Via Thomson Reuters: Pricing dispute hits supply of TB drugs in Pakistan. Excerpt:
Swiss pharmaceuticals firm Novartis AG said it has stopped making tuberculosis drugs in Pakistan in a dispute over pricing, prompting fears of a health crisis due to a shortage of drugs in a country with the world's fifth-highest TB rates.
As in many developing countries, the Drug Regulatory Authority of Pakistan (DRAP) sets prices for about 320 critical medicines. But pricing caps have not been significantly raised since 2001, making it unviable for firms to make many of the drugs.
The issue has become particularly acute for TB drugs. Of 18 companies licensed to manufacture TB drugs in Pakistan, only four, including Novartis, were making them this year, said Ayesha Haq, executive director of Pharma Bureau, a trade group representing 20 firms in Pakistan.
Doctors and public health officials said shortages could lead to a rise in drug-resistant strains of TB with tens of thousands of patients missing doses mid-treatment. The drugs include combinations of antibiotics as well as substitutes for patients with complications.
"It's an emergency in the making," said Naseem Salahuddin, an infectious disease doctor in Karachi.
With a population of 190 million, Pakistan has around 500,000 TB patients every year, according to the World Health Organisation.
Rana Iftikhar Anjum, a resident of Multan in Punjab province, said it took him weeks to track down TB drugs for his 15-year-old niece, and Muhammad Rafiq, a pharmacist at a leading Islamabad hospital, said he had to pay 2,000 rupees ($19) in bribes to get the drugs for his brother, who suffers from multi-drug resistant TB, from a government hospital.
Novartis spokesman Dermot Doherty said the company, which controls around 30 percent of Pakistan's TB drug market, was looking to exit the business, and Ahsan Raees, in charge of the company's regulatory affairs in Pakistan, blamed the production halt on the price dispute. "If they had given us the price increase, we would never have done this," he said.
Pfizer Inc, which controls another 30 percent of the market, has also seen supply disruptions in recent months, adding to shortages, spokeswoman Trupti Wagh said. She did not elaborate on the disruptions, but said they were resolved last month. She declined to say whether the pricing dispute was a factor.
A local TB drug maker, Schazoo Zaka, also partially cut production because of the pricing dispute, said Ejaz Qadeer, who heads Pakistan's anti-TB programme. Schazoo Zaka did not respond to a request for comment.