Medicine market runs with 30-yr old list

Mahfuz Emran: In 1993, the government listed primary health care drugs so that the people of the country can buy the drugs used in primary health care at affordable prices. Many of the drugs on that list created 30 years ago are no longer produced by companies. Apart from this, doctors also prescribe more advanced and effective drugs. But patients have to buy these medicines at higher prices as they are not listed. Public health experts said that it is important to update the list of medicines in this situation.
The health system of the country is divided into primary, secondary and tertiary. Accordingly, primary care physicians will prescribe drugs listed in primary care. Prescribe drugs one step up in secondary treatment. And at the tertiary level, high potency drugs can be prescribed.
According to the type of disease, the 117 drugs in the primary health care list are divided into 13 categories. The price of these generic drugs will be determined by the government. The price of other drugs will be determined by the respective companies. There is an obligation on companies to manufacture at least 60 percent of the listed drugs. But many companies are not making these drugs. As a result, patients and relatives have to spend extra money to buy medicines outside the list.
Nifedipine is one of the eight generics listed in the Primary Health Care List for the treatment of heart disease. Now, instead of this, doctors write amlodipine generic medicine in the prescription. Besides, bisoprolol and nebivolol are being used instead of atenolol.
Flucloxacillin is now used instead of cloxacillin antibiotic tablets to prevent infections. And for central nervous system problems, clonazepam instead of diazepam, propofol injection instead of thiopental is being used. These drugs are used in primary care but are not included as the list is not updated.
Medicine expert and former principal of Sir Salimullah Medical College, Abu Azhar said, many new and improved medicines have come out due to the need of time. Because of this many primary health care medicines are not prescribed. This list needs to be updated. Failure to do so will create a risk of incorrect medication administration.
Currently more than 250 companies are manufacturing allopathic medicines in the country. In 1994, there were 350-400 generic drugs in the country. Currently the number has increased to thousands. But the list of drugs whose prices are fixed by the government has not increased.
Recently, when we talked to drug dealers and pharmacists of Mitford, Babubazar and Badamtali areas of old Dhaka, the largest wholesale market of drugs in the country, they said that new drugs are being manufactured in the country. For this reason, doctors are not writing these drugs in the prescriptions. No one is picking up those medicines from the shops as they are not on the prescription.
Ayesha Akhter, deputy director of 250-bed TB hospital, said, “Although amoxicillin, ampicillin, tetracycline and other drugs of primary health care are effective, now third and fourth generation drugs have arrived in the country. Because of this, many people are not prescribing earlier drugs. However, the primary health care list should be updated.
Md. Halimuzzaman, Treasurer of Bangladesh Medicine Industry Association and Managing Director of Healthcare Pharmaceuticals, said that 117 listed medicines are essential. Companies are not producing these drugs because the price is not increased. Those who did, had to sell at a loss of 70-80 percent. Due to this, these useful medicines are being smuggled from India to the country. On April 21, there was a meeting of the industrial owners with the health minister regarding updating the list of medicines. In that meeting, the minister insisted on updating.
Health and Family Welfare Minister Dr. Samant Lal Sen told that action will be taken very soon to update the list.