Drugs

My Icommons article this month deals somewhat inadequately with the issue of access to medicine in the context of drug manufacturing in India. I say ‘inadequately’ because in the course of my daily news-trawlings I come across a diverse range of articles dealing with ‘counterfeit drugs’ and ‘drug rackets’ that are obliquely, but not directly pertinent to the issue of access to medicine.

While I’m dimly aware of there being some connection between International Taxation Laws, Intellectual Property and access to medicine, I’m going to use this article as a placeholder for interesting news clippings until I am able to understand the full significance.

So my newsletter today has two articles that report incidents of confiscation of Ketamine Hydrochloride – a veterinary anaesthetic that is also used as a party drug. Some 10kgs were recovered from a courier package in Chennai and another 25kgs from a passenger travelling to Singapore. The articles mention a significant price differential between the cost of manufacture in India and the drugs’ international sale price.

Last month (Jan 16th?), several leading pharmaceutical companies in the EU were raided by European regulators “in an inquiry into whether they conspired to keep up the price of drugs after patents expired.”
About time too, I think, since I’ve encountered news articles describing “delayed launch” deals between pharma majors and generic companies that have an eerily familiar ring to them. For instance, in the past few months, three generic manufacturers – Sun Pharma, Watson and Dr. Reddy’s Labs – entered into agreements with Novartis to delay “until sometime prior to the expiration of the patents” the launch of their variants of the drug Exelon – used for the treatment of Alzheimer’s disease . In return Novartis would abandon patent litigation that had been instituted against each of them.

Over the past few months, there have been three e-pharmacy related crackdowns reported in the news.

In September a person of Indian origin was convicted for selling Viagra and other drugs illegally in the UK in what is described as “UK’s biggest fake drug racket”. From the news report

Ashish Halai, 33, masterminded the multimillion-pound movement of fake Viagra and other lucrative drugs from factories in China, India and Pakistan into the UK and then on to the Bahamas and the US.

It is unclear whether these were ‘fake’ drugs because they were ineffective or because they were unauthorised reproductions. The MHRA press briefing on the case mentions that the accused were charged with offences relating to Trade Name fraud.

In a second incident, less than a fortnight ago, a joint Indo-US initiative unearthed an “online drug racket” with its operations based in Tamil Nadu. Excerpts from the news report:

Under the joint Indo-US initiative called Operation Cyber chase, the US Drug Enforcement Administration tipped off the Narcotics Control Bureau (NCB), resulting in busting of an online drug racket that has spread its tentacles to Coimbatore in western Tamil Nadu.

The three drugs, Alprazolam, Atrivan and Nitrosun, categorised as anxiolytic drugs, are prescribed for mentally stressed patients to reduce anxiety

A strip of 10 0.2mg Alprazolam tablets costs a mere Rs 7.50 in India, in the US, the over-the-counter cost is an exorbitant $US 125 for 60 tablets

Ramakrishnan traded in drugs that come under Schedule I of the Narcotic Drugs and Psychotropic Substances (NDPS) Act, prohibited from export.

The company did not have the necessary licence either to export the drugs, having registered with the RBI for trading in consumer items alone.

Lastly, the Sanjay Kedia case sometime back involved a person allegedly arranging for the supply of the drugs phentermine and butalbital through a website called “TRUEVALUEPRESCRIPTIONS.COM”. The petitioner’s plea that he was merely a network intermediary, and so immune from prosecution under the IT Act was rejected by the Supreme Court.

The final news clipping in this series describes a fraud committed by two Indian drug firms “duped World Bank and Govt despite layers of checks“.

For seven years, between 1997 and 2004, two pharmaceutical companies, according to the World Bank’s review, sabotaged an elaborate system of checks and balances of both the Government of India as well as the World Bank. Not just in one healthcare project but three — spanning across reproductive health, control of TB and malaria. Ironically, these two companies secured contracts although they had been debarred by the Government in another health scheme — a fact that remained undetected.

Update
20 Mar 2008: 5 kg of ketamine hydrochloride worth Rs. 50 lakhs siezed from a Kuala Lumpur-bound, 23-year-old passenger