August 19, 2006	Saturday	Rajab 23, 1427

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ISLAMABAD, Aug 18: The government has failed to regulate the over Rs3 billion annual sale of psychotropic drugs in the country’s lucrative market which the multinationals are openly exploiting by corrupting consultants and doctors, claims a latest report.

Drug manufacturing companies are capitalising on the growing number of Pakistanis suffering from various psychic and mental disorders by introducing expensive drugs.

These drugs serve only doctors and manufacturers and the patients get no relief despite conceding huge monetary losses, states a report released by The Network for Consumers Protection here on Friday.

“It seems that big multinationals have picked Pakistan as a favourite spot for creating and treating patients with mental and psychiatric disorders through the sale of such drugs,” the report observed.

It reports that a multinational pharmaceutical company recently launched a drug for dementia in Pakistan and flew about 70 Pakistani doctors to Bangkok, Thailand, for a three-night all- expenses-paid trip. Pakistani doctors were part of a larger group that also included doctors from other countries. A conservative estimate of costs for the Pakistani doctors alone is about seven million Pakistani rupees ($120,000).

Though the company could justify it, questions linger about the rationale for spending this huge amount in a developing country without a health care system and where all health care is out-of-pocket expenditure.

The drug in question costs Rs320 ($5.40) per recommended daily maintenance dose - prohibitively expensive for the vast majority of Pakistani patients.

The annual psychotropic drug sales (allopathic only) in Pakistan is touching Rs3 billion figure. For only one year (July 2003 to June 2004) the sales stood at Rs2.76 billion ($46.77 million).

Of these, antidepressants sales were Rs821.17 million ($13.4 million), which saw an increase of 23 per cent. The sales of tranquillisers and hypnotics reached Rs1.36 billion ($23.18 million) and increased by 18 per cent to 137 per cent, respectively, compared to the previous year.

The sale of antipsychotics was Rs377.02 million ($6.39 million).

Interestingly, sales of drugs categorised as ‘nootropics’ - so-called brain stimulants - were Rs187.6 million ($3.18 million). To put the above figures in context, the Gross Domestic Product (GDP) of Pakistan is approximately $61.6 billion whereas the per capita income is $440.

There are only 150-200 qualified psychiatrists and the people have to resort to general practitioners for the treatment of mental and psychic diseases. However, such drugs are sold even without prescriptions. The patients who could not afford doctors’ fee or purchase expansive drugs have to rely on quackery.

Pakistan’s population of 150 million makes it the world’s sixth most populous country. Community-based prevalence studies for common mental disorders give high figures of 25-66 per cent of women and 10-40 per cent men. There are an estimated 3 million drug addicts in Pakistan.

Suicide rate has increased dramatically in the last few years, from a few hundred to more than 3,000 every year. Serious mental illnesses account for another 1-3 per cent of the population. Health spending is a pitiable one per cent of the government’s annual budget. There are no separate allocations for mental health.

The report says there is no health insurance and a poorly funded public health service is accessed by only the poorest. All health care costs are borne by patients themselves. Mental health services are almost nonexistent and limited to either psychiatry departments of teaching hospitals or privately run clinics.