E-drug: Non-availablity of pyridostigmine (Mestinon) in Pakistan
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We are having a serious problem in Pakistan with regard to
non-availability, short supply, and black-marketing of Pyridostigmine
(Mestinon), the only essential drug for Myasthenia Gravis - an acquired
autoimmune disorder that involves a failure in the transmission of nerve
impulses to the muscles.
About 8 months ago Roche, the only manufacturer of the drug (according
to our information) sold this product to ICN (an American pharmaceutical
company) which stopped supplying Pakistan in order to have a price
rise from the Ministry of Health (MoH). Roche was selling it at a price of
approximately USD 1 for 20 tablets of 60mg. Reportedly, ICN wanted to have
three to four times that price, otherwise it would not market it. There was
a sort of stand-off between and ICA and MoH although there are reports now that
both parties have finally agreed on a price, which has not been made public
yet but which is closer to the industry's demand.
Meanwhile the patients with MG have been suffering for want of the drug.
Although, on request from a local NGO (Pakistan Myasthenic Welfare
Organization) Roche provided them with some supply of the drug which this NGO
has been providing to the patients registered (more than 4000) with it, many
patients, not knowing about the organization are facing serious difficulties
as no drug means severe muscle weakness which can even lead to death. The
organization has a short stock anyway.
I have two questions to E-Druggers:
1. Is it true that Roche and now ICN is the only producer of Pyridostigmine
(Mestinon)? Information about any generic synonym in the world would be very
helpful. Also, does anybody know that any not-for-profit international
supplier can provide this drug to an NGO here, e.g. IDA, UNICEF, Echo.
2. Can people on this list share with us the price of the drug in their
country? It would be helpful for us and also for the MoH to have this
information.
Thanks in anticipation.
Dr. Zafar Mirza
Executive Coordinator
TheNetwork for Rational Use Drugs in Pakistan
(Association for the Rational Use of Medication in Pakistan)
H.No. 60-A, Str. 39, F-10/4, Islamabad
Ph. 281755; Fax. 291552
zafar@arump.sdnpk.undp.org
[Note from moderator: Price in Norway would be about 18 cents per 60 mg
tablet. We only have the Roche product (small market). I don't know of any
other supplier. Kirsten Myhr]
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