A dispute over the pricing of drugs in Pakistan that has led many of the pharmaceutical manufacturers in the country to stop making tuberculosis drugs is fanning fear among health officials of an outbreak of the disease.
Pakistan, which has the fifth-highest rate of TB globally, reports about a half-million TB patients a year out of a population of 190 million, according to figures from the World Health Organization.
Novartis ($NVS), of Switzerland, has stopped making TB drugs in the country altogether, while Pfizer ($PFE) has reported production disruptions in recent months that have led to shortages of the drugs, Reuters reported. Both Novartis and Pfizer each control about 30% of Pakistan’s TB market.
At the heart of the issue are pricing caps that have only seen small increases since 2001. The Drug Regulatory Authority of Pakistan (DRAP) sets those prices, which cover about 320 critical medicines.
"It's an emergency in the making," Naseem Salahuddin, an infectious disease doctor in Karachi, told the news agency.
As it stands, only four of the 18 companies licensed to produce TB drugs in Pakistan are currently making the products. A Novartis spokesman told Reuters that the company is looking to exit the market, and another blamed the halt of production on the price dispute.
"If they had given us the price increase, we would never have done this," Ahsan Raees, the head of the company’s regulatory affairs in Pakistan, said.
The shortage could spark an increase in drug-resistant strains of TB as patients begin missing doses in the middle of their treatments, government and health officials said.
A year-and-a-half ago, DRAP proposed an “orphan-drug” policy that would cover about three dozen drugs that wouldn’t have a price cap as an incentive for pharma manufacturers to make them. The hope would be that companies could sell TB drugs at cost price even though the disease isn’t considered rare in the country.
The proposal has yet to be approved.
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