The Bhutanese Leading the way.
Jigme Dorji Wangchuck National Referral Hospital (JDWNHR) has started collecting morphine tablets from other hospitals in the country.
A shortage of controlled drugs including morphine, which is used on cancer patients to relieve pain, has raised concerns among the health officials at JDWNRH. The controlled drugs are Morphine, Pethidine, Fentanyl, Codeine and Tramadol.
Health official of JDWNRH, Thupten Tshering, said the relevant authority has already re-tendered, but they are still worried that the might take time to receive the drug. However, JDWNRH is also looking for other alternatives, such as if there is any possibility to get controlled drugs from the open market.
He said they will not let the morphine tablets to go out of stock, so they are finding ways to get it.
Morphine tablets is mainly used for cancer patients and also non-cancer patients and the requirement is according to the severity of the pain with no such maximum dose limit. So each cancer patient would require 3 morphine tablets to 5 tablets in a day and sometimes it goes up to 15 tablets.
The shortage was reached due to the disqualification of local suppliers, KMT and Paras.
However, DRA gives exemption for non-registered medicines if it is really required by the government or if it is essential medicines. The procurement can made using an alternative arrangement.
Medical Superintendent, Dr Gosar Pemba, said there is an increase in the usage of morphine for cancer patients. In December 2018, JDWNRH has received 40,000 morphine tablets but still it is not enough.
He said since JDWNRH has started radiotherapy and chemotherapy, most of the cancer patients that travel to India are kept here. So that has also led to increased use of morphine.
“Other supply has started coming except for the controlled drugs, and we are worried that by the end of September or mid of October, the controlled drugs should reach the hospital or else there will be problem if it is late,” said Dr Gosar.
There was a similar incident of controlled drugs shortage in 2014. It was resolved the drugs were bought directly from the manufacturers.
As per the 2018 records, there were more than 2,000 cancer cases registered in the last four years. At least 500 new cancer cases are reported every year.
