• Healthcare sector sees over 40 drugs in short supply
• Manufacturers say rising raw material costs rendering most drugs unfeasible to produce
• Drap claims pharma sector gunning for across-the-board price rise

KARACHI: A tug of war between pharmaceutical manufacturers and the drug regulatory body is threatening to turn into a crisis after a decision by local companies to stop the production of several drugs has led to shortages of medicines in the market.

A list of around 40 different medicines, compiled by health professionals from leading public and private sector hospitals, seen by Dawn, indicates that several locally manufactured tablets, syrups, injections and ointments or drops are no longer available.

A senior pharmacist who was part of the team that compiled the list for the authorities in July told Dawn that these medicines include prescriptions for several conditions.

For example, all the brands of Lithium Carbonate — used to treat mental health issues and often referred to as ‘suicide prevention drugs’ — are not available in the market.

In addition, essential medicines, including methylphenidate for the treatment of attention-deficit hyperactivity disorder in children and clonazepam drops and tablets for epilepsy in children and adults, have not been available for the past several weeks.

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“It doesn’t end here. Medicines for patients of tuberculosis, epilepsy, Parkinson’s, cardiovascular disease and other conditions are also not available in the market… but I don’t know why this situation has failed to create any buzz,” he said.

Health professionals have already started experiencing the impact of this crisis and are seeking immediate intervention from the authorities. The situation is so grim that some healthcare professionals Dawn spoke to said that the number of products on the list was increasing with each passing day.

The issue behind the shortage stems from producers who have been complaining about rising prices of raw material in the international market, resulting in an elevated production cost, which they insist can only be met through a 40 per cent increase in prices across the board.

“Right now, several medicines are not available in the local market because their cost of production has increased several fold and it has become infeasible for manufacturers to produce these drugs,” said Qazi Mansoor Dilawar of the Pakistan Pharmaceutical Manufacturers’ Association (PPMA).

This demand, however, is facing resistance from the government, which sounded the alarm on the growing shortage of medicines last month when a task force was set up by Prime Minister Shehbaz Sharif to look into the crisis.

The task force met leaders of the pharmaceutical industry, who forwarded their proposals for increasing the prices of medicines, citing growing costs of production.

However, even as the task force works to complete its mandate, citizens are facing a serious shortage of drug supplies.

The pharmaceutical industry claims that local manufacturers have stopped importing raw materials owing to their rising prices in the international market. In the face of government refusals to allow them to raise prices, they claim that manufacturing the drugs has become “infeasible” for them.

The fresh import numbers suggest a sharp decline in the amount of raw materials purchased by local pharmaceutical companies, mainly from China, for the production of essential and critical medicines. Importers and their vendors refer to some “200 molecules” that are no longer being imported due to their higher prices in the international market.

According to PPMA’s Mr Dilawar, the emerged after international trade was opened following the lifting of pandemic restrictions. At the time, he said, the prices of raw material increased at a staggering rate, something which was not helped by the recent appreciation of the US dollar.

This had forced several producers to review their business plans, he said, adding that it the situation persisted, more than 200 generics would no longer be available in the market.

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An importer Dawn spoke to said: “This is the third week that no new order has been placed. Current production is all based on existing stock of raw material that was available to some producers, but this will not last long. Sooner or later, production will definitely grind to a halt.”

The authorities, however, term the industry reaction “somewhat exaggerated”, saying that it appears to be a bid to obtain approval for an across-the-board increase in the prices of medicines.

Although no one from the Drug Regulatory Authority of Pakistan (DRAP) was available to speak on the record, an official from the regulator told Dawn on condition of anonymity that the shortage was not as dire as was being portrayed.

“There’s a shortage of some medicines but it’s not as huge as is being claimed,” he said.

“This appears to be a move to obtain approval for the proposed increase in prices of all medicines, which is not possible. There were some supply chain issues for more than half a dozen drugs, which are not available in the market. There are some genuine issues and some 35 medicines have been identified so far [for price increase]. We have moved the case of these 35 with a proposal to review their prices.”

Published in Dawn, August 12th, 2022

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