ISLAMABAD: Even though the Ministry of National Health Services (NHS) has a fully-empowered federal minister at the helm, the controversy surrounding the prices of hepatitis drugs has yet to be settled.

A senior ministry official told Dawn that a new summary had been moved to the Prime Minister’s Office, which will be taken up by the cabinet, which will delegate the power to notify drug prices to the federal minister.

The Drug Regulatory Authority of Pakistan (Drap) had recommended the prices of daclatasvir (formula name) on April 10, but a notification in this regard has not been issued so far.

Despite elevation as federal minister, officials say cabinet must empower Saira Afzal Tarar to fix prices

In the past, the ministry had claimed that as a minister of state, Saira Afzal Tarar was not empowered to issue the notification and that then-prime minister Nawaz Sharif – who held the NHS portfolio – had been requested to delegate power to her.

But now, Ms Tarar is a full federal minister in the cabinet of Prime Minister Shahid Khaqan Abbasi. However, the ministry official claimed that things were not as simple as they seemed.

“Since the price of the drug was not approved by the PM Office when Ms Tarar was state minister, we moved a request that the power should be delegated to her so she could fix the price and notify the same in the Gazette of Pakistan,” he said.

“Now, as Ms Tarar has become a federal minister, we have moved a fresh request to the PM Office, seeking the delegation of the cabinet’s powers to the minister, so that prices can be notified. We hope that the federal cabinet will meet soon and delegate the required powers to the minister, after which prices can be fixed,” he said.

The drug daclatasvir is used in combination with other drugs - sofosbuvir and ribavirin - to treat hepatitis C. According to estimates by the healthcare sector, almost 10pc of the country’s population is afflicted with hepatitis and around 150,000 of them die of complications every year.

Sofosbuvir was introduced in the US in December 2013 and was approved by the Food and Drug Administration (FDA). It has a much better cure rate than interferon injections, with minimal side effects. Sofosbuvir is given to the patient for six months.

Though a number of companies had applied for the rights to manufacture the medicine, Drap did not fix a price.

As a result, the medicine (28 60mg tablets) was being imported from India under special permission and a one month course was available for Rs11,500 to Rs13,000. Moreover, a large quantity of the medicine was also being smuggled from India.

On April 10, Drap’s drug pricing committee (DPC) recommended that the price of 30mg daclatasvir would be Rs2,700 and 60mg of the same medicine would cost around Rs4,600.

Mian Aftab Ahmed, who had filed a petition in the Lahore High Court seeking directions for Drap to fix the prices of the new molecules and got a decision in his favour, told Dawn that the ministry had deliberately delayed the fixation of the prices because smuggled medicines worth Rs1.5 billion were already available in the market.

“Some elements want to continue selling the smuggled medicine because once manufacturing starts at the local level, no one will buy the Indian medicine, which is sold at three times the price,” he said.

He also claimed that there was no hurdle in the fixation of prices, as Ms Tarar had been elevated to the status of a federal minister. But the ministry was dragging its feet despite the fact that the ministry’s evaluation committee had already approved the prices suggested by its DPC.

Published in Dawn, August 13th, 2017