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Rs400m payment issue: Cancer patients being denied vital medicine in five Punjab hospitals

Updated March 09, 2019

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Punjab government has stopped payment of Rs400 million to a multinational company. — Reuters/File
Punjab government has stopped payment of Rs400 million to a multinational company. — Reuters/File

LAHORE: The recently procured medicines for cancer patients may end up in scrap after the Punjab government has stopped payment of Rs400 million to the multinational company, making it conditional with the ‘third party evaluation’ of the project under which the said drug had been purchased for the last five years.

The payment was stopped shortly after the DTL reports cleared the medicine which was brought in October 2018 from Switzerland to distribute it among the 5,000 registered patients of the five state-run mega teaching hospitals under a project titled ‘the Punjab CML Project’.

“Since then, the stock has been lying unused in the store of the Jinnah Hospital, Lahore and the hospital administration has refused to distribute it among patients,” a senior official of the health department told Dawn. He said the medicine was to be distributed among the patients registered in the five hospitals. They are Mayo Hospital, Lahore; Allied Hospital, Faisalabad; Nishtar Hospital, Multan; and Holy Family Hospital, Rawalpindi; besides Jinnah Hospital, Lahore.

The patients have no alternative medicine in the local market, said the official. Unfortunately, he said, a majority of them was either bed-ridden or living in miserable condition as they were dependent on the medicine.

According to the memorandum of understanding (MoU) signed by the Punjab government with the company Novartis Switzerland, the medicine was brought from Switzerland in ‘finished form’ and it was imprinted with warning, ‘government property not for sale’.

The company claimed that in case the government rolled back the scheme, the medicine would end up in scrap as according to the firm’s policy it could not be recalled or used for any other purpose after completing procurement process.

The official claimed that the issue surfaced when the finance department transferred the same funds either for health card scheme or for any other purpose.

Health Secretary Saqib Zafar clarified the position saying that after the expiry of the previous five-year contract with the company, the procurement was made in a haste. He said the principal of the Allama Iqbal Medical College purchased the medicine after approval from the Board of Management despite the fact that no summary was moved by the health department to the chief minister to extend contract for the next five years.

He said recently the department took a policy decision that since the procurement of the cancer medicine was being done through single source (without any competitor), the third-party validation must be done before extending the contract with the company in question.

“The second point is that procurement of medicines for the 4,000 cancer patients required a hefty amount to the tune of Rs1 billion,” he said, adding that the cost further increased with the passage of time.

Consequently, the health authorities wanted to review the contract in the light of the third-party audit of the programme in order to further take a decision, the health secretary said.

On the other hand, the official source said the last government had signed an MoU with Novartis Switzerland in 2014 after the company agreed to bear a major share of the expenses on the medicines for the cancer patients registered in Punjab hospitals in good faith.

According to the MoU, Novartis would bear 91pc of the total expenses on procurement of the cancer medicines while the remaining nine per cent would be paid by the Punjab government.

Initially, the medicine was purchased and distributed among the patients absolutely free of cost for two years under the agreement, the official said. Later, the MoU was extended by the Punjab government for another term of three years and the then Punjab cabinet approved the programme keeping in view the benefit of the poor patients.

In staring months of 2018, the then government processed the case for the extension of the agreement for another five-year period up to 2023. Later, the Jinnah Hospital approved the procurement of medicines for a four-month period during the caretaker set-up.

As the PTI government came into power, the order of procurement of the medicine for the aforementioned period was placed in September 2018 and the company supplied the drugs next month. The official said the government accordingly released the funds to make payment of Rs400 million to the company as per MoU formula of 9/91 per cent share.

However, the programme suffered a major setback when the health authorities apprised the company of a lack of third-party audit, refusing to make payment against the purchased medicine. The company later took up the matter with the health authorities and its GM Pakistan Shafiq Ahmed wrote a letter to Saqib Zafar to show displeasure.

“... the matter is pending at your end and we have not received official communication from your department about future plans of this project,” reads the letter addressed to the health secretary.

“We would humbly request if you could call upon the meeting of the supervisory committee constituted under the MoU to resolve this matter once and for all to avoid sudden interruption of the medicines to the cancer patients,” it says.

Published in Dawn, March 9th, 2019