The Central government’s recent notification banning the production and retail sale of Oxytocin in the private sector and entrusting a single public sector unit, Karnataka Antibiotics Pvt Ltd (KAPL), to produce and supply the drug for the entire nation, is all set to snowball into a major crisis in labour rooms across the country.
Oxytocin is a life-saving drug widely used in labour rooms and recommended by the World Health Organisation (WHO) for the management of postpartum haemorrhage, one of the causes of maternal mortality in the country.
Till now, gynaecologists and obstetricians, especially those in the private sector hospitals and clinics, have been agonising over the anticipated shortage of this essential drug and the spectre of more mothers bleeding to death in labour rooms.
It now emerges that the new price fixed for Oxytocin by KAPL, the sole manufacturer of the drug, can also seriously bleed the health budgets of State governments and private sector hospitals in the country. Oxytocin used to be a cheap drug, widely available in the open market in 28 brands and 22 generics. Maharashtra was purchasing the drug for ₹4.82 (five iu/vial); Kerala was procuring it at ₹5.90/vial and ₹9.25 (10 iu/vial).
“According to the information we have received from KAPL, the new price of Oxytocin will be ₹17.78 / vial (₹15.58 +12 % GST), which is unacceptably high and could seriously upset the budgets of small hospitals. Also, KAPL says that the minimum order quantity should be 1,000 ampoules, which might be difficult for small nursing homes,” according to gynaecologists.
“Pitocin, manufactured by Pfizer and a popular brand preferred by gynaecologists, was being sold at ₹13.77/vial for hospital supply and at a lesser rate for bulk purchase. It is unbelievable that an essential drug which used to be cheap even in the private pharma sector, has been made the monopoly of a single PSU and that hospitals are now expected to procure it at the highly exorbitant price of ₹17.78/vial. We cannot bargain with the lives of mothers,”says K.V. Babu, a Kannur-based physician and public health activist.
Concern over quality
Gynaecologists’ community also point out that KAPL is manufacturing Oxytocin for the first time and wonder if it is expected to take the quality and efficacy of the drug for granted.
“Though we have got a breather till August 31, we cannot purchase in bulk as Oxytocin cannot be stored in room temperature. Kerala’s annual requirement of the drug is estimated at 15-20 lakh ampoules (5 iu/ml) and it remains to be seen if KAPL can supply the drugs to all hospitals maintaining cold chain conditions,” says V. Rajasekharan Nair, a senior obstetrician-gynaecologist consultant.
Kerala Medical Services Corporation Ltd. (KMSCL), which procures Oxytocin for public sector hospitals, had placed orders for 1,57,870 (10 iu) ampoules and 6,57,675 (5 iu) ampoules. About 50% procurement had been completed when the ban order was effected.
“We do not anticipate an immediate shortage. While KAPL has agreed to meet our requirement in two schedules, this is an important drug and we are worried about the logistics. We are yet to receive an offer letter but the price difference is huge and can hit our budget hard,” a senior KMSCL official said.
