Despite essential drugs being available to the public at all health facilities, free of charge, a small number of patients (six percent of the total number of patients according to a health survey) still opt to purchase their drugs from the private sector. However, following the price revision of 48 essential drugs, many private pharmacies have begun turning away customers saying that certain commonly used drugs and vaccines were now unavailable in their stores/counters.
“I visited three private hospitals in search of the vaccine to immunize my 3 month old child against diphtheria, tetanus and whooping cough, but was told that their respective stores had run out of stocks.”, a young mother told the Sunday Observer, adding that even though she had to pay a steep fee in a private hospital, it was a more convenient option due to the long waiting queues for the same vaccine, given free at state hospitals.
MMR under the brand name Priorix produced by GlaxoSmythe LTD is currently sold for Rs 900 for 0.05 mg.
Influenza vaccine now in great demand due to the spread of colds and fevers islandwide, following the rains is also available in limited stocks in private hospitals, while state hospitals say, it is administered to only high risk patients with lowered immunity systems due to the high cost of import. Asked the price of an influenza vaccine, a private hospital drug store said, “We only have Vaxigrip, which is imported from France. Our retail price is Rs 1,178/- for a vial although our wholesale price is Rs 1,024/-.” He said, it was necessary to sell it at a higher price than the wholesale price in order to cover the importation costs.
He also noted, while this drug does not come under the new drug price list, the prices of 48 essential drugs had been revised.
Meanwhile, health officials denied rumours of a trial vaccine being experimented in a popular children’s hospital in Borella, stressing that no new vaccine would be added to the Expanded Immunization Program until scientifically proven to be hundred percent safe. “ At present, there is no such vaccine here”, an unnamed spokesperson from the Lady Ridgeway Hospital told the Sunday Observer, in a telephone interview.
A Private hospital, when contacted also said, the vaccine was not available for purchase from local suppliers as yet. “All we have are certain brands of the influenza vaccine”, a spokesman for a private hospital drug store said.
NCD related drugs
Meanwhile, patients with non communicable chronic diseases, such as, diabetes and hypertension have also complained that pharmacies in private hospitals had turned them away when they asked for a prescribed drug, after being examined by a doctor in the hospital.” They told us to come another day due to a temporary delay in replenishing their dried out stocks,” a patient told the Sunday Observer.
A female patient (74), with hypertension told us, a few days ago she had visited a private drug retail outlet opposite a leading hospital to purchase some drugs prescribed for her .
“The tablet was Losarton and I asked for a 50 mg card of ten tablets, now priced at Rs 10/30 according to the revised rates. I was told there were no SPC tablets available and the only brand they had was Losarton under the generic name Zaarc Ciba which cost Rs 195/- for a card . As it was a Poya day and some of the private pharmacies were not open, I bought a card and when I asked for a bill, I was refused, as I had not produced a doctor’s prescription.”
So who is at fault? The patient or the pharmacist? “Both”, says a health official. ‘While we now don’t allow patients to purchase a medicinal drug without the doctor’s prescription, the pharmacist must also not sell any drugs without such a prescription . Further, if a sale is done, it is illegal not to give the patient the bill”, a senior health official said.
A recent survey of drug stores, however, shows that many drug companies have complied with the revised rates and had reduced the prices of the 48 essential drugs gazetted by the National Medicines Regulatory Authority ( NMRA) last month. Drug suppliers contacted by the Sunday Observer said, Panadol was now selling for Rs 1/30 a tablet and Dionil used by diabetic patients was being sold at Rs 2/20 a tablet according to the reduced price schedule.
Losarton, used for high blood pressure was selling at Rs 10/30 ( maximum price ) per tablet., while the cholesterol tablet Zaarc was being sold for Rs 10/30 per tablet. Augmentene, a popular antibiotic was priced at Rs 71 per tablet.
When the Sunday Observer visited a leading private drug retail pharmacy in Kollupitiya, two weeks ago, and asked if the prices of the 48 essential drugs had been revised, the answer was, mostly all the essential drug prices had been revised according to the gazette notification. “We have over 120 suppliers. Most of them have printed their old price on one side and the revised price on the other side of the drug, so that the public can see both prices before they purchase the drug,” the manager said.
Asked why the new price list had not yet been hung up for public viewing, the response from the management was , “ As soon as we get the complete list of revised prices from all our suppliers.” However, when this newspaper visited the same pharmacy a few days ago,
we found that although the management admitted they had now received their complete list from all their suppliers, the list had yet to be hung up.
MSD
Meanwhile, responding to charges of drug shortages and price irregularities, the Medical Supplies Division( MSD) of the Health Ministry has assured that there are enough stocks to go round for at least the first three months .
They urged hospitals ( state) which were running short of any essential drug to inform the MSD, well ahead of time.
Meanwhile, the Pharmaceutical industry, while agreeing to co-operate with the Health Ministry’s decision maintains that there is a difficulty in retailing drugs at the new prices due to the cost invested in purchasing them ahead of time. The chamber of the Pharmaceutical Industry, the All Island Pharmacy Owners’ Association (AIPOA ) and other small time importers of drugs are reported to have urged the Health Ministry to give them more than the 45 day grace period to re-label their prices according to the new list.
It is understood that a review of the present scheme is also under consideration to look into the current difficulties of implementing the revision of prices.
Cancer drug fraud
Meanwhile, an alleged attempt to procure an Indian cancer drug, Abiraterone Acetate through fraudulent means is reportedly under investigation by the Parliamentary Procurement Committee.
It is reported that the Government Medical Officers Forum ( GMOF) had recently brought the matter to the notice of Health Secretary Anura Jayawickrama . The letter dated Nov. 4 sent to the Health Secretary is said to have been copied to the P.M’s office , Health Minister’s office, among others.
A GMOF spokesperson has been quoted as saying the tender worth nearly Rs 100 mn for procurement of 22,450 Abiraterone Acetate tablets ( 250 mg each) had been offered in May this year under questionable circumstances.
The revelation had been made in the wake of the government finalizing the Rs 990 million tender for procurement of the cancer drug manufactured in Russia, a leading daily newspaper has said.