Drugs: Patients face a bitter deal
By Asif Fuard and Vanessa Sridharan
Patients are having to pay a heavy price due to mismanagement and inefficiency in the chain of distribution of medical drugs to government hospitals, The Sunday Times learns.

At the top of the chain of distribution is the State Pharmaceutical Corporation (SPC) that sells the drugs to the Medical Supplies Division MSD which in turn distributes the drugs to government hospitals where patients are able to get them free of charge.

But most of the time patients are turned away by hospital officials who tell them that they are out of stock due to an SPC delay in providing the drugs on time to the MSD.

The MSD is the sole distributor of drugs to the country’s public health sector and 90% of these drugs are obtained from the SPC. The MSD orders the drugs from the SPC a year in advance prior to distribution and on an estimated quotation these drugs are distributed to all government hospitals.

However, The Sunday Times learns that the SPC has not been consistent in supplying the ordered quantity of drugs to the MSD, resulting in hospitals running out of stocks. It is also learnt that sometimes the SPC in a desperate bid to provide the MSD with drugs supplies them with drugs that are close to their expiry dates. This forces government hospitals to destroy medicines worth about Rs. 15-20 million a year, according to estimates by government health authorities.

The Sunday Times also learns that last year the treasury had allocated the MSD Rs. 7000 million which was largely spent on buying drugs from SPC. Despite the SPC’s drawbacks and inefficiencies the MSD continues to buy drugs from it because of its nominal prices.

However, when we contacted SPC director Sarath Silva he said they always provided the drugs on time and there has never been a shortage of stocks.
Underlying another problem, MSD Director Dr. B.V. Beneragama said most of the hospitals didn’t forward the estimated drug quotation on time and sometimes they even over estimated the quota which resulted in a wastage of drugs.

“We order the drugs from the SPC one year prior to the distribution date. We supply our drugs on time but sometimes we have certain difficulties. Sometimes hospitals open new wards and expect us to provide them with drugs immediately. These are some of the problems we face. These problems could be looked into if we had a drug review committee to keep tab on the hospitals’ use of drugs. This would prevent drugs from going waste.

Meanwhile, the Sri Jayewardenepura hospital, a semi government institution is in turmoil after authorities handed over the running of the pharmacy to the SPC which authorities say would reduce the inefficiency in the system.(Please see box). However trade unions are up in arms and they charge this may be the first move towards privatising the Health Sector in Sri Lanka. Hospital staff who are entitled to free medical benefits for themselves and their families fear that they will lose these benefits as a result of the SPC takeover.

The most affected by the hand-over are the kidney transplant patients.These patients were able to obtain their monthly quota of drugs for a nominal fee of Rs. 200. But now after the SPC takeover of the pharmacy they have to pay Rs. 35,000, The Sunday Times learns.

However, the hospital’s Chairman D.D.Ranasinghe defended the move saying it was necessary to minimize wastage of resources and improve efficiency.
The Sunday Times learns that the Government grants the Sri Jayewardenepura Hospital Rs. 440 million a year which officials say is not enough to run the institution since staff salaries alone come to about Rs. 470 million a year.
When we contacted Health Minister Nimal Siripala De Silva he first said the allegations were wrong and then cut off the line. When we called the same number another voice answered and said we had got a wrong number.

Meanwhile Sri Jayewardenepura hospital is facing a crisis with more than 400 kidney patients who used to get their monthly quota of medication for a nominal Rs. 200 now being forced to buy the drugs at an exorbitant amount of Rs.35,000.

These patients who are mainly from low income groups have joined hands with other kidney transplant patients to set up an organization, the Kidney Transplant Patients Association (KTPA).

Most of them feel robbed of the free medication that was provided to them until the pharmacy was handed over to SPC. The Kidney Transplant Patients’ Association secretary S.M.S Perera said; “We used to pay Rs.200 a month for all our drugs now we have to pay Rs. 35,000 a month and even then sometimes the drugs are out of stock. Sometimes we have to come to hospital every week to see if a particular drug is available. We have sent a letter to the Director of the Hospital asking him not to privatise the pharmacy since most of us cannot afford to pay for these drugs and we are awaiting a reply.

Dr.Chula Hearath, a kidney specialist at the Sri Jayewardenepura Hospital said most kidney transplant patients need these drugs to survive after the transplant and all Government Hospitals give these drugs free of charge and it should be the same practice at Sri Jayewardenepura Hospital too.
The Sunday Times also learns that the Sri Jayewardenepura Hospital owes the MSD Rs. 200 million and in order to cut off this debt they have pushed the burden on to the patients who were obtaining drugs for free.

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