The Hindu : New Delhi News : Drug companies chasing profits, cheating patients

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Wednesday, May 14, 2008
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Drug companies chasing profits, cheating patients

Bindu Shajan Perappadan

‘High-price Doxofylline being promoted as an alternative to low-price theophylline’
Doxofylline bulk drug is not a patented medicine and can be purchased in tons in China

NEW DELHI: Exploiting the ignorance of the common man, over half a dozen drug companies in the country have suddenly discovered the hidden virtues of an age-old, low-lying medicine called “doxofylline”, claim experts.

Before the aggressive promotion to sell the drug started last year, doctors were not even aware that such a molecule existed.

Explaining what he claims is the real reason for doxofylline’s entry into the country, the Editor of the medical journal, Monthly Index of Medical Specialities, Dr. C. M. Gulati, says: “The answer lies in the way drug prices are determined and controlled in the country. Doxofylline is being offered as a more profitable alternative to theophylline, prescribed to prevent and treat wheezing, shortness of breath, and difficulty breathing caused by asthma, chronic bronchitis, emphysema, and other lung diseases. It relaxes and opens air passages in the lungs, making it easier to breathe.”

“Theophylline and etofylline – molecules approved for sale in over 200 countries after having undergone rigorous post-marketing trials -- are scheduled drugs and subject to price control by the Government. By successive orders in 2006, all loopholes to sell theophylline products at high profit margins have been closed by the National Pharmaceutical Pricing Authority (NPPA), the body that monitors medicine prices in India. Therefore, nearly all companies selling theophylline formulations have been scouting for similar molecules outside the price control system irrespective of whether they are similar, better or even worse than their current brands” adds Dr. Gulati.

“The core issue is profits, not patients,” asserts Dr. Gulati. “The strategy is to stop selling less profitable, price-controlled products and replace them with hugely profitable alternatives of the same class. Doxofylline fits into this tactic. A molecule which is not even considered fit for mention in standard textbooks is being paraded as if it is major advancement in the treatment of asthma,” he notes.

Doxofylline bulk drug is not a patented medicine and can be purchased in tons in China at a very low cost without any licence. Yet to give it an international foreign flavour, some drug companies in India have proudly announced that their brands are being produced “under licence” from overseas entities.

Dr. Gulati has warned that patients in India are being made to pay excessively high price for a very ordinary medicine.

“While the cost of a ten-tablet strip of theophylline-400 mg is Rs.6.40, the cost of a ten-tablet strip of doxofylline is Rs.80.”

After the discovery of aminophylline, a double salt of theophylline and ethylenediamine, in 1910, attempts were made either to isolate similar xanthine alkaloids from plants or to synthesize them in labs. Result: dozens of derivatives of theophylline were discovered such as etofylline, theobromine, oxtriphylline, dyphylline, enprofylline, etamiphylline, proxyphylline and pyridofylline.

Doxofylline is just another derivative of theophylline in this chain and resembles the parent compound in its mode of action, efficacy and safety profile.

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