The Ministry of Health seems just not interested to protect the interests of the people

Oct 28 - Nov 03, 2002

The pharmaceutical industry of Pakistan is heading towards deregulation. The government has set up a committee, comprising officials of Ministry of Health, Ministry of Commerce and Ministry of Industries, to draft recommendations to deregulate the industry. Trade sources told PAGE that the committee has made a number of amendments in the Drug Act 1976 to deregulate the industry.

The question is: would the deregulation benefit a population in a country reeling from low per capita income and over-the-counter drug culture? On the other hand, would it satisfy the demands of an industry clamouring to be tightly regulated not being allowed to increase the prices despite substantial increase in cost of production.

While the final draft of the proposals covering all aspects of drug trade; be it manufacturing, prices, registration, quality, etc. is yet awaited, reports say the government has got into an understanding with the pharmaceutical industry to let it fix its own prices after a year on conditions that it would increase the prices at present.

An important question that should be asked here is: Will deregulation encourage the pharmaceutical companies to start manufacturing and marketing a range of life-saving drugs which many companies stopped to manufacture due to what they alleged "uneconomic low prices." Critics of the industry, on the other hand, say that drug prices in Pakistan are expensive compared to other countries in the region where the same multinationals are operating.

A prime example of this is a medicine to treat epilepsy. Market sources told PAGE that the drug is in short supply for last many years as a number of MNCs ceased to manufacture it altogether. The drug manufactured under a common name "Phenobarbitone" is also manufactured by some six local companies which are just not enough to meet the demand and thus the medicine has remained in perpetual short supply over the years. But whatever quantity is available still fails to benefit the patients as only the 1000 tablet bottle of the medicine is available in the market while 50-tablet bottle is just not available. The poor epilepsy patients are the worst hit sufferers of this unethical pressure selling as a vast majority of them just cannot afford to buy the 1000-tablet bottle.

The acute shortage of this medicine is resulting in rampant black marketing. The 50-tablet bottle of the drug manufactured by local companies is available in the market for Rs 35, more than four-times its original price of Rs 8. The 1000-tablet bottle is selling for Rs 300 instead of Rs 150.

The similar is the case with a life-saving drug, Panadura, used in the treatment of infants and adults with hole in their hearts. This drug is also in short supply for last many years as a multinational which used to manufacture it does not produce it anymore. Though the substitute is also made by a number of local companies, the acute shortage is resulting in rampant blackmarketing the 6 lac injection for children that should be retailing for Rs 7 is available in the market for Rs 100 while the 12 lac injection for adults that should be sold at Rs 13 is available in the market for Rs 200. Market sources told PAGE that the medicine is not available even at the highly inflated prices at present.

Not only a number of essential and life-saving drugs remain in perpetual short supply forcing the sick to dig deep in their pockets but the pricing policy pertaining to same drugs also remain extremely erratic. Look at the case of a product for ulcer treatment. Losec capsule imported by an MNC from a Swedish company Astra is available in the market for Rs 688 per 14 tablets. A similar drug marketed by MNC ICI by the name Etepro 20 mg tablet retails for Rs 420 per 14 tablets. The same drug marketed by another MNC, Merck, by the name Omolocid 20 mg is available in the market for Rs 189 per 14 tablet. This ulcer treatment medicine is also manufactured by a number of other MNCs and local companies and the products of the latter is available for as little as Rs 100 per 14 tablet.

The wide difference in the price of the similar drugs for the treatment of the same ailment highlights the need to make necessary amendments in the pricing formula. It is imperative to amend the drug pricing policy particularly the necessity, or the lack of it, to import a costly drug bleeding the national economy when affordable substitutes are produced by a number of companies within the country.

Sources also told PAGE that the Ministry of Health seems just not interested to protect the interests of the people. Instead, they alleged, the Ministry is more interested to protect the pharmaceutical companies, particularly the influential and affluent MNCs, at the cost of the people. For instant, they said, the Ministry refuses to grant registration to new products so that the MNCs would keep enjoying the monopoly over a certain money-making brands.