available in the pharmacies and are easily affordable for the average Bulgarian patient.

Tchaikapharma High Quality Medicines manufactures pharmaceuticals that can really change the prognosis of patients – ACE inhibitors, beta blockers, statins and calcium channel blockers, all of which are included in the guidelines of the European Society of Cardiology (ESC).

In addition, we are committed to serving pubic interest by actively exposing the misleading marketing campaigns of those pharmaceutical companies who maintain unreasonably high prices, while their medicines are of unknown efficacy, doubtful innovation and incomplete safety profile.

All meetings and activities follow the strict agenda set by the most pressing issues in each field of medicine – poor disease control, inadequate adherence to guidelines in everyday practice, implementation of new diagnostic or treatment algorithms, introduction of new molecules, latest advances from the world scientific events, our own epidemiological studies design and more.

Our healthcare modernization strategy involves regular regional meetings and seminars with physicians from outpatient and inpatient care, moderated by members of our advisory board. Along with the problems, the main discussion is focused on the solutions: better diagnostics, referral, treatment and outcomes. Academic leaders share updated information regarding disease control and patient segmentation in the respective region for various therapeutic fields.

These discussions and debates help us prepare an improved action plan with better problem targeting and involvement of all parties concerned – GPs, specialists, ER, hospitals, regulators. Agenda update and action plan implementation are entrusted to the regional leaders and the members of the advisory boards. All advisory boards are regularly consulted and guided by leading EU and US experts as part of the international activities of Tchaikapharma High Quality Medicines.

In cooperation with the Bulgarian Cardiac Institute, Tchaikapharma has decreased in-hospital mortality from acute coronary syndrome (ACS) in the entire region of Pleven by 30% in just one year. The agenda of all regional meetings organized by Tchaikapharma High Quality Medicines during this period was designed so as to promote not only affordable medical treatment, but also diagnostic and treatment algorithms for ACS, superior interventional treatment and discharge therapy guidelines.

“The Bulgarian Cardiac Institute has established a modern cardiac hospital with a cathlab in the Medical University in Pleven and has decreased the AMI mortality by 30% in one year, taking all the necessary steps according to the ESC guidelines”

Source: T Vekov, M Grigorov, V Georgiev, S Djambazov, L Groch, O Hlinomaz, J Sitar, M Rezek. Decrease in acute coronary syndrome mortality in Pleven region. Implementation of scientific evidence into everyday practice. Journal of Biomedical & Clinical Research (JBCR), Medical University Pleven, 2008, volume 1, number 1, 56 – 61

Tchaikapharma High Quality Medicines has operating Advisory Boards in various specialized fields, including:

• Cardiovascular diseases
• Acute cardiac care
• Endocrinology
• Neurological disorders
• Psychiatric disorders
• Respiratory disorders

Our board members are university professors from all Medical Universities in Bulgaria (Sofia, Plovdiv, Pleven, Stara Zagora, Varna), as well as international experts from the European Union and the USA

The results:
–          37.83% of the admission therapies complied with the ESC guidelines at an average price of BGN 46.87
–          84.13% of discharge therapies, including those with medicines of Tchaikapharma, complied with the ESC guidelines at an average price of BGN 31.80
–          Reported improvement of over 23% in therapy adherence after the follow-up campaign and a positive therapeutic effect of such adherence.

The conclusion:
Following strictly the ESC guidelines and prescribing Tchaikapharma medicines may reduce the cost of treatment by >32% compared to the current treatment practices in Bulgaria.

Source: Vekov T, Djambazov S. DETAILED ANALYSIS OF COMPLEX DRUG THERAPIES EFFICACY IN TREATMENT OF CARDIOVASCULAR PATIENTS; Modern Medicine, 2008, 3(59), 12-18

Source: Vekov T, Djambazov S. DETAILED ANALYSIS OF COMPLEX DRUG THERAPIES EFFICACY IN TREATMENT OF CARDIOVASCULAR PATIENTS; Modern Medicine, 2008, 3(59), 12-18

The average reimbursement value paid by the National Health Insurance Fund is 25%, while co-payment by the patient is 75%. Considering the average cost of treatment in Bulgaria, this means cardiovascular patients incur costs amounting to 11% of the average salary and 21% of the average pension. Therefore, the majority of patients find it difficult to purchase and adhere to an expensive therapy, which most of the times is even not the most appropriate one.

By offering affordable molecules for therapeutic strategies approved by the European Society of Cardiology, Tchaikapharma is bridging the gap between the guidelines and current therapeutic practice in the country.