LAHORE: Price escalation is likely to create acute medicines shortage in the country, as the government controlled rates remain unchanged, forcing the domestic and multinational pharmaceuticals to gradually suspend production of even life saving drugs such as thyroxin, ventoline inhalers and steroids, experts said on Saturday.
“Baring increase allowed on 80 medicines last month, the government has last increased the prices in 2001,” said Khwaja Shahzeb Akram, vice chairman of Pakistan Pharmaceutical Manufacturers Association (PPMA).
There should be a rationale, while increasing the rates of medicines. Increase allowed on one molecule should be applicable to all producers proportionately as input costs for all have increased, he said.
When the last price increase was announced in 2001, the dollar was available at Rs48, which has now gone up to Rs91, he said, adding that almost 95 percent of the pharmaceutical raw material is imported in Pakistan and the devaluation of the rupee has badly affected the viability of several drugs.
Besides, he said, the cost of living has increased substantially in last one decade. The salaries have increased, electricity rates have tripled and the transportation charges have quadrupled during the last eleven years, but the drug regulators remain indifferent to market realities.
“This is creating shortages of several essential drugs,” said Akram, adding that his company has discontinued several steroid preparations as it was not viable to produce them at the price allowed by the Drug Regulatory Authority.
Multinationals having well-known branded steroids are still in the market because of economies of scale, he said. “They would also go out of the market soon if prices were not increased,” he said.
An informal survey of the market revealed that some high demand drugs produced by the multinationals are no more available in the market. It includes thyroxin (for patients with problem in thyroid gland), ventoline inhaler for (asthmatic patients), Davenol an anti-histamine, Materna for pregnant mothers, Ascorbon (Vitamin C), and Caltrate (calcium preparation).
All the above and several other drugs have been discontinued by the multinationals because the cost of production of these drugs was higher than the retail price allowed by the regulatory authority.
Only Thyroxin is manufactured in limited quantity as a corporate social responsibility by one multinational as its fixed retail price is only Rs25 per 100 tablets that does not cover the cost of even packing and marketing, he said, adding that this drug is available in the black market at Rs100-400 per bottle, depending upon the severity of shortage.
“Patients with malfunctioning thyroid have no other option, but to buy this medicine at any cost to survive,” said Dr Abid Iqbal Khokhar, a medical practitioner.
Executives of the multinational pharmaceutical companies (MNCs) said they have been making representations to the government for several years on the matter of pricing, but no progress has been made in allowing a general price increase to the industry.
They said that since most of them are Pakistani nationals they have been strong advocates of putting patient interest foremost and have continued to supply certain medicines at cost or below cost to ensure the patients have access to world-class medicines at the lowest prices in the world.
However, they said, things have gone out of control now as the profits of all these multinationals listed at the Karachi Stock Exchange (KSE) have deteriorated rapidly in the last few years.
“We are responsible to our shareholders and foreign principals and cannot survive by marketing medicines below the cost.” They said that the price issue is hurting the multinational and domestic medicine manufacturers. The only difference, they added, is that domestic firms discontinue the product as soon as it becomes commercially viable, while multinationals continue the production for a few years to facilitate patients.
Dr Khalid J Chaudhry, former president of Pakistan Pharmaceutical Manufacturers Association warned that if the situation is not immediately rectified most of the low-cost essential drugs would go out of production and patients would be forced to buy very high cost imported medicines.