ISLAMABAD: Scarcity of high-end and expensive life-saving drugs in the city is an old story. Now even drugs for relatively minor ailments are in short supply in the market.

Adnan Khan’s wife needs regular doses of Acetazolamide for a chronic eye problem but for months the medicine has been hard to find. That supply of the medicine is short surprised him and though the medicine costs little - a little over one rupee for a tablet - finding it has become a problem.

“I have to run from drug store to drug store all over the city in search of the medicine. Worse, the few stores which keep it would sell only in small quantities and at a black market rate,” Khan said.

Acetazolamide is prescribed for an intraocular pressure condition, but its unavailability is making him think of getting surgery for his wife. “That will cost me tens of thousands of rupees just because the one rupee medicine is not available in the market,” he said.

Optometrist Dr Muhammad Imshad Khan explained that eyes are a very complicated and sensitive part of the body and abnormal blood pressure can affect eye sight.

“If the pressure increases, peripheral vision is compromised. In other words, visual field starts narrowing and then the problem worsens into glaucoma and the patient can become totally blind,” he said.

In that situation, Dr Imshad said, the patient needs medicine to maintain eye pressure or should undergo surgery.

Fakhir Raza runs a medical store in I-10 but has stopped selling Acetazolamide. The reason he gave was that wholesale dealers of the medicine supply it at black market rates.

“That meant a retailer must do the same in order to make a profit. But to me that is be unethical and dishonest. So, I decided it was better not to sell the medicine at all,” he said.

Even the common pain killer, Panadol is in short supply, said the chemist sympathising with people who take it to relieve themselves of headache, migraine, nerve pain, toothache, sore throat and other minor pains.

Gastro-resistant tablet Deltacortril is also scarce in the market as is Phenobarbitone, prescribed to treat certain types of epilepsy, the apparent reason for which is that “drug addicts use it”.

Chief Executive Officer of the Drug Regulatory Authority of Pakistan (Drap) Dr Muhammad Aslam recognises that a number of medicines are in short supply in the market.

“There are many reasons for the shortage,” he told Dawn. “Several companies hold licenses to manufacture the missing medicines but don’t manufacture them because they think it was not viable to manufacture them at the current prices.”

“We have issued notices to 50 companies who have stopped manufacturing the medicines,” the Drap chief said.

Drap is considering involving the Pakistan Pharmaceutical Manufacturers Association in “motivating other companies to manufacture drugs which are short in the market.”

“Most companies have licenses to manufacture many medicines, and that is another problem. They alternately manufacture the medicines at different intervals,” he disclosed.

On the other hand, distributors buy all they manufacture and sell in the black market as supply of one dwindles.

“We are considering bringing a law to punish [whole sellers] with a fine of Rs1 million and one year imprisonment,” the Drap chief said.

A document placed before the National Assembly this week in reply to a question by MNA Munaza Hassan showed that as many as 18 life saving drugs are in short supply in the market.

They included anti-tuberculosis tablets, anti-epileptic drug Phenytoin, anti-arrhythmic and muscle relaxant Di-Hydan, Angised for heart patients, Thyroxin that regulates the metabolic rate of the body and the Folic Acid vitamin.

Injections which are scarce are the child vaccines MMR and Infanrix Hexa, Kenacort used to treat allergic diseases, the antibiotic Fortum, Lasix used to treat fluid build-up due to heart failure, liver scarring or kidney disease, Avil used to treat allergic conditions and the anti-viral drug Acyclovir, among others. Drap CEO Dr Aslam said efforts were being made to ensure the supply of medicines and new rules will be introduced to punish unethical trade practices.

Published in Dawn, August 18th, 2016