Essential drugs are in so short of supply that they are only available for a premium way above the printed prices

Apr 21 - 27, 2003

Money, money, money; It's so funny; It's a rich man's world. So goes a chart buster song of the famed pop group ABBA. However, the acute shortage of a wide range of inexpensive, but essential drugs in the market can hardly be funny at all due to grave concerns to an already neglected public health.

According to sources in the wholesale medicine markets here, a whole range of inexpensive but essential drugs are in so short of supply that they are only available for a premium way above the printed prices. What makes the situation even worse is that all of these drugs are inexpensive, all of them are in great demand and all of them are in acute short supply. Somebody is minting money at the expense of public health somewhere. Otherwise, why the acute shortage and all too visible black marketing of these daily-use drugs have not resulted in any firm action by the government.

Sources attribute the acute shortage and over-pricing of these essential but otherwise affordable drugs on two main factors. Number one, despite tremendous demand these inexpensive drugs despite offer less profit margins to the manufacturers then the expensive products. In short, the manufacturers' pre-occupation with expensive products are leaving them with no time to concentrate on these low-priced essential products more busy paying attention to expensive products as former offers them much greater profitability than the later. Secondly, these low-priced essential drugs have found a receptive market in many countries and the unscrupulous elements are pushing them into these markets illegally.

The acute shortage of these inexpensive yet essential drugs, the 'drugs of the poor', has thus taking a heavy toll on the over-the-counter drug market of Pakistan particularly as many of them have no 'substitutes' both by multinational or national companies available in the market.

So just how bad is the situation? Let us look at a number of examples to better understand just how bad it is. Pendura P.A. 12 Lac is an injection manufactured by multinational Wyeth Lederle. It is an essential medicine used in the treatment of hole in the heart. The retail price of this essential heart-treatment injection is Rs 14 but it is only available in black at seven-time the price at Rs 100. Similarly, Buscopan, another essential drug manufactured by multinational Merck is used to treat kidney and stomach pain. Both the 10 milligram tablet and compound versions of its are available in the market at a premium way above the fixed retail price. The 100-tablet pack is available in the market at Rs 150 double the retail price of Rs 75 while the compound is available at more than double the Rs 85 fixed price at Rs 200.

What makes the situation even more alarming is that the nefarious elements are particularly targeting the cheap essential products. Pheno Berbeton tablet, manufactured by a number of national companies, is one such drug. A 50-tablet bottle of this drug used in the treatment of brain-related disorders, including epilepsy, carries a retail price tag of just Rs 8. However, due to acute shortage this extremely essential drug is available in the market at five-times the fixed retail price. Just who is minting the money as the health officials at the great financial inconvenience of the sick?

These are just a few examples of the nefarious activities taking place under the very nose of the officials of the Health Ministry. However, there are a whole range of other such essential but inexpensive drugs which no remain inexpensive thanks to the profiteers who have seen it fit to mint money at the miserable of the poor sick. Other such drugs targeted by the profiteers are used in treatment of a number of diseases including respiratory problems, ulcers, blood pressure, malaria, pain, eye infection, so on and so forth.

Sources in the wholesale medicine market, who asked PAGE not to mention their names so as to avoid any repercussions by the manufacturers, also blamed companies for the shortage. "The companies have made it a habit to short supply a number of drugs for all orders placed with them. For instance, if a wholesaler place a Rs 100,000 order with a company the delivery is always short of a number of items, mainly these low-priced but essential drugs.

"Not only, these 'drugs for poor' are in perpetual short supply but they are also being smuggled out of the country to many other countries in the region, particularly to Afghanistan and from there to Central Asian Republics. The other major markets of these low-priced essential drugs are Sri Lanka, Bangladesh, Iran."

The acute shortage of low-priced essential medicines and their rampant black-marketing poses valid questions about the failure of the health ministry, and its officials, to protect the interests of the people. Isn't it time for the ministry to wake up from its slumber to do the job for which it is paid from the public coffers?