Few days back I
visited Satya Sai Heart Hospital in Ahmedabad. The hospital is doing
a wonderful job of providing free heart surgeries to children. During the visit
I came across a genuine issue: shortage of Furoped (syrup furosemide) in the
market.
For children with
heart failure, Furoped is a life-saving diuretic.
In an order in
November 2017, the price of Furoped was reduced by 92% with the MRP coming down
from Rs 106 to Rs 10/-. Then in June 2018, the National Pharmaceutical Pricing
Authority (NPPA) increased the per unit price of Furoped from 29 p per ml to Rs
2.60 p.
A 30 ml bottle now
costs around Rs 78/-.
Before the November
price revision which was undertaken by NPPA without access to market data, the
monthly sales of the drug were to the tune of approximately Rs 30- 35 lakh.
Supplies dwindled to about 40% in the aftermath of that decision.
About two years back,
there was a shortage of two drugs in the market, d-penicillamine (DPEN)
and penicillin G potassium (Pentid-Abbott).
D-penicillamine is
used to treat patients with Wilson’s disease (copper overload) with liver,
neurological and psychiatric manifestations. And, patients have to be on this
drug lifelong. The Indian Medical Association (IMA) had raised this issue
and both drugs were freely available again.
There can be several
reasons for drugs running short in supply. These can include manufacturing and
quality problems, delays and discontinuations.
In the United States,
manufacturers provide the FDA with most drug shortage information. And,
the agency works closely with them to prevent or reduce the impact of
shortages. All current and resolved drug shortages and discontinuations
are reported to FDA at drugshortages@fda.hhs.
But, unfortunately no
such system exists in India to take care of drug shortages.
Furosemide
is included in the National List of Essential Medicines (NLEM). All
formulations of the drug (Tablet 40 mg, Oral liquid 10 mg/ml, Injection 10 mg/
ml) are to be available at all levels of healthcare
- primary, secondary, tertiary, as per the NLEM. This means that it
is under price control and profits are limited.
The continuing
shortage of any life-saving or essential drug is a matter of concern.
All pediatric
cardiologists, if they find that Furoped is still in shortage, should voice
their concern.
All drug shortages can
be reported on the platform of Medical Voice for Policy Change.
Read our earlier
stories on this issue:
IMA is change maker:
Medical voice is heard
Artamine shortage
|
An Open letter to the DCGI
To
The Drugs Controller General of India (DCGI)
Central Drugs Standard Control Organization
Directorate General of Health Services
Ministry of Health & Family Welfare
Government of India
Dear Sir
This is to bring to your kind attention that there
is a shortage of Furoped (syrup furosemide), a diuretic drug, in the market.
Furoped is a life-saving drug for children with heart failure.
All formulations of furosemide (tablet, oral liquid
and injection) are included in the National List of
Essential Medicines (NLEM) and are to be available at all levels of
health care – primary, secondary and tertiary.
The continuing shortage of any life-saving or
essential drug is a matter of concern.
We request you to look into the matter and ensure
that the shortage is taken care of and that no similar shortages or of any
other drug included in the NLEM occur in the future.
Warm Regards
Dr KK Aggarwal
President Heart Care Foundation of
India
|
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of
Medical Associations in Asia and Oceania
(CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of
India
Past National President IMA
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