Substandard drugs flood Kerala govt hospitals, pharmacies

Medicines used to treat fever, heart ailment, asthma and various infections among those that failed to clear the quality tests at labs.
Image used for representational purposes
Image used for representational purposes

THIRUVANANTHAPURAM: When contracted with diseases including life-threatening ones, lakhs of people, especially those from economically weaker sections, depend on government hospitals, but the bitter truth is that several medicines given to them are of inferior quality. Documents accessed by TNIE showed the drugs used to treat fever, heart ailment, asthma and various infections, and others given to children and pregnant women are among those failed to meet the quality standards.

Based on the drugs controller’s reports on medicines that failed the tests at labs, the health and medical directorates have been issuing instructions to district medical officers to stop their use and distribution. But as the reports often land late, most of these medicines would have been consumed by the patients by then. TNIE examined some of the orders issued by the directorates from April 1 to 3 and found such recalls have become regular. The analytical labs in Thiruvananthapuram, Thrissur and Ernakulam have flagged the use of Paracetamol tablets, Amoxicillin oral suspension, ORS powder, Aspirin gastro resistant tablets, iron and folic acid syrup, Salbutamol sulphate tablet, Cilnidipine tablet, Atorvastin tablet, etc.

Most of them are supplied by the state-run Kerala State Drugs and Pharmaceuticals (KSDP) in Alappuzha. Drugs manufactured by companies based in Belagavi (Geno Pharmaceuticals), Haridwar (Ravian Life Science), Himachal Pradesh (Morpen Laboratories), Jammu (Ravenbhel Healthcare), Faridabad (Nestor Pharmaceuticals) and Haryana (Maiden Pharmaceuticals) figure in the list.

The Kerala Medical Services Corporation Ltd (KMSCL) purchases drugs worth `500 crore every year and distributes them to government hospitals and pharmacies.“KSDP is a major beneficiary of drug purchase by KMSCL. But some of their medicines, especially the commonly used antibiotics, have consistently failed in quality tests. The company does not have buyers other than the state’s health department. In the case of other drug companies, KMSCL is focused more on cost than on quality. As a result, companies which are blacklisted in other states find a market here,” said a health department official.

The KSDP has issued a statement that the company plans to increase production to solve the drug shortage in government hospitals. It has handed over drugs worth `14 crore of the `23-crore order to KMSCL. Doctors in government hospitals are concerned. “No specific study is done on the impact of substandard medicine. Take for example doxycycline, which we largely distribute to prevent leptospirosis. If inferior, it can lead to serious infection and can even be fatal. Economically weaker sections who live in places susceptible to infections suffer the most,” said a doctor.

“If there is no sufficient drug in the tablet, effect will be less. If the binders used in a medicine aren’t good, it could cause allergic reactions,” said Idukki Government Medical College Pharmacology Department head Dr Jayan P S. “We suspect contamination of drugs when we notice an adverse reaction in a patient. We report it to the drug inspector, who takes a sample. It is a time-consuming process and more people might have used the medicine by the time the report comes. However, there have been instances where we withheld the batch supplied. Paediatricians are quick to report such incidents,” said Kozhikode Medical College Pharmacology HOD Dr Seema P Muhamed Ali.

Drugs Controller P M Jayan said labs give quality report of a particular drug even before it is supplied. “Providing the quality report in 60 days is a mandate under the law. Sometimes the drug is checked again based on the complaints,” said Jayan. He said labs in the state have a capacity to test only 10,000 batches a year while the state gets more than 2 lakh batches.

BITTER PILL

Based on drugs controller’s reports on medicines that failed tests, the health and medical directorates issue instructions to DMOs to stop their use and distribution. However, the reports reportedly land late.

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