The National Pharmaceutical Pricing Authority of India’s (NPPA) initiative to bring drugs under price control, thus making them affordable to all, seems to have backfired as chemists from across the country are facing acute shortage of several price controlled antibiotic eye drops and vitamin C tablets. This has caused severe inconvenience to the consumers.
The antibiotic eye drops which are in short supply include chloromycetin eye drops (Vanmycetin), marketed by FDC Ltd; gentamycin eye drops (Genticyn), marketed by Allergan India Ltd; Bacitracin (400IU) + Neomycin (3400IU) + Polymyxin B (5000IU) eye drops (neosporin eye drops), marketed by GlaxoSmithKline Pharmaceuticals (GSK); and Framycetin eye drops (soframycin eye drops), marketed by Sanofi India. Framycetin was manufactured and marketed by Roussel India many years ago. The company was acquired by Sanofi.
These antibiotic eye drops used to be prescribed as first line treatment. Unfortunately, because of tight price control, companies seem to have stopped marketing them. Prices of the products are less than Rs. 10 per bottle, said Goa based community pharmacist Raj Vaidya.
On the other hand, there are 30 brands of moxifloxacin eye drops, available in the market which are not under price control. The prices of these eye drops go up to Rs. 285 per bottle. These costly medicines are being prescribed as first line therapy because of less options available in the market, he pointed out.
Besides this, vitamin C tablets- Limcee tablets and Celin tablets manufactured by Abbott Healthcare and GSK respectively are also in short supply. The products are under price control.
Though vitamin C is not a life-saving drug and we as community pharmacists do suggest alternative natural sources of vitamin C such as Amla, our customers especially senior citizens have great faith in the above products which are the only vitamin C formulations available in the market. Vitamin C is an important component of senior citizens’ wellness programme, said another Goa based community pharmacist Savio Figueiredo.
People in drug industry cited rise in prices of Sodium ascorbate, the key starting material (KSM) for manufacturing vitamin C tablets due to crackdown on Chinese manufacturers over environmental issues, for disruption in supply of the products.
However, chemists have attributed short supply of price controlled drugs to dilly-dallying approach of country’s drug price regulator.
Despite several letters, no concrete action has been taken by NPPA to ensure supply of the antibiotic eye drops and vitamin C tablets, they rued.
Last week Raj Vaidya had written to NPPA about non-availability of antibiotic eye drops and vitamin C tablets in Goa.
NPPA has asked him to provide the details regarding medicine brand name, manufacturing and marketing company, composition, strength, dosage form, place of shortage, copies of order placed on companies (along with all enclosures) which have not been supplied by that company, acknowledgement of receipt of that order from companies, reply of companies and copy of your drug license, GST/TIN no. and postal address etc., for enabling it to examine the issue.
Upset with this, Vaidya said “We are a community (retail) pharmacy. So we place our orders with the stockists/wholesalers and not with the companies. NPPA should have talks with the companies and see what is the best way that patients get the medicines. Unnecessarily asking me questions won’t solve the problem. Typical government style of working. Where is the network that the NPPA is supposed to have to monitor the prices of medicines? They can just walk down to a chemist and find out if the medicine is available or not. They can ask stockists if it is available.”
He said shortage of both Celin tablets and Limcee tablets have been reported all over India. NPPA is just delaying the matter and no concrete action has been initiated by the drug price authority to improve the supply.
Responding to Vaidya, NPPA had provided him responses shared by GSK and Abbott on supply of their vitamin C tablets.
Rajesh Shetty, head- distribution and infrastructure, GSK has refused to accept any shortfall in supply of Celin tablets in Goa. In a reply to NPPA on September 12, 2018, he said “We have been consistently supplying the product to Goa.”
Abbott India also denied short supply of the vitamin C tablet in Goa. “We have been consistently supplying Limcee 500 mg tablets to distributors in Goa based on their demand. These distributors in turn services to all chemists in Goa. However, we have increased our supply in this area,” said Arun Roy, associate director- business finance, Abbott Healthcare Pvt Ltd in a letter to NPPA on October 18, 2018.
Vaidya said “Despite companies’ claims, the products are still in short supply. This may be due to non-remunerative prices. Antibiotic eye drops and vitmin C tablets are under DPCO. The drug companies make small supplies to few of their distributors so that they can then claim that they have been supplying regularly as seen in their replies. There are a number of pending orders of the various distributors pan India.”