The Bhutanese Leading the way.
Despite consistent registration, a big shortage of drugs remains in the health sector. In the months of January and February this year, about 88 drugs were registered with Drug Regulatory Authority (DRA) excluding temporary registration. Till date, the total number of drugs registered was around 1,759.
In the recent Meet the Press, Lyonchoen asked the health minister to submit a health report on drug shortage that will be submitted in a week.
However, reports state that “the system is being put in place,” which would take time.
Pharmacies have become people’s last refuge but even they do not guarantee a ready stock of medicines all the time.
“We suggest patients to get medicine from Jaigaon in India if we are running short of a particular medicine,” said an employee in Kuenphen pharmacy, Thimphu.
“Even wholesale dealers presently don’t have the basic medicines though they have registered,” she added.
According to her, wholesalers gives the pharmacy a list of drugs registered but particular drugs like antidiabetics, Digoxin for cardiac patients, Glibenclamide, Aldactone and many more are always out of stock.
Anti-migraine drugs like Vasograin and Topiramate; eye drops like Prednisolone, Flur, and others like Slidenafil citrate, Tamsulosin, Asthalin are in short supply, she said. The reason for the crises, she said, is always a low market because Indian companies need business volume.
She added that people tend to look for alternatives now but they have more side effects and hence are dangerous.
“We usually don’t give substitution medicine,” she said.
City Pharmacy currently does not have Oral Rehydration Solution (ORS), cold medicines, Sinarest, and KCL (Potassium Chloride) in stock.
“When we direct customers to other shops, they come back saying it’s not available there, too. Sometimes we forward them to Imtrat hospital but we get scolded for sending our customers there,” added the pharmacist.
According to Karma, a driver from Lhuentse, also a gout patient, some drugs were prescribed to him by the Monggar hospital but the medicines had to be ordered from Jaigaon.
The Norling pharmacist said that “looking at the customers’ demand for particular drugs, these kinds of drugs have to be registered for sale”.
However, a businessman, Pasang, said it’s a good decision to restrict some of the drugs since the number of patients is comparatively less than other countries. “But there should be alternative for life saving medicines”.
Since January last year, not a single unregistered drug has been allowed in the country by DRA in order to ensure quality, safety and efficacy of the medicines.
Drug Controller Sonam Dorji talked about the flooding of the market with counterfeit drugs. He said Bhutan has neighboring countries where lots of substandard and counterfeit drugs are manufactured and traded.
Talking about disease pattern change and communicable diseases in the country, where the incidence of diarrhea and ARI (Acute Respiratory Infection) like cough is very high, he added that though the treatment seems to be simple many antibiotics and syrups are taken in irrational combinations.
He said that at present there are seven registered paracetamol companies and the bulk stock from it goes to the health ministry while a smaller portion goes to private companies.
He said DRA is not restricting accessibility without a reason.
“We are trying to stop people from taking medicines irrationally. The responsibility of the DRA is not only to look at quality aspects but also how rational it is to let products be in the country.”
He further said that the regulations are not rigid.
“In fact we have public friendly legislation in terms of medicinal products.” If there is a national emergency, patients can bring medicine from outside but with prescriptions.
If some of the drugs which are in the essential drug list of the health ministry are also out of stock, the person can show the prescription at the pharmacy and can bring the required amount of drugs.
“We are trying to facilitate and reduce regulatory and registration complications as far as possible, making a conducive environment so that people can come and register but we don’t want to compromise,” he said.
