Cytostatics on the black market: A journalist in Venezuela bought drugs to expose crime
How does the black market for the resale of cytostatics work? In 2016, investigative journalist Alicia Hernández from the Armando media in Venezuela began following the trail of a "smuggler" in charge of diverting oncology drugs from state hospitals to the black market where they can be sold 300 times more expensive. Her motives were some of the most basic questions: Are these people angels or opportunists? How do they create their networks?
It doesn't take a lot of intelligence to understand why someone would go to the black market to buy a cancer drug, knowing that in 2016 Venezuela had a drug shortage of 86 percent compared to needs. The black market for biological therapy and cytostatics has become a regular practice in this country, which goes hand in hand with the crisis. But few people talk about it. The dominant fear is that they did something illegal. That's why discovering the person who gave them a small dose of life, and at the same time stole the same dose from another oncology patient - is a step that few people decide on.
Anna (a fictitious name to protect her identity) is an oncology patient. When she faced the disease, she also faced the dilemma of whether to venture into the underground market where cancer drugs are procured. And at the time of writing Armando's article, she continues to receive the cycles prescribed by the doctor, but the most difficult phase of the treatment is over.
- What they are doing to us is inhumane. No one should resell cancer drugs, she said at the first meeting with the journalist.
A few months later, Anna ran out of Avastin, a monoclonal antibody used in the treatment of various types of cancer, including breast cancer.
- I needed it. It is desperate to be sick with cancer and on top of that to be worried that there is no cure. When I was diagnosed with cancer, they told me to avoid stress, she adds.
At the clinic where she was treated in Venezuela, she came into contact with the illegal market of resale of oncology drugs. Her doctor gave her a phone number.
- He told me that I can find everything I need at that phone number. He had already spoken to other resellers, but they hung up. I paid good money, but I didn't get anything, adds Ana about "Armando".
The reseller seemed to have everything, when there was literally nothing at the hospital.
-For example, there were filters for Taxol. He had everything I could have asked for, says Anna.
He made several transactions with her. She paid him into the transaction account, and a friend took over the "deliveries". How is it possible to have such an amount of overpriced drugs? Were they stolen, imported from another country or counterfeit? To clarify these questions and understand how the black market for overpriced anti-cancer drugs works, the journalist needed at least a few samples of those sold by the "dealer".
The first meeting
In order not to draw attention to herself, the author of the investigative story, journalist Hernandez, pretended to be a buyer. Using a pseudonym, she contacted the reseller R.L. She asked him to buy Methotrexate tablets of 2.5 milligrams, which are used to treat breast, skin and lung cancer. The price for one "strip" of 10 tablets is 8 thousand Venezuelan bolivars (the currency in Venezuela is the bolivar). The meeting for the handover was in the square "Plaza el consul in la Guaira" one Saturday morning in 2016.
The meeting lasted only a few minutes in a square full of people, cars, buses and traffic. At no point could it be determined whether he was alone or other people were observing the process. A hidden camera shows this meeting aimed at taking illegally bought cancer drugs and then investigating them if they are counterfeit or genuine by the research team. At this meeting, the journalist pretending to be a patient is promised by the seller that he can provide her with a year's supply of Avastin.
- I have several friends who need medicine and they ask what kind you have. You know it's too hard to find certain drugs. - I only have oncology drugs. I am not in the business of selling ordinary drugs, is the answer he receives in a text message.
In Venezuela, only the Ministry of Health and the Drug Bank have the right to import cancer drugs. The drug bank is an institution that then distributes them to pharmacies.
A few weeks after the first meeting with the smuggler, the journalist met him a second time. This time she asked him if he had Taxol, Doxorubicin and Tamoxifen.
- I only have Taxol and Tamoxifen. The doxorubicin has been gone for a month and a half. Not in Venezuela. - When will he have it again?- I don't know, I have to wait to see in the monthly purchases when it arrives. - When is that?- Between the fifth and tenth of every month, he answered.
The journalist then orders him a vial of Taxol. This vial must be kept in the refrigerator and costs 13 thousand Venezuelan bolivars. The smuggler asks to come and pick up the vial with his own refrigerator, to preserve the cold chain. He takes the vial out of his refrigerator and puts it in the journalist's refrigerator.
Then she arranges a third meeting with the black market seller, but this time he is already informed that he is meeting with a journalist and not a cancer patient. She asks him to reveal the network and its workings to her.
- I am like a mediator. Four nurses in four different clinics who are in charge of these drugs call to tell me that a patient is going to ask me to ask for a product. They already inform me how much they have in stock and how much money it is. I don't know where the drugs come from and what is behind them. I take 15 percent of every sale, he says.
He has been involved in black business for two years. He says that he had more buyers and earned 250 thousand Venezuelan bolivars a month. But at the time of the investigative story he had three patients a week as more people joined the scheme.
According to him, nurses are responsible for the scheme.
- They tell me that they have a weekly supply, from what the clinics buy and then the remaining doses are given to me by those who return it to the families or from those bought by the hospital. They are from the La Trinidad, La Floresta and El Avila clinics, the smuggler says.
When the journalist enters these three clinics, she realizes that this version is not true. These three hospitals either do not have their own chemotherapy and drugs, but the patients bring them from outside and they are only administered inside, or they have strict rules with a name and surname for each patient and keeping them under cameras.
But the "smuggler", as the journalist found out, himself worked at Luis Racetti Hospital, a hospital that treats oncology patients in Venezuela. He worked there in the hospital pharmacy.
At the entrance to this hospital, "Luis Razzetti", you are greeted by a soldier in uniform who asks for a pass. The only way you know there are drugs to treat cancer is if you work there.
There are several posters stuck on the walls, including one that says "no filters for Paclitaxel", the same ones that the smuggler sold to the journalist on the black market.
The manager of the pharmacy in this hospital, Dr. Lisde Gonzalez, says that every day they record what enters and leaves the pharmacy.
- We have rigorous processes for records. It is very difficult to get anything out of here.
But when the journalist mentions the name of her "dealer of oncology drugs from the black market", the manager stops in shock and answers:
- He is in charge of the administrative part. It usually stays overtime. He can change the data in the inventory computer. The control method is a simple excel table.