NCI given green light to directly procure its own drugs

As crippling dearth hits cancer patients


by Suresh Perera

The National Cancer Institute (NCI) has been given the green light to directly procure oncology drugs as the continuing tug-of-war between some importers has led to a critical dearth of certain life-saving pharmaceutical products, a senior health administrative official said.

"With the go-ahead, we have developed a new methodology to purchase all the vital cancer-related drugs required for patients under treatment", says Dr. Kanishka Karunaratne, NCI’s Director.

The coast is now clear for Sri Lanka’s biggest government-owned oncology facility at Maharagama to determine and directly access its own requirements, medical officials said last week.

This move comes in the wake of the recent cancellation of a multi-million rupee tender to procure drugs to treat patients suffering from advanced breast, lung and pancreas cancer, they noted.

This is the first time the NCI has been permitted by the Health Ministry to purchase stocks, which will eliminate inordinate delays and ensure timely medical treatment to cancer patients, Karunaratne stressed.

Under the new system, the NCI will computerize all stocks and make direct procurements, as required, he explained. "Through this process we can purchase good quality, time tested drugs".

Asked how the ‘cold war’ between certain suppliers would reflect on direct procurements, the director replied, "All that is expected to be sorted out soon".

The prevailing grave dearth of some oncology drugs – the negative fallout of the abrupt cancellation of the tender by the Director-General of Health Services (DGHS) — has resulted in many deaths and the prolonged agony of cancer patients, the officials asserted. "People continue to suffer and die".

It all began following a conflict over an Indian-made cancer drug registered for bids under the controversial "fast track system" drew vehement protests from the Sri Lanka College of Oncologists, which insisted on a comprehensive evaluation for its safety, efficacy and quality prior to considering procurement.

Earlier, Abraxane, a time-tested product from USA, was used on patients with advanced breast, lung and pancreas cancer, but supplies remain disrupted with the tender cancelled in the backdrop of another local supplier offering an Indian generic oncology drug at a relatively competitive price, the officials pointed out.

"Our product, which comes from India’s third largest bio-tech company, was adjudged the Best Pharma Product 2011 at the Bio Spectrum Global Awards", the supplier asserted. "As a US FDA and EU Germany approved drug, it has been in use since 2011".

He said the dossier on this product was sent to the Health Ministry in November 2013, but it was not known why it was not forwarded to the College of Oncologists for five months. "I had written to them five times in this regard".

But oncologists have taken up the firm position that pricing is not the sole criterion for procurement as the safety of patients is top priority. "They may be costly, but we need proven, time-tested drugs".

The Sunday Island learns that the dossier on this Indian drug has now been forwarded to the Sri Lanka College of Oncologists for evaluation and clinical trials.

"Yes, we have received the dossier from the Medical Supplies Division (MSD) and the due process is now underway", said Dr. Mahendra Perera, President of the College.

This task cannot be done overnight, he noted. "We will need a maximum of three weeks to complete the whole process".

The Consultant Oncologist explained that during the process of evaluation, it is standard procedure to also look at all aspects — the manufacturers, available literature, clinical trials and the use of the drugs in the respective countries.

Perera also serves as the Chairman of the Technical Evaluation Committee (TEC) on oncology drugs.

Asked to what extent NCI’s direct purchase of oncology drugs will benefit patients, he said that it is a matter outside his purview.

The disruption of supplies has spurred Health Secretary, Dr. Nihal Jayathilake to appoint a comprehensive board of experts comprising oncologists and pharmacologists to evaluate and recommend procurements on government tenders.

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