ISLAMABAD: Transparency International has written to the Ministry of National Health Services (NHS) seeking clarification on a number of issues related to the recent increase in drug prices.

Syed Adil Gilani, a member of Transparency International’s Pakistan chapter told Dawn his organisation frequently receives complaints, which are referred to the relevant department for clarification.

“After receiving a complaint regarding the extraordinary increase in the prices of drugs, we forwarded the complaint to the Ministry of NHS but the Drug Regulatory Authority of Pakistan (Drap) gave an unsatisfactory reply, so another letter has been sent to the ministry to clarify a number of concerns,” he explained.

The letter, which is available with Dawn, was sent by former Supreme Court justice Zia Perwez, a Transparency International trustee.

It said that Drap’s response did not explain why drug prices were increased thrice in 12 months, and circumstances leading to the revision of drug pricing regulations within the short period were not mentioned either.

Letter says Drap’s response to complaint did not adequately explain revision of pricing regulations

It said that the SC did not order Drap to devise a new drug pricing policy in Feb 28, 2018, order on HRC case 2858/2006.

“But Drap prepared a new pricing policy which was announced on 6th June, 2018 and submitted in court in Aug ‘18 after six months of Supreme Court’s order. This was a gross violation by Drap of the Supreme Court’s order, which were binding on Drap in submitting the resolution of issue within 30 days of Supreme Court’s order,” the letter said.

It added that the SC had asked all pharmaceutical companies to implement and enforce barcodes on all boxed and wrappers fixed upon containers or bottles of pharmaceutical products. The letter asked if Drap ensured that this was implemented by 2018.

The letter also asked why the formula for hardship cases was changed, increasing prices by up to 355pc.

“This is also to inform the Secretary NHS that the complainant has provided in a document that Drap has requested auditor general of Pakistan on 12th April 2019 to conduct a special audit of Drap for the period 2012-13 to date of the pricing mechanism to ascertain whether prices of drugs are determined justly, in accordance within the laid down policy and as per law. This information was omitted in Drap’s reply dated 24 April 2019 to Transparency International Pakistan,” the letter said.

The letter also asked how the auditor general could identify any ambiguities when Drap has asked for an audit in accordance with laid down policy, which means the auditor general cannot criticise or open the case of the mechanism of hardship cases that was increased by five times from the mechanism defined by the 2015 pricing mechanism.

Hardship cases are cases in which companies claim it is not viable for them to manufacture medicines at the approved cost, leading Drap to consider the case and increase prices.

“Transparency International Pakistan requests the secretary to examine the above issues, ambiguities and initiate urgent measures to rectify the defects made in Drug Pricing Policy of 2018 which was also approved by the cabinet and needs to be amended,” the letter said.

Published in Dawn, May 16th, 2019