Shortage of drugs to treat NCDs in govt. hospitals in Keralam

Hospitals across the State are up against a shortage of drugs for treating non-communicable diseases (NCDs). Several commonly prescribed drugs for blood sugar management (metformin), hypertension (telmasartan), and cholesterol (atorvastatin) are in short supply in hospitals, even as authorities have assured that these will be back in stock within a week.

“It is not as though we are running short on all drugs. But NCD drugs are medicines that people should be taking without fail as a matter of routine and disruptions in its supply can be worrying. We anticipated this shortage last month and moved fast to make local purchases so our patients do not miss the medication,” the medical officer at a family health centre in Thiruvananthapuram said.

“NCD drugs are in short supply but we have not had any issues because our hospital management committee has adequate funds, apart from the substantial resources that our block panchayat sets aside every year for purchasing drugs, for making local purchases. If a substantial amount of drugs has to be purchased, then we float a tender. However, there are also health institutions in smaller panchayats which might be struggling to make local purchase because of insufficient funds,” the superintendent at a taluk hospital in the suburbs said.

Ideally, when a patient registered at the NCD clinic of a particular healthcare institution comes for review, the hospital should have at least 30 days’ stock of the NCD drugs for the patient to take home. In the present situation, many hospitals are not able to ensure that.

Medical officers said this year, the Kerala Medical Services Corporation Limited (KMSCL) released only the drug supplies of the first quarter and that the second quarter release of June did not happen at all which led to the shortage of some drugs, including NCD drugs.

The KMSCL purchases around ₹700-800 crore worth of medicines every year for supplying to around 8,000 government healthcare institutions. In its last procurement exercise, 180 items reportedly received no bids, while suppliers quoted higher prices for another 171 items. This resulted in re-tendering and delays in placing fresh orders.

According to sources, the supply orders given in January-March, for some 18 non-bidder drugs, were cancelled by the new government because the prices quoted were considered far too high, which triggered the present shortage. However, fresh procurement orders have been placed and the supplies are expected to arrive within a week, it was pointed out.

The fact that the KMSCL owes over ₹2,200 crore to various pharma firms, for drugs purchased for hospitals as well as the drugs purchased by hospitals for patients under the Karunya Arogya Suraksha Padhati, has not helped the situation. The massive delays in payment is one of the reasons why many pharma forms do not respond to tenders floated by the KMSCL.

Health Minister K. Muraleedharan had directed that the procurement procedures for the next financial year begin in October itself and that the entire process be completed by the end of December.

He also directed that middlemen be removed from the tender processes and that agencies dealing directly in imported medicines also be allowed to take part in tenders. He said a comprehensive overhaul was under way at the KMSCL

According to sources, there are also efforts to form a consortium with medical service corporations of other States so that common purchase tenders can be floated, which might likely bring prices further down.