• Apeksha Hospital depends mostly on donations by local and int’l donors
• Receiving donations for meds in short supply, but need more donations: Dr. Jayatilake
• Medicines vital for survival including cancer meds out of stock: Gankanda

 “Life is uncertain, but how can that be decided by the weaknesses of our rulers,” Samanthi Premalatha, a mother from Polonnaruwa, laments while waiting for a vital medicine that can help her 17-year-old son who is battling cancer at the Apeksha Hospital in Maharagama.  

As she waited for the third consecutive day, she still had hope that her husband would somehow find the medicines and bring them as soon as possible to treat their only child, who had been admitted to the hospital two weeks ago due to a sudden onset of rapidly spreading, rare cancer.

“All I have is hope,” she continued. “This is not a rare medicine, but it is now out of stock. We checked almost all pharmacies and hospitals in Colombo. However, we still couldn’t find it,” the distraught mother said.

There are many such stories of patients and their loved ones eagerly waiting for medicines. Several others who are also facing a similar plight spoke to The Sunday Morning regarding the heartbreaking wait they had to endure.

While many have succeeded in getting medicines from private pharmaceutical companies, the prices of these drugs have increased significantly, making it extremely difficult for most patients to purchase from private pharmacies.

“What is most important is my father’s life,” another guardian of a patient waiting for chemotherapy at the Apeksha Hospital told The Sunday Morning.

“We struggled a lot to find one vital drug last week. The price of the drug in the outside market is around Rs. 124,000. We somehow found that drug and purchased it after pawning my mother’s jewellery,” he shared.

A severe shortage of essential medicines is not a new phenomenon in the country given that this situation has prevailed for the past several months as the Government has failed to properly address the shortage by supplying sufficient drugs to the local market to meet the demand.

However, unlike other medicines, the cancer medicine shortage poses a serious threat as almost all medicines, except a few that were being used as painkillers, are important lifesaving ones due to the sensitive nature of the disease.

The Sunday Morning learnt that a number of key cancer medicines were now out of stock and even the import of several medicines had now been delayed due to the unavailability of necessary funds in the midst of the severe economic crisis.

Apeksha running on donations

“All cancer medicines are important and vital for the survival of patients. As of now, we are managing mostly with donations,” Apeksha Hospital Director Dr. Aruna Jayatilake told The Sunday Morning in an exclusive interview held at the hospital premises on Thursday (2).

Explaining the severity of the situation, he said the hospital welcomed donations of any category, especially of medicines that were in short supply.

“We are managing for now and there is no major shortage of medical equipment. We are receiving donations of medicines that are in short supply, but we need more donations,” he stressed, adding that the hospital was in urgent need of more donations.

He said that those who wished to donate to the Apeksha Hospital could contact the following numbers for any information: 0777468503 or 0112850252, ext. 1629.

When asked about the vital medicines that were in short supply, Dr. Jayatilake noted that the availability of meds could vary day by day. “One medicine that is available today might not be available the next day. That is why we need continuous assistance,” he said.

However, The Sunday Morning learnt from the Director that the Apeksha Hospital now depended mostly on the donations given by local and international donors.

“We can manage the hospital functions, but the situation of cancer wards operating in regional hospitals is worse,” he stressed.

Confirming what was said by patients, a senior consultant medical doctor, who wished to remain anonymous, told The Sunday Morning that he had personally informed the patients of the medicine shortages before starting treatments, as most patients cursed at the doctors if anything negative befell their loved ones midway through the treatment process.

“Cancer is a very sensitive area in the health sector and therefore, it is very important to provide an uninterrupted supply of medicine,” the doctor noted, adding that those who had money and power survived while poor patients suffered due to the shortages.

Dr. Jayatilake further noted that while the hospital had received certain types of medicines from the Medical Supplies Division (MSD), most medicines had been from donors.

Govt. ignoring healthcare sector

Meanwhile, when The Sunday Morning contacted All-Island Private Pharmacy Owners’ Association (AIPPOA) President Chandika Gankanda, he alleged that the medicine situation in the country had worsened due to the Government ignoring the sector.

“The number of medicines that are vital for the survival of most patients including cancer medicines have now gone out of stock and the situation is very dangerous,” he alleged.

He explained that as of Thursday (2), the commonly available Jeevanee (electrolytes) was almost out of stock.

“Imagine not being able to find Jeevanee at a local pharmacy. Most medicines including antibiotics, painkillers, and vital medicines necessary to treat mental diseases, kidney patients, heart patients, and cancer patients have already gone out of stock,” he stressed.

Highlighting their names, Gankanda said that medicines such as methylphenidate, chloral 1 g, phenobarbitone IV, oral penicillin, piriton IV, Jeevanee, warfarin 5 mg, thiamine, paclitaxel IV, and some cancer drugs including fluorouracil injection, ifosfamide 1 g, cisplatin 50 mg, metoclopramide, and carboplatin 450 mg IV were no longer available in the country.

“This is a very serious situation,” Gankanda stressed, adding that it was a life-and-death situation for most patients and that the medicines needed were important for the survival of any patient, except in the case of some of the painkillers. “It is the duty of the Government to provide an uninterrupted supply,” he asserted. 

SPC laments delay in Indian LOC 

State Pharmaceuticals Corporation (SPC) General Manager Dinusha Dassanayake acknowledged the shortage and claimed that there were certain cancer medicines amongst the currently unavailable medicines. 

“There is a shortage of some name-patented medicines too,” he revealed.

“All 14 lifesaving medicines are currently available. There are shortages of other essential drugs including cancer drugs. We are expecting several stocks but are still waiting due to shortages,” he shared.   

However, commenting on the situation in terms of the medicines being received through the Indian Line of Credit (LOC), a highly-placed source said there had been a delay due to certain issues regarding the opening of Letters of Credit (LCs).

Minister confident of resolution

Meanwhile, when asked about the shortages, Health Minister Keheliya Rambukwella admitted that there was a shortage of cancer drugs and that a lot of donations were being received at the same time. However, he was confident that the current shortages would be sorted out within the next three weeks and that 90% of the entire drug shortage would be sorted out during the first quarter of this year.

“A lot of donations are coming to the cancer hospital. We have expedited the Indian credit line and now we have deviated from the normal practice where 18 approvals had to be obtained for one tender. When the issue was raised, the President gave orders to do away with all these unnecessary approvals. Hopefully within the next two to three weeks we should have sufficient medicines for the cancer hospital,” the Minister said.  

Rambukwella added: “At the same time, we have a problem with some of the colleges as some doctors refuse to use available substitutes. If we take oncology for example, some doctors are not willing to use substitutes and we cannot also challenge it as it is the responsibility of the doctor. If we say instead of ‘Y’ drug, you can use ‘X’ drug, they will turn around and say ‘you’re not the doctor, I’m the doctor and it is my responsibility to look after my patient,’” he stressed.

“Each treatment might have three different drugs. One might be Rs. 25,000, another might be Rs. 10,000, and a third Rs. 5,000. Doctors might prescribe Rs. 25,000 drugs whereas Rs. 10,000 drugs are available. Those are the issues that we have to gradually sort out. As I promised, within the first quarter, I think 90% of the shortages will be sorted. As of now, we have made requests from colleges to manage with what is available,” Rambukwella said.

Medicines in short supply as of 2 Feb. at Apeksha Hospital 

Inj oxaliplatin 100 mg, docetaxel 80 mg, daunorubicin 20 mg, vinblastine 10 mg, cyclophosphamide 1 g, methotrexate 1 g, carboplatin 450 mg, irinotecan 100 mg, 5-fluorouracil 1 g, cisplatin 50 mg, clindamycin 300 mg, amikacin 500 mg, vancomycin 500 mg, gentamicin 80 mg, levofloxacin 500 mg, cefotaxime 1 g, ceftazidime 1 g, acyclovir 250 mg, piperacillin with tazobactam 4.5 g, teicoplanin 400 mg cap, lenalidomide 5 mg/10 mg, imatinib 100 mg/400 mg, tab co-trimoxazole 480 mg, ciprofloxacin 250 mg, and cefuroxime 500 mg.