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Pharmaceutical shortages: Patients forced to swallow bitter pill

10 Sep 2022

  • Life-saving and cancer meds in short supply islandwide
  • Rural hospitals worse off
  • Shortage of meds in both State and private sectors: GMOA 
  • Many hospitals short of 20-30 essential meds: Dr. Wijesuriya
  • Pharma shortages cause surgery delays: ACNU
  • Poor patients asked to bring essentials for their surgeries
By Maheesha Mudugamuwa   The ongoing shortage of foreign exchange has once again disrupted the smooth functioning of the national healthcare system, with both State and private hospitals on the verge of running out of essential medicines, including life-saving ones, The Sunday Morning learns. The Sunday Morning learnt that as of last week, there was a shortage of around 120 essential medicines including several life-saving and cancer medicines. It is understood that the impact on rural hospitals is severe. Several health trade unions have alleged that the shortages are now challenging the operations of major hospitals, including the National Hospital of Sri Lanka (NHSL) and other teaching hospitals countrywide. According to some health unions, medicines and healthcare perishables, ranging from basic medical gauze to surgical equipment and drugs needed for major surgeries, remain in short supply. Over the past year, The Sunday Morning has reported about the impact of the medicine, equipment, and consumables shortages that were affecting the health sector. Health trade unions stressed that patients were severely affected by the extreme shortages as they were being asked to bring the necessary medical equipment and drugs for their scheduled surgeries.     Severe impact on poor patients    Meanwhile, it is learnt that the situation in rural hospitals is far more severe than in the major hospitals, causing numerous difficulties for thousands of patients in rural areas. All Ceylon Nurses’ Union (ACNU) General Secretary S.B. Mediwatta stressed that the pharmaceutical shortage posed serious delays for routine surgeries and that in some cases, surgeries were getting cancelled when the patients were unable to source the required essentials. “The Government put the entire weight on the public and now poor patients are required to bring essentials for their surgeries. In some wards they have publicly displayed notices mentioning the types of drugs and medical equipment patients should bring from outside for their surgeries,” he stated.  “It is mostly the poor people who seek the support of Government hospitals and they can’t afford the medicines that they are required to bring from outside,” Mediwatta stressed, adding that the NHSL was currently facing a severe shortage of essentials and was allowed to opt for local purchases.  He charged that such local purchases on an emergency basis created opportunities for corruption, with a higher price being paid for the import of medical items in comparison to when they were imported by the State-run Medical Supplies Division (MSD). “The situation is serious and there should be an immediate solution to end corrupt practices,” he added.   Shortages in both private and State sectors    According to the Government Medical Officers’ Association (GMOA), there is a severe shortage of certain essential medicines within both the private sector and the State sector. These essentials include painkillers, anaesthetics, drugs for heart disease and respiratory system disorders, and anticancer drugs. Highlighting the gravity of the drug shortages faced by both the State and private sectors, GMOA Secretary Dr. Haritha Aluthge noted the importance of maintaining healthy stocks to prevent any serious inconveniences in the future. He revealed that a committee appointed by the GMOA had found out that some stocks available at Government medicine warehouses were not adequate, which could lead to a dangerous situation.   The GMOA further highlighted the affordability of medicines, sharing that a study conducted by the association had found that the prices of all medicines had increased around 100-300% compared to the prices three months ago. As a result, the patients were facing severe difficulties, Dr. Aluthge stressed.   While evaluating the prevailing drug shortages, the GMOA committee had identified shortcomings in the coordination between the Ministry of Health, MSD, State Pharmaceuticals Corporation, State Pharmaceuticals Manufacturing Corporation, and the National Medicines Regulatory Authority, etc. In order to overcome these shortages, the committee has suggested that a coordination committee be appointed by the Ministry of Health with a monthly progress review being obtained. Moreover, it has suggested the appointment of a technical committee to study the Auditor General’s recommendations that have been submitted within the last five years, in order to solve the problems that have arisen due to the lack of action taken regarding these recommendations.  The GMOA urged the Government to take immediate actions to solve the current shortages and make the required drugs available. Earlier this month, it was reported that the Lady Ridgeway Hospital for Children (LRH) was experiencing a shortage of about 30 medicines. The hospital anticipates that the situation will improve by the following month and it has not postponed any scheduled surgery due to the medicine shortage. According to Deputy Director General of Health Services Dr. G. Wijesuriya, many hospitals are short of about 20-30 essential medicines.   Private sector managing with substitutes    Meanwhile, Association of Private Hospitals and Nursing Homes (APHNH) President Dr. Ananda Kuruppuarachchi told The Sunday Morning that the situation in private hospitals was similar to that of Government hospitals, since the private sector too depended heavily on the MSD. “We have communicated the matter to higher officials as we are experiencing a severe shortage of essential medicines at present,” he said. Dr. Kuruppuarachchi stressed that unlike State hospitals, private hospitals were currently managing the situation because of their efficient staff, who somehow managed to find substitutes for the medicines that were in short supply. “The private sector is very small compared to the State sector and private hospitals are also dependent on the MSD for medicines. Therefore, the ongoing shortage has affected the private sector as well,” he added. The shortages have created a lucrative black market where pharmaceuticals are being sold at exorbitantly higher prices than their listed price, The Sunday Morning learnt. “Recently, we were desperately looking for one cancer drug and we found out that the drug, which has a short expiry date, is available at a certain place. The actual price of the drug is around Rs. 70,000, but when I spoke to the dealer, they said it would cost around Rs. 85,000-90,000. However, by the time we were about to confirm the purchase, the dealer doubled the prices,” Kottawa resident Damitha Ranasinghe shared. The pharmaceutical business is a lucrative one at present, as there are dealers who are ready to take advantage of the situation, he stressed. When The Sunday Morning contacted Health Minister Keheliya Rambukwella, he stressed that such shortages would be eased within the next two to three weeks as the Government was taking steps to address the issue. “There is a shortage, but we hope it will ease within the next two to three weeks,” he said. However, he would not elaborate on how the State planned to address the crisis which is currently threatening one of the best public health systems in the world.

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