The Directorate of Medicine and Health Products Supply, under the Ministry of Health and Social Protection, has launched a tender for the purchase of medications and medical devices intended for oncology centers, with the bid opening scheduled for April 24. This tender, divided into 95 lots, represents a budget of approximately 219 million dirhams, according to information accessed by TelQuel.

Within this list, three lots stand out due to their high cost, with estimates ranging from 21 to 42 million dirhams, totaling over 106 million dirhams. The first lot, with an estimated budget of around 22 million dirhams, includes the acquisition of 5,600 boxes of bevacizumab 100 mg and 4,910 boxes of the same medication in a 400 mg version.

This medication blocks the development of blood vessels necessary for the growth of certain cancerous tumors and is notably used to treat advanced cancers of the colon, breast, and kidney.

A medication more expensive than in Paris

According to the National Health Insurance Agency (ANAM), bevacizumab holds two marketing authorizations (MA). It is marketed by Roche under the name Avastin as the brand-name drug, priced at 2,908 dirhams per 100 mg box in pharmacies and 2,581 dirhams for healthcare facilities, while the 400 mg version is sold for 9,510 dirhams and 9,332 dirhams. It is worth noting that this medication was implicated in the loss to follow-up of 16 patients at the August 20 Hospital at the Ibn Rochd University Hospital in Casablanca, after being administered off-label to treat age-related macular degeneration (AMD) and diabetic macular edema.

The same active ingredient is also marketed in Morocco by Sothema, led by Lamia Tazi, under the name Ypeva. Although it is a generic version of Avastin, Ypeva is sold at exactly the same price as the brand-name drug—a practice described as “downright abnormal” by a pharmacist interviewed by TelQuel.

The pharmacist explains that a generic drug is expected to cost 20% to 80% less than its brand-name equivalent, as research and development costs have already been absorbed by the original laboratory. “In Morocco, the price of generics is not systematically reviewed after the MA is granted by the Ministry of Health. It can thus be aligned with the brand-name drug’s price for purely commercial reasons or to avoid direct competition,” they clarify.

Notably, the lot dedicated to bevacizumab is one of the few among the 95 to include two different dosages of the same medication. In comparison, other active ingredients, such as Vinblastine, are spread across up to six lots. The tender regulations stipulate that a bidder may “submit offers for one, several, or all lots. However, their bid must cover the entire quantity specified for the lots.” In other words, only one laboratory—Roche or Sothema—will supply oncology centers with this medication.

But what particularly stands out is that this anticancer drug is sold at a much higher price in Morocco than elsewhere. Zirabev, a generic version of Avastin marketed by Pfizer, is sold in France for €69.7 (722.6 dirhams) per 100 mg box and €311.6 (3,228 dirhams) for the 400 mg box. Mvasi, another generic by Amgen, costs €165 (1,710 dirhams) for 100 mg and €607 (6,294 dirhams) for 400 mg in France. In India, Intas Pharmaceuticals markets Bryxta at 1,061 dirhams for 100 mg and 1,173 dirhams for 400 mg.

While none of these generics have received marketing authorization (MA) in Morocco, it is important to note that in France, the Economic Committee for Health Products has approved a price reduction for Avastin (the brand-name drug, therefore). As of February 2025, the 100 mg box is sold at €71.23 (737 dirhams) and the 400 mg box at €262 (2,713 dirhams). If Morocco aligned its prices with those in France, this would represent savings of over 14.2 million dirhams—a 71% reduction!

A 396% price difference

The second lot involves the purchase of 2,861 boxes of pertuzumab 420 mg injectable. This recombinant humanized monoclonal antibody, used in the treatment of certain breast cancers, is developed by Roche under the brand name Perjeta. The acquisition is estimated at nearly 43 million dirhams. To date, no generic or biosimilar version of Perjeta is marketed, even though its patent expired in 2023 in Europe and in June 2024 in the United States.

This medication is sold in Morocco for 25,900 dirhams in pharmacies and 25,400 dirhams in healthcare facilities. However, in Egypt, the same laboratory offers it for only 5,118 dirhams—a price difference of 396%. “It’s normal for a medication to be cheaper in a country like Egypt, with 114 million inhabitants. The commercial potential there is significantly higher,” argues the pharmacist. But such a gap remains hard to justify.

“Egypt leverages its demographic weight to negotiate favorable prices, in addition to using a grouped and centralized purchasing system, which is not the case in Morocco,” our source adds. Aligning with Egyptian prices would allow the Ministry of Health to save 34.25 million dirhams on this single lot.

The ministry’s losses, the laboratory’s jackpot

The final lot, amounting to 41.38 million dirhams, involves the acquisition of 8,620 boxes of trastuzumab 600 mg injectable. This treatment, indicated for HER2-overexpressing cancers, is marketed by Roche under the name Herceptin Hylecta. There is currently no biosimilar available for this subcutaneously administered anticancer drug, which is patent-protected until 2030 in the United States. In Morocco, the medication is sold for 10,533 dirhams in pharmacies and 10,335 dirhams in healthcare facilities.

However, in Egypt, it is sold for 8,539 dirhams—23.4% cheaper. In India, the same treatment is offered for 2,524 dirhams, meaning it is 4.2 times more expensive in Morocco. Aligning with Indian prices would yield savings of 31.29 million dirhams.

In total, by aligning the prices of these three lots—at least two of which are expected to go to Roche—with those in other countries, the Ministry of Health could save nearly 80 million dirhams.

It is worth noting that in a similar tender launched in 2024 by the Ministry of Health, Roche indeed secured these three lots. The Swiss pharmaceutical group faced competition on only one lot, from Sothema, before winning by submitting the bid deemed most advantageous. And while Roche markets these drugs at significantly lower prices abroad—including in higher-income countries—the financial offers it submitted in 2024 for these three lots exceeded the ministry’s initial estimates.

For Avastin, the Directorate of Medicine and Health Products Supply had anticipated spending 22.04 million dirhams. This projection was 26.4 million dirhams for Perjeta and 33.62 million for Herceptin Hylecta. With no real competition, Roche ultimately secured the respective contracts for 23.9 million, 29.92 million, and 34.32 million dirhams.

“Since this laboratory operates in a competition-free environment, it has claimed the right to set and impose its own prices. This is compounded by Morocco’s lack of commitment to price negotiation or a centralized, bulk-purchasing strategy based on a comprehensive assessment of the needs of all healthcare facilities, both public and private,” laments the pharmacist.

The budgetary hemorrhage thus continues silently, at the pace of tenders, with no tourniquet applied. It is time for Health Minister Amine Tahraoui to correct this error, with less than a month remaining before the market allocation date.

Written in French by Younes Saoury, edited in English by Eric Nielson