{"id":16906,"date":"2026-07-06T14:55:45","date_gmt":"2026-07-06T12:55:45","guid":{"rendered":"https:\/\/zawia3.com\/?p=16906"},"modified":"2026-10-24T15:00:23","modified_gmt":"2026-10-24T13:00:23","slug":"schizophrenic-patients","status":"publish","type":"post","link":"https:\/\/zawia3.com\/en\/schizophrenic-patients\/","title":{"rendered":"Schizophrenia Medicines in Egypt: Recurring Shortages, Rising Prices and Official Denials"},"content":{"rendered":"

As the date of the monthly dose approaches, the family of Manal Abdel Azim (a pseudonym), aged 57 and a stage-four schizophrenia patient, prepares to search for the “Invega” injection in Cairo’s pharmacies, contacting them through the hotline to reserve it, before travelling the kilometres from Alexandria, where she lives, to Cairo to obtain it. <\/span><\/p>\n

Since last year, the family has regularly repeated this ordeal, which has been compounded by the rise in the price of the injection alongside its complete disappearance from the market over the last four months.<\/span><\/p>\n

Mariam Hassan (a pseudonym, at her request) recounts that its price at the start, when the case was diagnosed as schizophrenia three years ago, was 3,500, then jumped to 5,500, and for a year they have been unable to find a single ampoule in Alexandria’s pharmacies, which forced them to come to Cairo every month; instead of bearing only the cost of the injection, the family now bears an additional financial burden, the cost of travel, “because the pharmacy refuses to ship it to Alexandria”.<\/span><\/p>\n

The family thus began setting aside about EGP 7,000 a month, the price of the ampoule (a single dose), in addition to the cost of travel from Alexandria to Cairo and back; however, the shortage of the injection in the market recently forced them to secure the dose every month and a half, after she used to take it monthly, “and at the times when we struggle to find it, the patient goes into relapses”.<\/span><\/p>\n

The “Invega” injection is the only solution for dealing with Manal’s condition, according to the doctor who diagnosed her with schizophrenia three years ago. One of Manal’s first-degree relatives tells Zawia3 that after leaving the sanatorium she kept refusing to take the tablets and would throw them in the rubbish without anyone in her family knowing, and for this reason the doctor had no option other than replacing the pills with the injection, because she was not adhering to her medication.<\/span><\/p>\n

Schizophrenia is a serious mental <\/span>illness<\/span><\/a> that causes major disturbances in perception and changes in behaviour; its symptoms include persistent delusions, hallucinations, disorganised thinking, highly disturbed behaviour or severe agitation, which makes the person affected suffer from difficulty concentrating.<\/span><\/p>\n

Schizophrenia<\/a> affects about 23 million people, or one in every 345 people worldwide, according to the latest statistics published by the World Health Organization. The number of schizophrenia patients in Egypt<\/a> is estimated at about one million people.<\/p>\n

Data published by the US National Institute of Medicine point to a rise in the prevalence of schizophrenia<\/a> from 13.62 million to 23.18 million between 1990 and 2021, and global indicators suggest that it will continue to rise, causing a societal and economic burden.<\/p><\/blockquote>\n

In recent months, a crisis of shortages of long-acting injectable preparations has emerged in the medicines market, and doctors who spoke to Zawia3 explain that they are available only in the hospitals of the General Secretariat of Mental Health, but the quantities available there have begun to decline.<\/span><\/p>\n

The doctors point out that this shortage has had a direct impact on a number of patients, especially those who face difficulty adhering to oral treatment, as the interruption of treatment for some of them has led to relapses requiring hospital admission, whether in the public or the private sector, which has placed an additional burden on families.<\/span><\/p>\n

The prices of the alternatives available in the market have reached thousands of pounds, compared with the original price, which does not exceed EGP 20 to 30, which they described as a large price gap that makes it harder for patients to obtain regular treatment, according to the doctors, who called on the Ministry of Health to intervene quickly to ensure the provision of these injections before the situation gets worse.<\/span><\/p>\n

 <\/p>\n

Recommended reading: <\/b>Psychiatric Drug Shortages in Egypt: A Daily Struggle for Survival<\/b><\/a><\/p>\n


\nLong-Acting Antipsychotics<\/b><\/h1>\n

“Invega” falls among the long-acting injections and is scientifically called a long-acting <\/span>antipsychotic<\/span><\/a>; it is used to treat patients with schizophrenia, delusional schizoaffective disorders and bipolar disorder. <\/span><\/p>\n

They are pharmaceutical formulations that stabilise the level of the drug in the blood, and they have many advantages compared with oral treatment, because they keep the drug stable on a regular basis; they are given to a number of patients who do not adhere to treatment and who pose a danger to the lives of others, as they help improve their lives and reduce the severity of negative <\/span>symptoms<\/span><\/a>.<\/span><\/p>\n

New generations of long-acting <\/span>antipsychotics<\/span><\/a> appeared in 2018, after receiving the approval of the US Food and Drug Administration; some are taken monthly, and there are other types taken every three months.<\/span><\/p>\n

 <\/p>\n

Dr Mostafa Shehata, a psychiatrist and former director of Abbasiya Hospital, stresses to Zawia3 that there is a severe scarcity of long-acting medicines in the market, pointing out that a large number of patients have been affected by this shortage, specifically schizophrenia patients, and explaining that providing these injections is not a luxury, especially for patients who do not take their therapeutic doses regularly, “because they control the acute symptoms of the illness for a longer period than ordinary medicines”; they are considered essential for many psychiatric patients who deny their illness.<\/span><\/p>\n

Shehata points out that the high price of the injection has made matters worse, as the price of a single injection has exceeded EGP 5,000, and despite that it has been unavailable in the Egyptian market for nearly a year, stressing that its shortage has increased the occurrence of relapses and the admission of many patients to psychiatric sanatoriums, which increases the financial burden on the Egyptian family: “I had only two options: either the patient is treated at home, or admitted to the sanatorium.”<\/span><\/p>\n

He says that these patients are among those who suffer repeated bouts of relapse, and their families could not find the injections, so we had no option other than admission to psychiatric sanatoriums, “because the patient had been used to taking these injections for years”.<\/span><\/p>\n

A Burden on Doctors <\/b><\/h1>\n

For her part, Dr Nehal Zein, a psychiatry specialist, says that antipsychotics are divided into two types, tablets and injections, and that among these injections some are intended for emergencies and others are long-acting, which she always prescribes for her patients in specific monthly doses that may reach two doses a month, to help them stabilise, pointing out that when the doses are not taken regularly, patients are in their most dangerous state, believing that those around them are conspiring against them and will harm them.<\/span><\/p>\n

She adds to Zawia3 that the availability of these injections limits these thoughts and also makes it easier for them and their families to follow them up and to live in a calmer way on both sides, but the disappearance of many products from the market for a period that is not short has become a burden on patients and their families.<\/span><\/p>\n

She points out that the shortage of antipsychotics has not been limited to imported products only, noting that the crisis has spread to both imported medicines and their local alternatives, and among these products are haloperidol injections and their alternative, Halonez tablets, in addition to Clopixol injections, stressing that they become available for a short period and then disappear again, which has been happening in recent years, as she tells Zawia3.<\/span><\/p>\n

The shortage of long-acting antipsychotics forces the psychiatry specialist to resort to giving patients tablets as an alternative to injections, which puts doctors before the dilemma of patients not adhering to the tablets, which Nehal attributes to the patient being in a state of loss of insight: “They pretend that they have taken the tablets and swallowed them, but in reality they have hidden them from their caregivers, unlike the injection, with which the patient receives the dose for a longer period without the need to make sure it has been taken.”<\/span><\/p>\n

This has affected Hagar Ali (a pseudonym), a young woman in her twenties with schizophrenia: after her family lost hope of finding the haloperidol injection in the pharmacies of Qena Governorate for many months, Hagar stopped taking the tablets prescribed by her psychiatrist altogether.<\/span><\/p>\n

Her sister says that because of the shortage of antipsychotics, the psychiatrist was forced to prescribe tablets with a higher concentration, but Hagar refused to take them, adding that she also stopped going to her doctor.<\/span><\/p>\n

She explains that during her hospitalisation last year, after the symptoms of her illness worsened, Hagar received her therapeutic doses regularly, because the long-acting injections were available at the hospital, but after she left, the family could not find them in the market, as the repeated answer was “it is out of stock”; she adds that Hagar’s stopping treatment, combined with her refusal to take the alternative tablets, led to her condition deteriorating again and to the return of some old behaviours and symptoms that she had overcome during the treatment period.<\/span><\/p>\n

A First-Line Treatment Option<\/b><\/h1>\n

According to the US National Library of Medicine, long-acting injectable antipsychotics were designed to increase the effectiveness of treating schizophrenic disorders, and analytical <\/span>studies<\/span><\/a> have concluded that they achieve many advantages, which may extend to reducing the likelihood of relapses and hospital readmission, shortening the length of hospital stays and lowering mortality, compared with other oral antipsychotics; long-acting treatment is also associated with lower total medical expenditure.<\/span><\/p>\n

An American organisation has published a <\/span>guide<\/span><\/a> calling on psychiatrists, specialists and psychiatric treatment institutions to expand the use of long-acting injections; the organisation considers that all those working in community mental health services and the treatment of substance use disorders should offer long-acting medicines to patients as a first-line treatment option, and it encourages its members to promote their safe and effective use.<\/span><\/p>\n

It also points out that scientific research supports adopting long-acting medicines as a first-line treatment option, instead of restricting their use to later stages as a second- or third-line option.<\/span><\/p>\n

According to the guide, early intervention with long-acting antipsychotics contributes effectively to preventing relapse in most patients, which helps avoid the progressive neurological deterioration and subsequent disabilities associated with schizophrenia.<\/span><\/p>\n

Numerous <\/span>studies<\/span><\/a> have also revealed a close link between poor adherence to treatment and a high relapse rate; the studies showed markedly higher adherence rates among patients receiving long-acting medicines, in whom the worsening of psychotic symptoms or relapses declines compared with patients receiving oral treatment.<\/span><\/p>\n

The published <\/span>guide<\/span><\/a> points out that despite the improvement these medicines achieve in cases of schizophrenia, which is reflected in turn in rates of illness and death and in quality of life, as well as in reducing the direct costs of healthcare, such as hospital stays and outpatient treatment, and the indirect costs associated with disability,<\/span><\/p>\n

long-acting medicines are still used at lower rates than required and are often given after relapses have occurred instead of being used early from the onset of the illness, and many doctors rely on tablet treatment for their patients, which leads to repeated relapses.<\/span><\/p>\n

According to statements by Dr Ali El-Ghamrawy, head of the Egyptian Drug Authority, during a meeting held by Prime Minister Mostafa Madbouly last January, there is no <\/span>shortage<\/span><\/a> of medicines; the head of the Egyptian Drug <\/span>Authority<\/span><\/a> also presented, in an interview, figures on the size of the Egyptian medicines market from 2025 until the current year, pointing out that the total size of the market exceeded EGP 422 billion, distributed between the private and public sectors, with the private sector accounting for about 70% of the total financial value against about 30% for the government sector, and noting that these indicators show stability in the medicines market after it declined in 2024, which produced a strong growth spurt in the medicines market that reached 22%, or $1,300,000,000, in 2025, while in 2024 it reached $1,070,000,000, a difference of about $230 million. He also spoke about the government’s interest in the file of localising the pharmaceutical industry, explaining that the state manufactures 91 packs out of 100 locally.<\/span><\/p><\/blockquote>\n

 <\/p>\n

Recommended reading: <\/b>Medicine Shortages Double the Suffering of Cancer and Kidney Failure Patients<\/b><\/a><\/p>\n

<\/span>A Crisis of Local Manufacturing<\/b><\/h1>\n

For his part, Dr Mohie Hafez, a member of the Export Council for Medical Industries, reveals in statements to Zawia3 that all long-acting medicines for psychiatric and neurological illnesses are still imported from abroad and have not been manufactured locally, attributing the reason behind their disappearance from the market to the fact that manufacturing them requires the availability of advanced technology and manufacturing materials that are found only in the global market; what he says in this context agrees with Tarek Saad, a professor of psychiatry, in earlier statements, that the problem with these medicines is that they require a difficult <\/span>method<\/span><\/a> of preparation. <\/span><\/p>\n

He adds to Zawia3 that the lack of interest in them is due to weak consumption inside the country, despite what the figures indicate about the existence of nearly one million Egyptian citizens suffering from schizophrenia.<\/span><\/p>\n

The member of the Export Council for Medical Industries stresses that the imported quantities of long-acting antipsychotics are usually available first in public hospitals and psychiatric sanatoriums, explaining that these serve as a main source of supply for patients held inside hospitals, far more than for doctors in clinics, and he attributes this to doctors using them less than the sanatoriums do.<\/span><\/p>\n

He points out that relying on importing these injections from abroad may create a shortage or deficit at times, noting that he knows how important the availability of long-acting antipsychotics is for those patients who are unwilling to take daily doses, and doctors’ preference for giving them long-acting antipsychotics.<\/span><\/p>\n

On the rise in the prices of long-acting injections, he comments that the continuation of the import crisis, which resulted from the earlier rise in the exchange rate, affected the price of a single injection, adding that in the end their pricing in Egyptian pounds remains far from their pricing in foreign currency; despite the movement in prices, their prices are still high, and for this reason there is always a shortage, given the nature of this matter.<\/span><\/p>\n

The Egyptian medicines market witnessed a <\/span>large rise<\/span> in prices, an increase of 25%, during 2024, when an acute <\/span>shortage<\/span><\/a> of medicines spread, and El-Ghamrawy explained its causes, which were due to the difficulty of providing hard currency to import medicines from abroad and the difficulty of importing raw materials for production inputs.<\/span><\/p>\n

The Egyptian government says that it succeeded in containing the medicine shortage crisis, which at the time reached the disappearance of 1,000 types, as 80% of the missing medicines were provided, while it is seeking to provide the remaining imported quantities, explaining that it is trying to provide them.<\/p>\n

However, the Drug Authority explained during an earlier press conference in 2024 that Egypt needs 100<\/a> million dollars a month to import raw materials, because it imports 85% of raw materials from India and China, and because of the currency shortage during the medicine shortage crisis in 2024, stocks inside factories declined.<\/p>\n

The crisis of providing dollars affected the import process: before the liberalisation of the exchange rate, pharmaceutical companies obtained dollar credits<\/a> from banks at the official rate of EGP 30.85 to the dollar to meet their needs for raw materials and production inputs imported from the global market, but the floating of the pound in 2024 and the rise of the exchange rate against the dollar, at about EGP 48, was reflected in the cost of production.<\/p><\/blockquote>\n

The Government Moves<\/b><\/h1>\n

For his part, Mohamed El-Bahy, head of the Federation of Industries, tells Zawia3 that the disappearance of some products from the market cannot be considered a shortage of medicines, but he attributes it to the challenges facing the state in terms of the decline in imports from abroad due to the difficulty of obtaining foreign currency, in addition to the delay of active ingredients that used to come from East Asia and China, and the recent disruption of trade traffic in the <\/span>Red Sea<\/span><\/a>, adding that some pharmaceutical products are affected by the security situation in the Red Sea, and stressing that the state is working to make medicine available, especially for chronic illnesses.<\/span><\/p>\n

El-Bahy points to the increase in the number of factories to 180 factories that seek to cover all pharmaceutical products and their alternatives continuously, but he justifies the shortage of long-acting medicines by doctors relying on certain companies rather than others for patients, explaining that the medicines produced in Egypt cover about 94% of patients’ needs and that what is imported does not exceed 6% of the volume of medicine used in the country: “Egypt is the oldest country in the region with a pharmaceutical industry, dating from the last century.”<\/span><\/p>\n

El-Bahy believes that the Egyptian Drug Authority is keen to provide all medicines, as it has pharmaceutical policies, reviews all missing products and tries to make them available, even directing some state-owned factories to produce the products in which there is a deficit.<\/span><\/p>\n

In an interview during the current year, El-Ghamrawy had announced that the Authority had begun implementing the drug track-and-trace system, with the aim of tightening control over the circulation of medicines within the Egyptian market, ensuring that the path of a medicine pack is tracked from production until it reaches the consumer, in an attempt to curb the practices of illegal stockpiling and smuggling that the market witnessed in past periods.<\/span><\/p>\n

He explained that the system is being implemented gradually within a project spanning three to five years, pointing out that since last February it has begun to be applied to some basic therapeutic groups, with all medicines to be included in this system over the coming years.<\/span><\/p>\n

For his part, Dr Mohie Hafez stresses that the Egyptian Drug Authority is placing the manufacture of medicines in its coming plan, within the strategy of localising industry, and is striving to manufacture local equivalents through Egyptian companies to reduce reliance on imports, pointing out that localising the pharmaceutical industry has become an important and sensitive issue and a just demand for these patients, and saying that Egypt has the capacity for research and development in such matters.<\/span><\/p>\n

He advises citizens who struggle to find long-acting medicines to contact the Isaaf Pharmacy, as it is the first source for the availability of medicines, or to contact the shortages department at the Drug Authority on the hotline, so that they are directed to the areas where the medicines are available, since at times the injections are available in some places and short in other areas, varying from one governorate to another, and in that case to make sure that particular products are missing from the market.<\/span><\/p>\n

Editorial correction: The first version of the report stated that long-acting antipsychotics appeared in 2018; the correct statement is that new medicines among them became available in that year, while this class of medicines has been in use for decades.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

The price of the long-acting schizophrenia injection rose from EGP 3,500 to EGP 7,000, and at times it disappears completely from pharmacies, while it is available inside government sanatoriums to private-clinic patients who search for it on journeys from one governorate to another, as the Drug Authority denies any shortage.<\/p>\n","protected":false},"author":4,"featured_media":19364,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"om_disable_all_campaigns":false,"footnotes":""},"categories":[413],"tags":[],"kateb":[15846],"class_list":["post-16906","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-society-en","kateb-marwa-mohey-eldin"],"jetpack_featured_media_url":"https:\/\/zawia3.com\/wp-content\/uploads\/2026\/10\/schizophrenia-medicine-2026.png","_links":{"self":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/16906","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/comments?post=16906"}],"version-history":[{"count":6,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/16906\/revisions"}],"predecessor-version":[{"id":23993,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/posts\/16906\/revisions\/23993"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/media\/19364"}],"wp:attachment":[{"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/media?parent=16906"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/categories?post=16906"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/tags?post=16906"},{"taxonomy":"kateb","embeddable":true,"href":"https:\/\/zawia3.com\/en\/wp-json\/wp\/v2\/kateb?post=16906"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}