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Expert proposes measures to reduce drug prices
With medicinal drug prices going up as a result of total deregulation last year, one of Sri Lanka's leading pharmacists yesterday proposed several measures to provide quality drugs to the common people at affordable prices.

Parallel imports, compulsory licensing and rational prescriptions were among the measures proposed by Professor Tulie de Silva, President of the Pharmaceutical Society of Sri Lanka.

He was speaking at a workshop on how to provide quality drugs at affordable prices. The seminar held at the SLFI auditorium was organised by Health Action International Asia Pacific in association with the Ministries of Health and Consumer Affairs and the SLFI. Though practical proposals were made to bring down prices, key decision makers of the Health or Commerce Ministries were not present.

Among the measures proposed by Professor De Silva were:

* Change the present system of pricing to a system, of costing formula that takes into account comparable prices in the region

* Allow parallel import of highly priced branded products, which will bring down the costs to patients

* Insist on rational prescribing and use of drugs from the list of essential drugs recommended by the Ministry of Health

* Take action on unethical promotional practices of the companies

* Restrict unethical advertising of over-the-counter-drugs

* Introduce good dispensing practices including counselling at the pharmacies

* Introduce a category of pharmaceutical inspectors to detect dispensing errors and bad dispensing practices

* Promote public awareness of drugs and preventive health

* Make drug information centres more effective and service oriented

* Collect and disseminate adverse drug reactions

* Implement the law on dispensing of prescription-only drugs to avoid self-medication and

* Introduce deterrent punishment for supplying and selling poor quality drugs.

Professor K. Balasubramanium, coordinator of HAIP in a keynote speech said the Central Bank had proposed that the Public Health Service be exposed to market forces - in other words privatisation.

The Bank had also proposed that state subsidies on public health be reduced. But Dr. Balasubramanium pointed out that according to the tax structure in Sri Lanka the government subsidy for the Public Health service came from public funds which came mainly from the poor people, mainly from taxes. According to the tax structure only 15% came from income tax paid mainly by the richer classes. But upto 80% of tax money came from indirect taxes imposed on goods and services and paid even by the poorest people.

Professor Geetha Fernando head of the Department of Pharmacology of the Kelaniya Medical Faculty said irrational prescribing practices were resulting in a waste of millions of rupees. She pointed out that upto 250 million rupees a year was being spent on anti-rabies vaccine or serum.

In many instances government doctors were prescribing these vaccines unnecessarily. Millions of rupees could be saved and patients also spared of side effects if this vaccine was given only when essential. Professor Fernando also pointed out that in the State sector upto 90 million rupees a year was being spent on the import of the antibiotic Amoxycillin and it was being unnecessarily prescribed even for fever where a paracetamol would be sufficient. She said as a result of excessive use of the antibiotic a majority of patients had also become resistant to this.

Top medical personalities, health officials and members of the National Movement for the Rights of Patients (NMRP) who took part in the workshop strongly protested against the reported moves to privatise the State Pharmaceuticals Manufacturing Corporation. An SPMC official who spoke at the workshop said that the corporation, while making good profits was manufacturing and selling essential drugs at affordable prices.

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