The Hindu : Karnataka / Bangalore News : Drug shortage worries haemophilia patients

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Saturday, Aug 09, 2008
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Karnataka

Karnataka - Bangalore

Drug shortage worries haemophilia patients

Afshan Yasmeen

Bangalore: Use of expired drugs is legally not permitted. But often doctors are forced to use such drugs in the event of an acute shortage and when serious cases need to be attended. This is exactly what is happening with haemophilics in the country. Acute shortage of the anti-haemophilic factor (AHF) and its high cost is making it inevitable for pathologists to use medicines that have crossed the expiry date.

Haemophilia is a life threatening, non-curable chronic bleeding disorder which can disable the affected person when left untreated. Doctors, who specialise in treatment of the disorder, say that the plasma-derived intravenous injections that are used to manage deficiency of Factor VIII and Factor IX in affected persons is actually a “clotting protein” that cannot cause any side effects or complications even if it has crossed the expiry date.

According to Suresh Hanagavadi, vice-president of Haemophilia Federation (India), who is an haemophilic himself, use of expired medicines had become inevitable as medicines are not easily available and beyond the reach of the common man.

“As the medicine is a blood clotting protein, there will not be any complications in using it. But the potency will definitely be lower than fresh medicine. When nothing is available during times of life-threatening bleeds, it becomes necessary to use such medicine,” he said.

Clarifying that doctors associated with the Haemophilia Federation were not encouraging the use of expired medicines, Dr. Hanagavadi, who is a Professor of Pathology at the JJM Medical College in Davangere, said the problem could be solved if the Government sets up “plasma fractioning” centres.

“As the medicine is not manufactured in India, we have to import the medicine from western countries. With most of these countries now adopting DNA Recombinant Technology (that will avoid the risk of HIV and other diseases) to derive artificial anti-haemophilic factors, there is an acute shortage of plasma derived medicine. While the plasma derived factors are costly enough, the artificial factors are priced at four to five times more than the former,” he said.

Mahendra Bolar, a city-based pathologist associated with the federation, said some U.S. and Germany-based manufacturing companies that supplied AHF to India at subsidised costs often sent medicine with short expiry dates. “If we want fresh stocks, we have to pay more. As treatment of haemophilia is highly expensive and causes financial stress on the families of the affected persons, we have to manage with whatever we get,” he said.

Haemophilia Federation (India) supports about 13,000 affected persons in the country. “Though studies show that there are more than a lakh haemophilics in the country, only 13,000 have been identified. Of these, around 5,000 are from Karnataka,” Dr. Hanagavadi said.

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