ISLAMABAD: After nearly three months, the Ministry of National Health Services (NHS) has finally forwarded a summary to fix the prices of hepatitis medicines to the Prime Minister’s Office.

However, the NHS ministry’s media coordinator Sajid Hussain Shah said the Sindh High Court (SHC) issued a stay order on fixed prices for essential medicines. The stay was challenged in the Supreme Court, and in the meantime the Lahore High Court (LHC) decided that prices can be fixed, after which the summary was moved.

After much controversy, the Drug Regulatory Authority of Pakistan (Drap) on April 10 recommended fixing the price for the hepatitis medicine formula daclatasvir, but a notification could not be issued as the summary was stuck in the NHS ministry.

Summary moved after LHC order allowing medicine prices to be fixed

Daclatasvir is a medication used in combination with other medications, such as sofosbuvir and ribavirin, to treat hepatitis C.

Sofosbuvir was introduced in the United States in December 2013, and was approved by the US Food and Drug Administration. The medicine has higher cure rates than interferon injections, with minimal side effects. Hepatitis C patients are prescribed sofosbuvir for six months, and if a tablet of daclatasvir is also prescribed with the sofosbuvir results improve and the course is shortened from six to three months.

Although a number of companies applied to manufacture the medicine, Drap did not recommend the price, because of which 60mg medicines were imported from India with special permission and sold for Rs11,500 to Rs13,000. A large quantity of the medicine was also being smuggled from India.

On April 10, Drap’s Drug Pricing Committee recommended that Rs2,700 be fixed for 30mg of daclatasvir and Rs4,600 for 60mg.

Mian Aftab Ahmed, a citizen who petitioned the LHC to direct Drap to fix prices for new molecules and received a favourable verdict, told Dawn the ministry was deliberately not forwarding the summary in question because Rs1.5 billion worth of smuggled medicines were on the market.

“Some elements wanted to ensure that the smuggled medicine would be sold before the arrival of local medicines because otherwise no one would buy the smuggled medicine at three times the rate. A sum of almost Rs1bn was involved in it,” he claimed.

“However, as the summary [has been] moved, I just want to suggest that Drap ensure that the 30mg medicine is available in the market, because the 30mg medicine has the same results as the 60mg medicine, but companies try to manufacture double potency [products] for maximum profit,” he said.

“It is unjust to force poor people to buy medicines worth Rs4,600, which could be made available at Rs2,700, at almost three times the rate,” he added.

Mr Shah, the NHS ministry’s media coordinator, said the maximum retail price (MRP) of essential drugs were held up for some time by pending litigation and specific orders that the MRP of essential drugs could not be set unless all flexibilities were exhausted in a transparent manner.

He told Dawn a stay was issued by the SHC on the registration of new essential drugs, because of which it was not possible to fix the prices.

“Subsequently another order of the LHC helped Drap and the ministry resume essential drug pricing. The law division was also consulted. The Drug Pricing Committee was immediately convened, scrutiny of pricing by the ministry’s committee was also done and pending cases will be shortly notified with the approval of the competent authority,” he said.

Published in Dawn, July 17th, 2017