Thai govt’s main healthcare scheme may run short of key heart drug

[webfact]

NHSO may run short of key heart drug
Pongphon Sarnsamak
The Nation

Supplier blamed for shortage; hospitals may be told to buy pills at retail prices

BANGKOK: -- The government’s main healthcare scheme is facing a shortage of tablets for heart disease, which will affect more than 50,000 patients suffering from the condition.

The National Health Security Office (NHSO) said it only has about 500,000 tablets of Clopidogrel in its stock, which would cover about 52,000 patients for two weeks, NHSO spokesperson Atthaporn Limpanyalert said. Heart disease patients need to take one tablet of Clopidogrel daily.

Realising the impending shortage, the NHSO held an urgent meeting with the Government Pharmaceutical Organisation (GPO) yesterday. Atthaporn put the shortage down to mismanagement on the GPO's side.

The NHSO had previously placed an order for 18 million tablets of Clopidogrel for this year, as it prescribes about a million of these tablets every month. GPO delivered the first batch of 6 million tablets in the first half of the year, but said it was unable to complete the order because India's Emcure Pharmaceuticals Co Ltd, which supplied the drug to the GPO, had problems with the supply of raw materials.

Thailand imposed compulsory licensing for medication for heart-related diseases in 2007 and started importing the generic version from India.

"The Indian company did not provide any details about what kind of problem it is facing," Atthaporn said, adding that the NHSO was discussing possible solutions with the GPO so the shortage does not affect hospitals and patients.

In fact, he said, Clopidogrel is available in the retail market, but at a higher price. In the worst-case scenario, if the GPO is unable to provide the medication, he said, hospitals will be advised to purchase the drug at retail price.

"We just hope this problem is resolved soon because we don't have a plan B," he said.

Meanwhile, Public Health Minister Pradit Sintavanarong said he has instructed GPO chairman Dr Pipat Yingseri to find out why the stocks have run out.

"Somebody needs to take responsibility for this problem," he said.


-- The Nation 2013-07-25

[hansnl]

May I ventilate the thought a US based medicine company might be at the heart of the problem?

[Utley]

"Somebody needs to take responsibility for this problem," he [Public Health Minister Pradit Sintavanarong] said.

Ah...may I suggest that since you are the top dog - that would be YOU!

[Utley]

May I ventilate the thought a US based medicine company might be at the heart of the problem?

Pure speculation adds nothing to this discussion.

[Bagwan]

Meanwhile, Public Health Minister Pradit Sintavanarong said he has instructed GPO chairman Dr Pipat Yingseri to find out why the stocks have run out.

If the chairman doesn't already know then fire the bloody idiot. This might well cause only a a minor hiccough since another incompetent will take his place, but if repeated enough times maybe the penny will eventually drop. Inaction has turned a minor inconvenience into a possible disastrous situation.

[Bagwan]

"Somebody needs to take responsibility for this problem," he [Public Health Minister Pradit Sintavanarong] said.

Ah...may I suggest that since you are the top dog - that would be YOU!

The need will go unfulfilled - as usual.

[laurab74]

May I ventilate the thought a US based medicine company might be at the heart of the problem?

I am a long term veteran of the pharma industry and have no liking for them at all. I doubt that this has been engineered by BMS, the originators of the product. The patent on clopidogrel expired a sort time ago, and hence there is a huge demand for generic versions of the product, which has probably caused a raw material shortage. I doubt that there is anything sinister.

The GPO should try to have more than one supplier for key products, although this can be difficult prior to the expiry of the drugs patent. India is a favorite supplier because it doesn't recognize the patent on the molecule, but only patents on method of manufacture (which are very easy to get around). Poor countries get an exemption on recognizing patents for essential medicines like AIDS drugs under a program called TRIPS. The US have been trying to kill TRIPS ever since it was introduced. Thailand actually lead the way in introducing AIDS and cardiovascular meds under TRIPS. They also have a special scheme for oncology drugs which often cost several thousand dollars per course of therapy.

[belg]

thailand is so good in copying everything, so why not make it local ? could that not save many billions?

who cares if they produce fakes, as long as the patients think it is the real thing

goes for so many things in the country of scams

[drdoom6996]

"We just hope this problem is resolved soon because we don't have a plan B," he said".

I didn't know anyone had a Plan B ever.

[geriatrickid]

May I ventilate the thought a US based medicine company might be at the heart of the problem?

Why would you blame a US pharma company?

The original patent was owned by Sanofi the large French multinational. The molecule originators were 3 French researchers funded by Sanofi. The joint patent for the Plavix version was held by Sanofi and Bristol Myers Squibb (a US hqed multinational). However, the drug has been off patent in the USA for over a year. Why would a US company sabotage this, when there are 11 generic versions of the drug approved in the US market alone.

Dr. Reddy's Laboratories, Gate Pharmaceuticals, Mylan Pharmaceuticals, and Teva Pharmaceuticals have FDA approval for 300 milligram (mg) clopidogrel. Apotex Corporation, Aurobindo Pharma, Mylan Pharmaceuticals, Roxane Laboratories, Sun Pharma, Teva Pharmaceuticals, and Torrent Pharmaceuticals have FDA approval for 75 mg clopidogrel.

The problem is in India with the supply of the active ingredient. This component has to be synthesized and sometimes, there is a problem in the supply chain, especially in the manufacture of a drug with multiple steps and multiple contract manufacturers. Every country has problems sourcing drugs throughout the year. Machinery breaks down, goods are lost in transit, batches fail quality control etc.

[surangw]

is it just my western interpretation of the word scheme that make me think its a scheme rather than a plan ?

[lawrence1366]

Thought only yesterday they were offering universal healthcare to the Cambodians too?

[NeverSure]

May I ventilate the thought a US based medicine company might be at the heart of the problem?

US bashing gets really old around here, especially when it's a lie.

This drug Clopidogrel is known as Plavix. Its patent has expired and anyone can make it. It is available rather cheaply as various generics.

There is no US drug maker with an interest in stopping India from making that drug.

Now, when a drug company invents or discovers a new "wonder" drug and spends huge sums of money on it and as long as ten years testing it to get it approved, then they are entitled to their profit until their patent expires.

That's not the case here.

[pmarlin]

May I ventilate the thought a US based medicine company might be at the heart of the problem?

BS, been sold in the generic form since 2012. Produced all over the world.

[SICHONSTEVE]

Meanwhile, Public Health Minister Pradit Sintavanarong said he has instructed GPO chairman Dr Pipat Yingseri to find out why the stocks have run out.

If the chairman doesn't already know then fire the bloody idiot. This might well cause only a a minor hiccough since another incompetent will take his place, but if repeated enough times maybe the penny will eventually drop. Inaction has turned a minor inconvenience into a possible disastrous situation.

May be the best thing to happen if they do run out actually as there are a number of herbs and spices that do precisely the same thing (without the deadly side-effects that this drug has) - namely, garlic, ginger, ginkgo and the wonderful super-spice 'turmeric'.