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Sunday, July 15, 2018

India facing shortage of life-saving albumin serum

Some hospitals are using only 5 per cent albumin instead of 20 per cent to tide over the situation.

Written by Abantika Ghosh | New Delhi | Published: October 16, 2014 2:25:01 am

For two months now, hospitals across the country for around are grappling with an acute shortage of life saving human albumin serum – a protein in blood plasma which is critical for treatment of patients suffering from liver disease, kidney failure, or recuperating from a transplant surgery.

According to several doctors, the situation is a result of the government’s attempts to impose price control as a handful of companies importing that serum have now stopped its supply. There is a local brand of albumin serum, but it is not favoured by many doctors. The supplies from even that firm have become erratic, doctors said.

Several surgeons are now going for alternatives like hydroxy ethyl starch – a complex carbohydrate molecule with additives – but the results are often satisfactory.

“Albumin is crucial for critical care patients, especially those with liver and renal diseases. When kidney function is impaired, it prevents fluid loss. There has been a shortage for some time now. Companies are telling me that because the government brought it under price control, they are unwilling to import it,” said Dr Subhash Gupta, consultant liver transplant surgeon at Indraprastha Apollo Hospital.

National Pharmaceutical Pricing Authority has lowered the price of albumin, though sources in the origanisation said the shortage is not linked to the revision. “Representatives from the company had come to us, and we told them that volumes have to be maintained. However, there is an issue with what is known as low salt albumin as the price lists do not account for the different sourcing of the two products. We are looking to rectify that,” said an official.

Albumin is crucial for maintaining filtration pressure of blood so that fluid is not lost from the body and stays within the circulatory system.

During a liver transplant surgery, 10 to 30 units of albumin may be used. Each unit costs Rs 6,000 approximately. Low albumin serum increases the risk of rejection of a graft.

Some hospitals are using only 5 per cent albumin instead of 20 per cent to tide over the situation.

Dr Abhijit Chowdhury, who heads the department of digestive and liver diseases at Kolkata’s SSKM Hospital, said there are market forces at play in the shortage.

“This is a life-saving serum, but it is not manufactured by many companies. So attempts at price control are difficult to implement.”

Dr Subbarao Kanchustambam, Visakhapatnam-based liver transplant expert, said, “It may also be linked to not enough blood donation being received. Albumin is filtered out from blood, if there is enough blood in stocks.”

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