Medicine stocks abysmal at Bengal public hospitals

The availability of medicines at West Bengal government hospitals is abysmal, even for drugs that are easily available at private retail counters, says a survey by a prominent consumer rights body.

The survey by the Consumer Unity and Trust Society (CUTS) revealed that medicines obtained from public hospitals free of cost by poor patients are economical but the overall unavailability in this sector nullifies the advantage of free drugs.

The survey found that medicines are readily available from private retail counters but this comes at a price higher than international reference prices, with brand premium for many items.

According to the CUTS survey released in October, the availability of medicines at public facilities during the period of the survey, September to December 2004, was poor with surveyors encountering only 13 of the 32 medicines (40.6 percent) they looked for.

Only amoxicillin 250 mg tablets/capsules showed over 90 percent availability in public hospitals.

The survey found that only four of seven anti-bacterials were available. These were dismal trends for the treatment of bacterial and other infections at public hospitals, the survey said.

Isosorbide dinitrate, which is a very emergency medicine for acute anginal attacks, was not available.

The treatment of epilepsy would not be possible at public hospitals as neither phenytoin nor carbamazepine (or for that matter other antiepileptics) were available.

Diazepam tablets were missing while there were no inhalers for asthmatics and also no drugs to calm acutely agitated psychiatric patients.

The availability was adequate in the private sector, with median availability of 40 percent for IB (innovator brand or patented drugs) medicines, 70 percent for MSGs (most sold generic) and 77 percent for LPGs (lowest price generic equivalent).

Medicines for all therapeutic categories in the survey were available in the private sector, although the innovator brands may be unavailable. On the other hand there was widespread availability of generic equivalents.

“Urgent steps are needed to assess the functioning of the public procurement system for medicines in West Bengal to rectify the situation,” said Dalia Dey, survey manager and one of the authors of the report, along with doctors Santanu Tripathy and Abhijit Hazra.

“Enhancing the efficiency of central medical stores public procurement mechanisms is required,” said Dey.

Tripathy, author of the report and vice-principal cum superintendent of the state-run SSKM Hospital (PG) here, said: “This is a baseline survey in which we have identified the problem but not the reason. Further we need to concentrate on this specific issue only after studying the public distribution system.”

“We don’t have a state-level essential medicine list. We must prepare that to make our procurement more focused,” he said.

The survey followed the World Health Organisation (WHO) and Health Action International (HAI) methodology.