Patients suffer as production of cheap medicines for mental ailments discontinued

Despite a multifold increase in the prevalence of mental health and neurological diseases, dozens of cost-effective medicines used for the treatment of psychiatric illnesses and neurological disorders have vanished from the Pakistani market after local and multinational companies discontinued their production for being non-profitable for them, causing immense hardships to patients.

These drugs include psychoactive drugs antipsychotic drugs, antidepressants, mood stabilizers, anticholinergics, antihistamine, sedative and antiemetic, stimulant for Attention Deficit Hyperactivity Disorder (ADHD) and anticonvulsants. All these drugs used to be prescribed to people having mental health issues and neurological disorders as they were immensely cost-effective and in the reach of common people, experts said.

“On the one hand, mental health issues are on the rise due to the economic recession because of Covid-19, and on the other, cheap and cost-effective medicines for the treatment of mental disorders have vanished from the market,” Prof Iqbal Afridi, an eminent psychiatrist and president of the Pakistan Psychiatric Society (PPS), told The News on Saturday.

Prof Iqbal Afridi maintained that in addition to drugs for the treatment of mental disorders, several other medicines used for the treatment of neurological diseases and conditions had also disappeared from the local market, saying now people had no choice but to buy “very costly” medicines, which were out of the reach of over 90 per cent of the patients.

“Unfortunately, people facing mental health issues like schizophrenia, bipolar disorder, depression and other diseases need to take medicines for years, so it is very important that the medicines they are using are not only cheap and cost-effective but also are of good quality and standard. Unfortunately, most of the good quality medicines which were affordable to the common people have vanished from the local market,” he deplored.

To a query, Prof Afridi said the disappearance of cost-effective medicines from the local market had economic reasons as their prices were not increased, so the companies producing them halted their production as they were not earning any profit.

“For instance, 1,000 Phenobarbital tablets were available for just Rs20 in Pakistan. Now this medicine is not available. Unofficially, the pharmaceutical company says it was not feasible for them to produce them on such a low price after rupee devaluation and increase in the cost of production,” he added.

Appeal to SAPM

Prof Afridi said that as president of the Pakistan Psychiatric Society (PPS) he had written a letter to the Special Assistant to Prime Minister (SAPM) Dr Faisal Sultan for his intervention on the availability of psychotropic and other medicines as mental health issues were on the rise due to the pandemic and people needed cost-effective medicines instead of costly, unaffordable drugs in the time of the current crisis.

“The new adviser to PM on health is a leading physician of the country and he has the experience of running a tertiary-care health facility in the country. I have written a letter to him, requesting him to intervene and use his office for the resumption of the production of several medicines, which are highly essential for the treatment of mental health and neurological disorders,” he added.

He said most of these drugs were being produced by multinational companies, which had discreetly discontinued their production due to economic reasons. He added that even if these companies were allowed to increase the prices of these medicines by 50 per cent, they would remain affordable for common people having mental health and neurological disorders.

“Lithium is a very cheap and known drug for the treatment of mood disorders. The multinational company which used to produce it has halted its production. Now a local company is producing it, but it is not as effective as the one produced by the multinational firm. We request the authorities to take this issue on a humanitarian basis and resume the production of these drugs in Pakistan.”

Industry’s version

Representatives from local and multinational pharmaceutical firms, when approached, said some of the medicines that were not available in the local market were discontinued by the manufacturers after their cost of production became unbearable for them due to the massive rupee devaluation, an increase in utility service charges, and an increase in the prices of raw material.

“The increase in the prices of medicines in Pakistan is a very touchy and sensitive issue. When we demand an increase in medicine prices as their cost of production has increased manifolds, both the pharmaceutical industry and government are badly criticised. In these circumstances, what other option is left for the industry but to discontinue the production of drugs which are not economically viable for them,” an office-bearer of the Pakistan Pharmaceutical Manufacturers Association (PPMA) told The News on conduction of anonymity.