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Pharmacists threaten to increase cost of drugs

Thursday October 10 2019

Pharmacists

Pharmacists and drug retailers have threatened to increase the costs. PHOTO | FILE | NATION MEDIA GROUP 

NATION TEAM
By NATION TEAM
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Pharmacists and drug retailers have threatened to increase the costs of medicine if President Uhuru Kenyatta does not rescind his statement which introduced stringent measures on imported goods, especially medicines.

As a result, Kenyans are not only staring at a health crisis brought on by a national shortage of medicines, but will also have to dig deeper into their pockets and wait longer just to access the life-saving drugs.

INSULIN SHORTAGE

Pharmaceutical firms have said that if the President does not withdraw the directive, they will have no choice but to increase the cost of medicines by 40 to 60 per cent, to shoulder the new charges of inspection imposed on them.

The tug-of-war between importers, who make up to 80 per cent of pharmaceutical imports in the country, and the government, has seen the former cease importation of pharmaceutical products until the matter is resolved.

The Kenya Diabetes Study Group and specialist physicians treating diabetes Wednesday said that they were already experiencing a shortage of insulin compelling them to change the type commonly prescribed to patients.

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“Currently five brands of insulin are unavailable in both hospitals as well as numerous pharmacies countrywide. Insulin is a life-saving drug that many Kenyans living with diabetes need on a daily basis,” says the letter addressed to the President.

The group reported that another month of shortages could mean deaths for children and adults with diabetes.

TOO WEAK

Ms Mary Catherine Maina, a patient says the directive was slowly shutting down her system since she cannot survive without her drugs.

“It starts with muscles which become too weak to do the most basic tasks including lifting a cup. Soon you can’t walk. Talking becomes a problem and finally, your respiratory system becomes too weak to breathe. To prevent this, I have to be on medication,” she says.

Myasthenia Gravis (fatigue of the muscles) patients asked the President to revoke the directive for them to get access to their medicine.

Dr Vijai Maini, the MD of Surgipharm, a pharmaceuticals importer, said: “We have orders in the pipeline which cannot be dispatched from the manufacturer’s warehouses because of delays caused by this new rule.” He added that their stocks were getting depleted.

CAUSE DELAYS

Dr Kamamia Murichu, the chairman of the Kenya Pharmaceutical Distributors Association, said failure to meet requirements would have the medicines shipped to countries of origin. He added that seven containers belonging to a local importer had been sent to India.

The directive has significantly affected parallel importers who serve 30 per cent of the Kenyan market. There are about 250 pharmaceutical companies.

Some of these companies also supply Kenya Medical Supplies Agency which distributes medicines to the counties.

Health CS Sicily Kariuki on Tuesday held a crisis meeting with pharmaceutical firms to forge a way forward where she asked distributors to give evidence of how the double inspection brought by the pre-export verification of conformity (PVoC) regulation will impact on the duration of importing and cost of drugs.

According to players in the pharmaceutical industry, the directive just worsened the situation, as it introduces ‘unnecessary’ double inspection. The process of acquiring a PVoC, they added, will cause delays in importation and impose hefty charges.

SEVEN CONTAINERS

“We have orders in the pipeline which cannot be dispatched from the manufacturer’s warehouses because of delays caused by this new rule,” Surgipharm limited managing director Dr Vijai Maini said, adding that available stocks are fast getting depleted.

If the goods do not have PVoC they will not be allowed into Kenya and instead will be returned to the country of export. If they come in, the importer will have to pay 30 per cent of the value of the consignment.

“Consignments are already being sent back to the countries of origin. For example, seven containers belonging to one of the local importers were returned back to India,” Dr Murichu said.

The directive has significantly affected parallel importers who serve 30 per cent of the Kenyan market. There are about 250 pharmaceutical companies that import and distribute medicines and pharmaceutical products such as medical equipment and consumables to the 5,000 registered pharmacies across the country.

HEFTY CHARGES

Some of these companies also supply the pharmaceutical products to the Kenya Medical Supplies Agency (Kemsa) which distributes medicines to the counties. According to players in the pharmaceutical industry, the directive just worsened the situation, as it introduces ‘unnecessary’ double inspection. The process of acquiring a PVoC, they added, will cause delays in importation and impose hefty charges.

As a result, shipments that previously took between three to five days now take close to six months, added Dr Kamamia Murichu, the chairman of the Kenya Pharmaceutical Distributors Association (Kpda).

“The President made a political decision at the expense of Kenyans without consulting with. Interestingly the cabinet secretaries are saying that he is the only one who can retract the directive,” explained Dr Murichu.

REQUIREMENTS

Health Cabinet Secretary Sicily Kariuki on Tuesday Sicily Kariuki held a crisis meeting with pharmaceutical organisations to forge for way forward where she asked distributors to give evidence of how the double inspection brought by the pre-export verification of conformity regulation will impact on the duration of importing- and cost of drugs.

According to a circular dated June 4 head of public service, Joseph Kinyua said that the new rules are meant “to improve the cost of doing business and efficiency at ports of entry.”

He added that the rules were meant to ensure that goods coming into the country adhere to regulatory requirements and conform to quality standards.

Some of the industry players are already feeling the negative impacts of the directive.

“We have children who urgently need surfactant, yet, we cannot get the drugs into the country as fast as they are needed,” Dr Kamau Ng’ang’a, an importer.

As a result, shipments that previously took between three to five days now take close to two months, says Dr Kamamia Murichu, the chairman of the Kenya Pharmaceutical Distributors Association (Kpda).

CHRONIC CONDITIONS

“The President made a political decision at the expense of Kenyans without consulting with. Interestingly the cabinet secretaries are saying that he is the only one who can retract the directive,” explained Dr Murichu.

Although there are about 35 local drug manufacturers, imports meet the bulk of local demands. According to data from the Pharmacy and Poisons Board (PPB), the industry brought in pharmaceutical imports worth Sh75.6billion (USD $728 million) last year.

“You cannot inspect medicines the same way you inspect curtains and car tyres. The appointed companies have no technical capacity to inspect drugs,” said Dr Ng’ang’a.

The most affected are patients managing chronic conditions like cancer, diabetes, hypertension, pain management among many others. The main issue, Dr Kamau added, is in urgent shipments. Kenya has scheduled orders for some drugs that are allowed into the country on need-to-need basis. These scheduled drugs are mostly prescribed to patients who urgently need them and are imported under special permits faster than other medications.

SPECIAL MOLECULES

But with the new regulations also affect the importation of these kinds of drugs.

“The main issue is with cancer drugs, especially some special molecules needed to treat some patients. For instance, about a week ago, a doctor from one of the private hospitals had ordered for Darzalex for a patient. When the consignment arrived through DHL, we were asked to pay 25 per cent on top of the cost of the drug which we bought at one million shillings, for the drug to be released. We had to transfer the extra cost to the patient,” added Dr Kamau.

Import of pharmaceutical products is regulated by the Pharmacy and Poisons Board (PPB). The importer is required to import a drug sample that is used to facilitate registration of the drug in Kenya. A product registration certificate is then issued by the Pharmacy and Poisons Board after product evaluation has been completed successfully.

Report by Elizabeth Merab, Angela Okech and Nasibo Kabale