WHY WE CAN’T STOCK LASSA FEVER DRUGS – PHARMACISTS

FIP WORLD CONGRESS OF PHARMACY – SEVILLE 2020

Nigerian pharmacists say they do not stock the Lassa fever drug of choice, Ribavirin, because it is not a medication for the treatment of “typical day-to-day ailments.”

They said that only the Federal Government that can stock products like that. The pharmacists and operators of pharmaceutical outlets disclosed this to PUNCH HealthWise as Nigeria continues to fight the haemorrhagic fever that has continued to spread throughout the nation.

At least 12 states have recorded over 200 confirmed cases of Lassa fever outbreaks, with about 41 deaths, according to the Director General, Nigeria Centre For Disease Control, Dr. Chikwe Ihekweazu.

Ihekweazu said 89 per cent of the confirmed cases were from Ondo, Edo and Ebonyi states.

Ribavirin is an antiviral medication that is used in the treatment of viral infections, including Lassa fever, Respiratory Syncytial Virus, hepatitis C and some viral haemorrhagic fevers.

It may be recalled that, on January 4, 2016, the World Health Organisation in Nigeria donated 7,000 vials of Ribavirin to Nigeria towards treating cases of Lassa fever outbreak then.

However, many drug outlet operators have expressed their unwillingness to stock it.

Speaking to our Correspondent, Business Head, Vanguard Pharmacy in Ibadan, Oyo State, Mrs. Adedoyin Osho, said requesting Ribavirin in a pharmacy is like asking for drugs to treat Ebola.

“We don’t usually stock such drugs. The reason is obvious. They are often used for haemorrhagic fevers, which are not a day-to-day occurrence except in cases of outbreaks,” she said.

Again, chairman, Association of Industrial Pharmacists of Nigeria, Mr. Ignatius Anukwu, said only the Federal Government can stock products like that.

“It is a risky investment that no pharmaceutical company wants to bear.

“I think what the Federal Government can do is to include emergency funds in its annual budget to stock up antivirals like Ribavirin in anticipation of disease outbreak.

“If the stock expires after three years, it would be an issue for us.”
Anukwu said his company had invested in Ribavirin several years ago, but it stopped doing so because of “some level of losses.”

“The challenge here is that when you order the shipment when there is a serious outbreak, it may take another two to three weeks before it arrives. By then, there is every likelihood that the disease would have been contained.

“You are left with the option of leaving the products in the warehouse for another one or two years in anticipation of another outbreak, which may not occur.

“At that point, you would have incurred serious losses. The truth is that, stocking up Ribavirin, just like most products, comes with its risk. When you ask clients seeking such drug to make part-payment to help ship it for them, they would decline,” he lamented.

Meanwhile, a licensed Superintendent Pharmacist at the Alpha Pharmacy, Cornelius Umanze, said besides not being economically viable, Ribavirin is not an all-season medication.

He noted that even if any pharmaceutical company ventures to bring Ribavirin into the country, there is the hurdle of securing the permit from the National Agency for Food and Drug Administration and Control, which may or may not be granted.

“NAFDAC reserves the exclusive right to either grant you the permit or waive it. Even if you pay to register the permit, how many would you sell to recoup the money?

“It makes no economic sense stocking it. What this also means is that all the foreign exchange you deploy into bringing that shipment would go into the drain,” he said.

On why the average local pharmaceutical companies find it difficult to manufacture drugs like Ribavirin and market them on a large scale, Umanze remarked that the number of patients that would patronise it (with or without Lassa fever) is minute.

Umanze recalled supervising the sale of Rebetol, a brand of Ribavirin, in Alpha Pharmacy in 2003 for N120,000, noting that the pharmacy switched to Ribavirin generics which sold for as low as N4,000 in 2007.

“Yet the drug itself does not have the power of prophylaxis. There is nothing like ‘Take Rebetol, it would prevent you from having Lassa fever. No, it is not prophylactic,” he disclosed.

The licensed pharmacist called on the government to develop a strategy to stock up the drug in such a way that anybody who tests positive to Lassa fever can access treatment within hours.

He noted that Lassa fever has become a recurring decimal in Nigeria since 1969.

“By 2029, we would be talking of 60 years of not having a strategy, or a strong resolution that nobody deserves to die of Lassa or other viral infections in this country.

“This means people are dying from the disease because we are ill-prepared and not necessarily because we don’t know the infections would come,” he said.

Source: The Punch Newspaper

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