Turkish patients are finding it increasingly difficult to access key drugs, with producers blaming the shortages on an inflexible pricing system for medicines that exposes them to losses from the lira’s swift decline.

Pharmacist associations are reporting supply problems with nearly 650 drugs, ranging from painkillers and cough syrups to treatments for asthma, influenza and cancer.

The second bottleneck in supplies in as many years shows how this year’s steep drop in the value of the lira is taking a toll on critical imports in a heavily regulated market place. It’s a serious matter for unwell Turks and another headache for President Recep Tayyip Erdogan, whose ruling party lost support as prices spiraled.

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The government each year sets an exchange rate that pharmaceutical companies must use when pricing their products, many of which are imported or made in Turkey using ingredients from overseas. In February, officials set the rate at 4.57 liras per euro, roughly 60% below the current 11.27 liras.

Read more: Bloomberg