Shortage of medicines worsens amid price freeze

KARACHI: A number of drugs, including some life-saving ones, are running in short supply as manufacturers say stagnant, low prices have rendered their local production unfeasible.

These medicines are prescribed for treating epilepsy, thyroid disease, neurological disorders, etc.

Some of the drugs in shortage are Actifed P, Cafcol, Panadol CF, Benadryl and Benatus syrups, Ventolin tablets (40mg), Flagyl, Freccium, Nicotex, etc.

Drugs that are available at some chemists but not available in some areas are: Arinac Forte, Thyroxin, Lomotil, Polyfax ointment, Panadol drop, Myrin Fort, Citlarca and Folic Acid.

Sources said some hospitals are facing shortage of Keyexalate, Colomycin, Neurobion, Zyrtec, Furolin, Merevan, Apresoline, Primaquine, Napa, etc. These drugs are used to cure hepatitis C and B, malaria and epilepsy.

Besides, some hospitals have run out of Pyrazinamide and Ethamdultal, two essential drugs to cure tuberculosis, or TB.

The shortage of these basic medicines may cause “catastrophic epidemics”, hospital sources said.

One reason behind the shortage is that around 20-30 per cent essential drugs are not produced in Pakistan because of a decade-long price freeze. Drug makers say it is simply unfeasible to manufacture some medicines.

Oxytocin and Methylergomet­rine Maleate, medicines classified by the World Health Organisation (WHO) as essential to control maternal deaths, are also in short supply. Out of the 10 companies that are allowed to produce these life-saving drugs, only three are manufacturing them. The rest of the companies have stopped production citing “high input costs and extremely low maximum retail price (MRP)” allowed by the Drug Regulatory Authority of Pakistan (DRAP).

Sources said that one of these companies, which has almost 90pc market share, is now forced to import these life-saving medicines at significantly higher costs.

These discontinued drugs are either smuggled or imported at a very high rate and are then sold to patients at prices much higher than those requested by the industry from DRAP. “Maternal mortality rate could grow manifolds due to the absence of these two essential medicines,” a gynaecologist at a government hospital said.

The industry is often blamed for seeking refuge in court’s stay orders, whereas it accuses DRAP of inaction which pushes the manufacturers to go to courts. At present, around 50 cases are pending at the Sindh High Court (SHC) regarding different matters, including pricing, registration and import approval.

The SHC was recently approached by a manufacturer after DRAP refused to raise the price of a life-saving injection drug or allow its import. The court then directed the regulatory authority to allow its import within three days. The drug, sold for Rs5 was to be imported at $1 per injection.

The industry earlier went to courts twice, in 2013 and earlier this year, against low drug prices.

Meanwhile, the Pakistan Pharma­ceutical Manufacturers’ Association (PPMA) has said some 70-80 medicines have become disappeared from the market due to “utterly unfair pricing mechanism” due to which their indigenous manufacturing has become unfeasible. The pharmaceutical sector was the only industry in the country which paid general sales tax on certain inputs but it could not charge consumers for it, the association said.

It said the price controlling powers of DRAP should be confined only to WHO’s “Model List of Essential Medicines”, a globally accepted list that contains all life-saving and other emergency medicines. Drug makers have now been left with no option but to approach the superior court, it said.