Drugs shortfall solution sought

The Health Authority-Abu Dhabi is launching an online programme to manage drug shortages in the emirate.

ABU DHABI // Drug distributors, public and private hospitals and all pharmacies will be required to provide monthly updates on what medications are available on shelves, so that drug shortages can be avoided.

The mandatory monthly reports will be used to populate a database of available medications on the website of the Health Authority-Abu Dhabi (Haad) from next month.

"The problem of drug shortages is present worldwide, for various reasons, even in those countries where drug manufacturing companies exist," said Dr Mohammed Abu Elkhair, section head of drug and medical products regulations at Haad. "We are not immune here, neither in the UAE or in Abu Dhabi emirate, but it is our responsibility to find as many solutions as we can," he said.

A Haad-led survey among pharmaceutical providers in 2008 and 2009 revealed that of the 7,039 medications registered in the country, only 4,036 were routinely available, according to Dr Abu Elkhair.

Although the survey is now two years old, it is still representative of the current situation, he said, as there has been only a slight increase in drug registration since then, with 7,226 medications currently registered.

The results of the survey illustrated that "this is a very critical issue", said Dr Majdolin Abu Musallem, an import and export drug regulation officer at Haad.

"Our biggest concern is when there is a shortage of life-saving, essential medications that have no alternative, where the unavailability of the medicine can lead to the death of a patient," she said.

Such incidents did happen, said Dr Abu Elkhair, citing the example of a patient who died last year in Al Gharbia because the hospital did not have Dantrolene, an antidote to hyperthermia or high fever.

"The patient was at the dentist, and after being given an anaesthetic, the doctor discovered that the patient was allergic to the anaesthesia. The antidote, Dantrolene was not available, and no alternative was present, so the patient unfortunately died of complication," said Dr Abu Elkhair.

Another shortage is in psychiatric and narcotic medications, said Dr Abu Musallem, many of which are new and not yet registered.

"With the increase in psychiatrists and in diagnosis, there is a larger demand for medications, and yet we still face problems because importing psychiatric and narcotic medication takes a long time and the profit is not big enough for the distributor," she said.

Today in Abu Dhabi, there are at least three registered medications, all life-saving and considered essential, that are not available. Warfarin 1mg, an anticoagulant used to prevent strokes, is only available in 3mg or 5mg, and patients must cut their pills in order to take the lower dosage, which is "very dangerous", said Dr Abu Musallem.

Glucagon injections, used by diabetics in case of a sudden drop in blood sugar, are also unavailable.

"This is why we wanted to launch this online tool, so that we can look ahead, see what medications have alternatives and what don't; see the trends of market history to know what drugs are more likely to be in shortage," Dr Abu Elkhair said.

Instead of addressing a shortage after a doctor, hospital or patient files a complaint, Haad hopes the monthly reports will help shortages.

"We recently had a case of a patient in Abu Dhabi visiting three or four pharmacies looking for Noortropil 800mg tablets, that he later found in Dubai," said Dr Abu Elkhair.

"Our programme will help map out exactly where medications are all over the country, so a patient or doctor knows where to go."

Through monitoring the online reports, Haad will be able to advise hospitals and pharmacies on the availability of alternatives, restrict the use of drugs in short supply, monitor usage and resupply, facilitate the import of drugs across the region, and, when needed, make them available in Abu Dhabi.