Concern over drugs shortage

LAHORE

Healthcare professionals from across the country have drawn the attention of the minister of National Health Services Regulation and Coordination and Drug Regulatory Authority of Pakistan (DRAP) towards the shortage of Oxytocin and Methylergometrine Maleate drugs, which have put the lives of expectant mothers in danger.

Dr. Sarah Feroze, gynaecologist and obstetrician, has sought immediate attention of the authority to resolve the shortage of two major medicines Oxytocin and Methylergometrine Maleate, which have been classified by the WHO as ‘essential’ to control maternal deaths.

Dr. Sarah said that life-saving drugs, essential to prevent maternal deaths during childbirth complication have vanished from open market, putting the lives of thousands of would-be mothers at risk. The maternal mortality rate in Pakistan is 170 per 100,000, according to World Health Organization (WHO).

Meanwhile, sources in the healthcare profession and pharmaceutical industry confirmed that local production of the two essential life-saving medicines has been discontinued for the past one year. ‘There were 10 companies registered and allowed to produce the drugs, but only three are currently producing them,’ said a source. And, the source added, the rest of the companies have stopped production due to high input costs and extremely low MRP allowed by DRAP i.e. Rs10 and Rs5 whereas the imported alternate cost around 1 US dollar (around 104). ‘Surprisingly one of them has almost 90 percent market share and even that the company is now forced to import the life-saving medicines at significantly higher costs,’ added the source.

The source added that the company had decided on its own to keep the products available at the same low and unviable rates to serve needy patients. ‘Since this is not a sustainable situation, it appears that imports of the two products may be discontinued very soon, leaving women of childbearing age in Pakistan at the mercy of quacks and spurious alternatives,’ reasoned the source.

He stated that the average cost of a delivery in Pakistan is estimated to be around Rs15,000 to Rs20,000, and the prices set for the two life-saving essential medicines are approximately Rs10 and Rs5, respectively. ‘It is difficult to believe that anyone would be unwilling or constrained to pay even double price to get these drugs to save the life of mother and child,’ he added.

The DRAP being overburdened due to unrealistic control over medicine registrations and pricing has not only failed to ensure the availability of critical life-saving low-priced drugs but also miserably failed to promote healthy competition to motivate other companies to produce it. Dr. Zubaida Masood, Associate Professor Gynae and Obs at KMDC and Abbasi Shaeed Hospital, asked that can anyone explain how the precarious situation has been allowed or if any of the regulating authorities are even considering corrective actions?

‘Often accused of favoring the pharma industry through price increases, the DRAP has actually been ignoring its prime objective, eg. across-the-board availability of quality medicine, as even Rs 5 and Rs 10 life-saving drugs which are essential during childbirth, are not available in open market,’ she added.

In the absence of the two essential medicines the maternal mortality rate could grow manifold from 170 per 100,000 with an estimated 5 million births a year. ‘While no one expects that all socio-economic reasons related to maternal deaths will be resolved overnight, the least policy makers should do is to ensure that medicines designed to prevent such deaths are readily available throughout the country,’ she added.