Missing medicines

LAHORE: Various essential and lifesaving drugs, manufactured by multinational as well as local pharmaceutical companies, have disappeared from the market, putting health and even lives of patients at risk, Bol News has learnt.

Common citizens are the ultimate victims as the majority of the unavailable drugs hardly have any substitutes.

In case of availability of any substitute of a drug, it is not being prescribed as doctors have little or even no confidence in efficacy. Senior doctors, manufacturers, wholesalers, retailers and government officials gave varying reasons for the unavailability of essential drugs.

Essential drugs including Ventolin 2mg/4mg tablets, Ventolin injection, Xanax 0.5/0.25/1mg tab, Ativan 1/2mg tab, Betnesol tab, Clenil Compositum, ViDaylin syrup, Epuram syrup, Epuram tab, Silliver tab, Fortum 250/500mg injection, Cloberite cream, Cloberite oil, Gaviscon syrup, Panadol tab, Calpol tab, Klaricid drops, Klaricid syrup, Primolut N, Febrol tab/syrup, Coldrex tab, Actifed P, Glucobay tab and various others have gone missing from shelves at pharmacies.

These essential drugs are not available at the medicine market at Lohari and medical stores including outlets of all leading chains of pharmacies.

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

Lives of heart patients are at high risk as an important drug Inderal 40mg tab effective in controlling high blood pressure and irregular heartbeats is not available in the market.

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

The medicine Fortum 250/500mg is effective for a wide range of bacterial infections, Cloberite cream and Cloberite oil for inflammation control, Gaviscon syrup for heartburn and indigestion, Klaricid drops, Klaricid for lower respiratory tract infections like acute and chronic bronchitis and pneumonia, Primolut N for premenstrual syndrome, Febrol tab/syrup for mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis or cold/flu) and to reduce fever.

In addition to this, Coldrex tab for relief from sinus pain and nasal congestion, Actifed P for relief from common cold, flu, allergies or other breathing illnesses, Glucobay tab for type 2 diabetes and Panadol tab and Calpol tab for reducing fever.

A senior doctor told Bol News that the shortage of these lifesaving and essential drugs was routine as there was no proper mechanism to safeguard the interests of patients.

He also said that there was no substitute for ‘orphan’ drugs. Referring to the reasons for unavailability of important drugs, he added that companies pay no attention to meet the requirements of the patients as prices of these medicines were low and there was little profit margin. Prices of these medicines have not been revised for many years, he elaborated.

Profits over people?

Professor Javed Akram, Vice Chancellor (VC) of University of Health Sciences (UHS) stated, “Multinational companies supply less medicines as there is little or even no profit margin. They prefer manufacturing and selling other profit-oriented medicines to earn more money. Local companies also show least interest in manufacturing these drugs due to the same reason.”

Referring to the shortage of different brands of paracetamol, he added that the most recent revision of prices by the Drug Regulatory Authority of Pakistan (DRAP) would help normalise the situation.

“Companies are not there just for the service. You need to give them a realistic profit margin”, he said, adding that less price was the cause of shortage of a drug in 99 per cent of the cases.

There are other issues like provision of raw material and registration of drugs, the UHS VC explained. “But these contribute only 1pc to the shortage of a drug. The government needs to revise prices of all orphan drugs to ensure their availability in the market.”

The government should revise prices of essential drugs after due consultation with the stakeholders, he suggested.

Timely revision of prices of essential drugs is necessary for stopping more additions in the list of orphan drugs, said Amjad Ali Jawa, chief executive officer of Wilshire Laboratories, a leading pharmaceutical company having reasonable local market share, besides exporting medicines to more than 20 countries in Asia and Africa.

“The government usually forces the companies to manufacture orphan drugs in the required quantity. Even manufacturing and supply in the required quantity could not check the shortage of these drugs in the market.”

He also said that lower prices encourage hoarding and sale of these medicines at Whigher rates at the retail outlets. As such, he added, the only way of overcoming shortage of these drugs was giving a realistic profit margin to the entire supply chain from manufacturers to the retailers.