Free stents, cheaper meds: promise in waiting | Sunday Observer

Free stents, cheaper meds: promise in waiting

Stents

It has taken a long time coming. But the promise to reduce the price of medicinal drugs while ensuring their quality, finally seems to be nearing fulfillment.

For nearly six decades Lankan patients have waited patiently for affordable quality drugs dished out on a regular basis and constantly monitored and reviewed by experts in the field. That process towards realizing the elusive dream began when the Sri Lanka Essential Medicines List ( SL-EML) was created for both, state and private sector hospitals. In addition, the Ceylon Hospitals Formulary was published by the late Prof. Senaka Bibile to provide information for the use of these medicines. Prof. Bibile also set up an International Procurement System which decreased costs and at the same time increased availability of these medicines. The same process gained further mileage when in 1985, Sri Lanka made its first publication of an Essential Drug List on the recommendation of the World Health Organisation. Since then the List has been revised periodically on the advice of several expert committees. Director, Medical Technology & Supplies Dr B.V.S.H. Beneragama in a foreword to the SL-AML stated the following objectives : ensure availability of efficacious , safe and good quality medicines regarding health care to the people of Sri Lanka in a sustainable and equitable manner; promote rational use of medicines by health care professionals and consumers; promote local manufacture of essential medicines.

In 2009 the Committee of experts, set up for the fourth revision of the list, attempted to follow the WHO recommended process in selecting essential medicines, and used the WHO model list as a template, albeit modifying it according to the needs, determined by statistics published by the Annual Health Bulletin. But, it ran into problems. The difficulties were related to actually implementing the WHO list of Essential Medicines.

Seven years on, the question on everyone’s lips is “ How long more do we have to wait for that overdue promise to realize?”

Announcement

Not very long – if the Health Minister’s recent announcement reported in all media, is to be taken at its word.

On September 23, this year, Healthcare, Nutrition & Indigenous Medicine Minister Dr Rajitha Senaratne declared , that within the year or at least by early next year, he would personally ensure that drug prices would be reduced. It would be done in different stages; prices of 47 essential drugs including heart and diabetes drugs would be reduced under the first phase of the National Drug Policy ( NDP.) and prices of more drugs at a later stage.

That the announcement of the formula to reduce drug prices came during the 39th Prof. Senaka Bibile commemoration at the Sri Lanka Foundation Institute (SLFI) Auditorium, organized by the State Pharmaceutical Corporation, at which the Minister was a distinguished invitee, was all the more significant, with the Minister reportedly making it a point to say the NDP introduced by the later Professor was now being implemented.

That announcement won him the collective praise of Lankans whose lives are dependent on essential life saving drugs which for more than 90 percent of the population , still remain beyond their budget. Prior to that, Sri Lanka’s National Drug Regulation Authority ( NDRA) had agreed to issue the Gazette notification announcing the reduced prices of pharmaceuticals by August 31. Once the Gazette on reduced prices of medicine is issued, pharmaceutical companies will not be allowed to revise the CIF prices and arbitrarily increase prices of medicines, health sources said.

While there is a conflict of opinion over the so called essential drugs, a pharmacologist said over 70 percent of 3,436 pharmaceutical product registrations were found to be drugs ( or alternatives) named in the country’s essential drug list, adding the essential drugs concept therefore appears to have influenced the pharmaceuticals registered in Sri Lanka.

While the exact amount by which they will be reduced is still a matter of conjecture, the Sunday Observer learns they could be anywhere from 60 to 85% for the cheaper and most common drugs and about ten percent for the more expensive drugs, and less used drugs such as cancer drugs.

Asked if he could give us a date when the drugs would be reduced under the first stage , Director Medical Supplies Division Dr Kamal Jayasinghe told the Sunday Observer it was not possible to give an exact date as the prices had not yet been gazetted. “ Once the gazette notice is released we will reduce the prices immediately. But the Minister is the only one who will be in a position to take this decision”. Questioned on the proposed revised prices of the 47 drugs under the first stage , he said although he could assure that there would be a reduction, it was difficult to say by how much a particular drug could be priced due to there being so many different brands for a single drug such as paracetamol for example.

Asked when and if cancer drugs would also be reduced soon, considering the number of patients in need of them, he said they would fall into the next phase . He assured that all patients in need of an essential drug whatever the disease , would be provided them free of charge from any state hospital. “We have enough stocks to go round and the hospitals only need to call us when they want a drug. If it is a hard to get drug and we know in advance , we will import it “, he promised.

Free stents

The Health Minister has also reportedly promised to provide free stents to needy heart patients, after learning that several patients postponed surgery due to the expenses involved in purchasing stents as the prices now ranged from Rs 60,000 to Rs 100,000 per stent.

With hundreds of patients on the waiting list for heart surgery, we asked if the free stents could be provided in the near future.

“ As they are costly and imported, we will first call for global tenders . Once an item is selected technically, and we have several bidders, whoever the supplier is , they will have to face strict lab testing according to our medical system before registering with us. Our maxim is assurance of a good product at a reasonable price which should be acceptable in quality and fair pricing.”

Since a stent is a life investment, we wondered how long a stent normally lasts? A heart specialist we contacted said, “ It could be 10 or15 years, or more. But it depends on the quality of the stent. However, being inexpensive does not necessarily mean it is an inferior product”, he added. He said, free stents have been distributed to needy patients for sometime in state hospitals. A beneficiary from a free stent contacted by us said, “ There are rumours that some unscrupulous persons have been ‘sold’ these stents by patients . If the rumours are true it will only work negatively for us, the patients “.

GMOA

Meanwhile, the Government Medical Officers Association ( GMOA), which has welcomed the Health Minister’s recent announcement, has urged the Health Ministry to gazette the generic names of the 47 essential drugs whose prices are to be regulated according to the Senaka Bibile Drug Policy. Assistant Secretary, GMOA Dr Haritha Aluthge told the Sunday Observer, under the National Medicinal Regulatory Authority ( NMRA) a Pricing Committee had to be appointed to review the market situation before regulating drug prices . He charged, the 47 medicinal drugs being regulated were not commonly used drugs. “We don’t know what the drugs are and we need to know if the prices match the present scenario. That is why we have asked the Health Ministry to gazette the generic names .”

The GMOA spokesman also emphasised the need for a Quality assurance lab.

When we asked if the lab already existing under the Cosmetics Devices Regulatory Act was not up to the mark, his reply was, “ It is mot equipped to test all the drugs. We know, some drugs now have to be sent to Singapore and Thailand for testing. The Minister said he would set up a hi tech lab with Chinese assistance . We hope it will become a reality soon”.

Cosmetics

The 1980 CDDRA was revised last march. A serious omission under this new Act is the absence of laws and regulations pertaining to cosmetics.

“We hear a new Committee is to be set up to regulate cosmetics. The sooner something is done to rectify this void, the safer it will be for all those patronizing beauty parlours or using cosmetics purchased over the counter from supermarkets”, he said.

And as the battle of drugs soldiers on, we invite readers to send us their views.

[email protected]

Comments

CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.