ISLAMABAD: Up to 260 per cent increase in prices of medicines has compelled a major segment of patients to reduce drug dosage or discontinue treatment, while leading pharmaceutical manufactures believe the move will ensure availability of medicines in the market.

However, pharmacists and some manufacturers of medicines allege that the pharmaceutical industry played its cards well by linking the drug prices with electricity cost and US dollar instead of the raw material prices that have dropped drastically from $2,000 to only $25.

Dr Faisal Sultan, Special Assistant to the Prime Minister on Health, is of the opinion that the increase in prices will end the shortage of medicines in the local market, as many patients earlier had to buy imported medicines.

Some leading drug manufactures believe the government took a bold and timely decision to increase the prices, warning that any U-turn may end chances of huge foreign investment in the pharmaceutical industry in near future.

Pharma companies say any U-turn may stop likely foreign investment

On Sept 22, the federal cabinet took the decision to allow up to 260pc rise in prices of 94 life-saving medicines, followed by a press conference by the PM’s aide during which it was announced that the move — aimed at addressing the longstanding issue of drug shortage — was made on the recommendations of the Drug Regulatory Authority of Pakistan (Drap) under the ‘hardship category’ and as per the Drugs Pricing Policy of 2018.

Under hardship category, if companies claim that it is not viable for them to manufacture certain drugs due to their high cost of production, their prices can be increased.

Talking to Dawn, Dr Mazhar Qayyum, chairman of the Eye Donation Movement and former chairman of the Pakistan Medical Association, said: “The prime minister’s statement that the prices have been increased to ensure availability of medicines is not acceptable. It is a proof that the government is being blackmailed by corrupt mafia… We demand that the increase in prices be withdrawn.”

Revised prices

In the market, price of Acetazolamide, used to prevent and reduce symptoms of altitude sickness, has been increased from Rs60 to Rs219. Price of Doxycycline, an antibiotic used to treat infections, has been increased from Rs233 to Rs400. Cephradine, an antibiotic used to treat a wide variety of bacterial infections, was being sold for Rs58, but now it is being sold for Rs115.

Similarly, price of Norethisterone, used as birth control pills, menopausal hormone therapy and for treatment of gynecological disorders, has been increased from Rs62 to Rs100. Price of Tamsulosin capsule, used by men to treat the symptoms of an enlarged prostate, has been increased from Rs786 to Rs1,080. Price of Neurobion tablet, used for preventing and treating Vitamin-B deficiencies, has been raised from Rs535 to Rs977. Price of Adrenaline injection, used in emergencies and allergic reactions to insect stings/bites, food, drugs and substances, has been increased from Rs217 to Rs597. Similarly, prices of the medicines used by diabetics and patients of blood pressure have also been increased.

Mohammad Nadeem, a resident of Islamabad, said many poor patients had already been finding it difficult to afford their medical expenses, but with the recent hike in drug prices, the government had left them with no other choice but to discontinue treatment or decrease the dosage.

Drap’s role questioned

President of the Drug Lawyers Forum Pakistan Noor Mehr, who is also a pharmacist, said: “Drap remains uninterested in monitoring drug prices. On Jan 3, 2017, Drap wrote a letter to companies to provide details of prices and registration of medicines, saying that the prices will be mentioned on the website of Drap… Prices of 12,000 medicines were posted on the website but later removed due to unknown reason. Now there are only registration numbers of 1,100 medicines on the website.”

Mr Mehr said Para V of the Drugs Pricing Policy of 2018 mentioned that the companies would increase the prices of medicines on their own as per the consumer price index (CPI). However, the pharmacists approached the prime minister who got the clause removed despite opposition by the health ministry.

A manufacturer of medicines said the pharmaceutical industry linked the prices with the electricity cost and US dollar exchange rate without mentioning prices of raw material which had drastically decreased over the years. “A few years ago some salts [raw materials] were being sold at the rate of $2,000 per kilogram, but now their prices are fluctuating between $25 and $30 per kilogram only,” he explained.

He suggested that the prices of salts should be fixed to check money transfer, as some pharmaceutical companies were still showing purchase of salts for thousands of dollars with the result that foreign exchange was transferring out of Pakistan. “On the other hand, the companies, by showing high cost of raw material, not only avoid paying tax but also demand increase in prices under hardship category,” he disclosed.

He alleged that one multinational company claimed that it had been importing raw material for a blood pressure medicine at the rate of $36,000 per kg, while local companies imported the same raw material for only $25 per kg.

‘Pharmaceutical industry is a business’

Senior vice president of the Pakistan Pharmaceutical Manufacturers Association Malik Arshad Awan said people needed to understand that the pharmaceutical industry was also a business. “Manufacturers have invested hundreds of millions of rupees in production units and they import raw material from abroad. Moreover, cost of electricity increases rapidly and Pakistani rupee has been devalued.

“Profit on life-saving drugs is continuously decreasing. We cannot ensure availability of medicines unless genuine prices are fixed,” he said.

Mr Awan was of the opinion that the recent decision to ban imports from India also badly affected the business of pharma industry. “We were importing raw material at the rate of $80 per kg, but now we are importing the same raw material at the rate of $300 from Germany,” he added.

Pharma Bureau executive director Ayesha Tammy Haq said the government had taken a bold and timely decision to increase the prices of 94 life-saving drugs, as it would ensure availability of medicines in the market. “Media has been portraying that the prices have been increased by 100pc or 200pc without mentioning that the price of a certain medicine has been increased from Re1 to Rs2 or price of an injection from Rs3 to Rs5,” she said.

When reminded that the issuance of the notification of the price increase had been delayed by Drap, Ms Haq expressed the hope that the notification would be issued soon. She warned that there would be a drastic effect if the notification was not issued. “Maybe a huge investment in pharmaceutical industry, expected in near future, would stop,” she said.

Published in Dawn, October 2nd, 2020