Vanishing into Thin Air

Unavailability of various essential medicines puts patients’ lives at risk

Lahore: Various essential medicines, including those used for treatment of cancer and cardiac diseases have disappeared from the market, putting health and even lives of patients at risk.

The hapless patients are the ultimate sufferers, as the majority of the unavailable drugs hardly have any substitutes. In case of availability of any substitute, either it is more expensive or have little or even no confidence of physicians regarding its efficacy.

Senior medics, pharmaceutical manufacturers, wholesalers and retailers gave varying reasons for the unavailability of the essential and lifesaving drugs.

In addition to drugs, there is a shortage of chemicals used for laboratory investigation due to a delay in the opening of the letters of credit (LCs) for imports, owing to depleting foreign exchange reserves.

The pharmaceutical companies claim that high input costs due to unprecedented high inflation and the rupee depreciation and the reluctance of the commercial banks to open LCs for the import of raw materials have created this situation.

They demanded across-the-board increase in medicine prices and immediate opening of LCs for the import of raw materials to save the industry in the larger interest of the ailing humanity.

The doctors have accused the government of not monitoring the working of the powerful pharmaceutical companies, distributors, wholesalers and retailers.

Essential medicines, including Ventolin 2mg/4mg tablet, Ventolin injection, Xanax 0.5/0.25/1mg tablet, Ativan 1/2mg tablet, Betnesol tablet, Clenil Compositum, ViDaylin syrup, Epuram syrup/tablet, Fortum 250/500mg injection, Clobevite cream/lotion, Panadol tablet, Calpol tablet, Febrol tablet/syrup, Actifed P and various others have gone missing from the pharmacy shelves.

These essential medicines are unavailable at the medicine market at Lohari and medical stores, including the outlets of leading chains of pharmacies.

The unavailability of effective and cheap Ventolin tablet and injections and Fortum injection have made the lives of the Chronic Obstructive Pulmonary Disease (COPD) patients miserable in the highly polluted atmosphere of big cities like Lahore.

Reportedly, Xanax 0.5/0.25/1mg tablet and Ativan 1/2mg tablet are effective in treatment of anxiety/panic disorder, Betnesol tablet for controlling swelling, itching and redness, ViDaylin syrup for checking fluoride deficiency in children, Epuram syrup/tablet and Hepamerz sachet/syrup for liver diseases.

The lives of heart patients are at high risk, as an important drug Ismo 20mg tablet and Sustac 2.6mg tablet, effective in controlling angina and Benzibiotic injection for treatment of vulvular heart diseases are unavailable in the market.

Capsule Bioral used after liver, kidney and heart transplantation has also disappeared from the market. Nivaquin-P, used to treat systemic lupus erythematosus (SLE), is also unavailable. SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. It can affect the joints, skin, brain, lungs, kidneys and blood vessels.

Jakav 15mg tablet, used to treat blood cancer, bone marrow disorder and spleen enlargement, Neulastim 6mg/0.6ml injection, effective in controlling infection caused by low white cell count after chemotherapy, Eliquis 2.5mg tablet, a drug that prevent blood clots, Votrient 400mg film coated tablet, quite effective in treating advanced kidney cancer and soft tissue sarcoma and Opsumit 10mg film coated tablet prescribed for pulmonary arterial hypertension have also gone missing from the pharmacy shelves.

Similarly, Prograf 1mg tablet, used to prevent the attack of a transplanted organ by the immune system, Rifampicin 300mg, INH tablet and Ethambual 300mg tablet, used for treating tuberculosis and the vaccines for pneumonia, flu and typhoid have also disappeared from the market.

Similarly, Prothiaden 25/75mg, an anti-depressant, Meropenem 500mg and Augmentin syrup and tablet, antibiotic, Tegral tablet for epilepsy, PK Merz tablet for Parkinson’s disease, Pyodine gel for external wounds, Insulin 70/30/R, thyroxine tablet for treating thyroid and Genuric Forte used for urinary tract infection have also gone missing.

Missing drugs Fortum 250/500mg is effective for a wide range of bacterial infections, Clobevite cream and ointment for inflammation control, Febrol tablet and syrup for mild to moderate pain from headaches, menstrual periods, toothaches, backaches, osteoarthritis or cold and flu and to reduce fever.

In addition, the unavailable Actifed P is effective for getting relief from common cold, flu, allergies or other breathing illnesses, Glucobay tablet for type 2 diabetes and Panadol tablet and Calpol tablet for reducing fever.

Amjad Ali Jawa, chairman of Wilshire Laboratories, a leading pharmaceutical company having reasonable local market share, besides exporting medicines to over 20 countries in Asia and Africa, said that an immediate and across-the-board revision in the prices of medicines is necessary to save the industry.

“The high input costs due to a hike in the petroleum prices, electricity and gas tariffs, skyrocketing inflation, the rupee depreciation and difficulties in opening the LCs for import of raw materials have brought the industry on the verge of closure,” he added.

“You need to give a realistic profit margin to the entire supply chain of medicines,” he said, adding that any delay in the revision of prices and the reluctance to open LCs would lead to closure of the industry, which was against the interest of the country and the patients.

“The shortage of these lifesaving and essential drugs is a routine, as there is no proper mechanism to safeguard the interests of the patients,” said Dr Abdul Rauf, a family physician running his clinic in the congested locality of Usman Gunj in Northern Lahore.

“The recent increase in the medicine prices, more than double in the majority of the cases, has resulted in their availability. These drugs were taken away from the market to strengthen the case for an increase in their prices,” he said.

It was up to the pharmaceutical companies to ensure availability of medicines in adequate quantities, he added.

“Instead of fulfilling the responsibility of ensuring availability of quality drugs for the patients, the drug inspectors are busy in minting money,” he said, adding that there was no logic in the demand for an across-the-board increase in the medicine prices, as the profit margin was already much higher.

“Yes, an increase in the prices of some orphan drugs is needed. Enhancing the prices of all the medicines will be big injustice with the poor patients,” he said and suggested to evolve a mechanism to fix the prices that suited the ailing humanity.

Comment

The high input costs due to a hike in the petroleum prices, electricity and gas tariffs, skyrocketing inflation, the rupee depreciation and difficulties in opening the LCs for import of raw materials have brought the industry on the verge of closure

Amjad Ali Jawa

Wilshire Laboratories chairman