Price cap squeezes out key drug for children with heart ailment

Before the price cut, the spokesperson said, the company sold about 30-35 lakh units of the drug on average every month. But as the shortage continues, doctors said parents have been forced to break the adult dosage ampule of 40 mg to give the 2mg dose for babies.

Written by Abantika Ghosh | New Delhi | Updated: June 23, 2018 9:17:40 am
In November last year, the National Pharmaceutical Pricing Authority (NPPA) set a ceiling price of Rs 10 for the drug.  (Express photo by Prem Nath Pandey)

A CRUCIAL life-saving medication for paediatric heart patients has gone out of the market after the central government set a ceiling price that was less than a tenth of what the drug was being sold for.

Furoped or Furosemide, which is more commonly known as Lasix, is a diuretic that is prescribed in babies with heart ailments to drain the body of fluids to reduce the load on the heart. When respiratory distress starts as a result of fluid accumulation, there is little else that works in these babies other than this medication, according to specialists.

In November last year, the National Pharmaceutical Pricing Authority (NPPA) set a ceiling price of Rs 10 for the drug, which was being sold at Rs 100-110 in the market at the time. The existing stocks lasted a few months but the shortage really hit home a now. In a letter dated June 4, NPPA asked Samarth Pharmaceuticals, which sells the drug across the country, to “rush the supplies to affected area and submit a compliance report to this office”.

According to NPPA chairman R K Vats, supplies have come down by about 40 per cent. “The matter has been brought to our notice and we are looking into it. We had called the manufacturer earlier for information about production cost, etc., which they have now provided. It is our endeavour that nobody should suffer because of drug shortage, and we understand that nobody can sell a product below cost price. This will be taken up at the next meeting of the authority on June 28,” Vats told The Indian Express.

When contacted by The Indian Express, a Samarth spokesperson said the company has been receiving complaints about the shortage since November. “We have rushed supplies to wherever we received complaints from. But you have to understand that when it was brought under price control last November, the price was reduced by 92 per cent — our selling price was around Rs 106-107, which was brought down to Rs 10. As a commercial enterprise, I cannot sell a product at lower than my manufacturing cost. However, as responsible corporate citizens and because this is a medicine for kids and almost a monopoly situation, we are trying to maintain supplies. But we cannot do it in vast quantities,” said the spokesperson.

Before the price cut, the spokesperson said, the company sold about 30-35 lakh units of the drug on average every month. But as the shortage continues, doctors said parents have been forced to break the adult dosage ampule of 40 mg to give the 2mg dose for babies.

Dr Vikas Kohli, paediatric cardiologist and visiting consultant at Indraprastha Apollo Hospital, said one of his patients ended up being administered 10 times that dose because her parents, both IT professionals, “could not get the calculation right”. Kohli, who is also director of the Delhi Child Heart Centre, said he has red-flagged the shortage to NPPA.

“If educated parents cannot get it right, you can imagine what is happening to others. Having a baby with a heart problem is very difficult. It is distressing to see these parents struggling to cope with the drug shortage. Regulating the prices of drugs has its place but we cannot compromise the availability of such life-saving medication, especially for children,” he said.

Delhi-based Yogesh Raghav, father of a 18-month-old girl, said he has been trying to purchase the drug for the last one-and-a-half months. “My daughter was born with a hole in the heart. She needs that drug every day, or fluid starts accumulating. I have tried chemists everywhere in Delhi but the drug is not available,” he said.

Another parent from Ludhiana, who is seeking treatment for his six-month-old son in Delhi, said, “My son has a heart problem that makes fluid accumulate in the lungs. He was off this medication for some time. Last week, when the doctor restarted it, I could not get it anywhere. I borrowed half-a-bottle from another parent but once that this is exhausted, I don’t know what to do.”

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