Health Ministry in moves to purchase antibiotic despite ample stocks
With regards to the Meropenem 1g, documents show that the MSD received 450,000 new vials during the second week of September, raising its total stock to 566,573 vials as at yesterday morning. Another 300,000 vials have been ordered through Ceyoka and are pending.
The Medical Supplies Division (MSD) has moved to requisition a large consignment of over-priced, unregistered Meropenem antibiotic injections on an “emergency” basis from an Indian manufacturer despite having over half a million vials in storage and still more registered stocks on the way.
The total targeted order of 900,000 vials is valued at over Rs. 1.7bn. A single Indian manufacturer named Gufic Biosciences (Pvt) Ltd and its local supplier, Slim Pharmaceuticals (Pvt) Ltd, are earmarked to be the beneficiaries. Neither is registered with the National Medicines Regulatory Authority (NMRA) to supply Meropenem to Sri Lanka.
Slim Pharmaceuticals in one of the top five companies routinely favoured for waivers of registration (WoRs) from the NMRA. Other manufacturers and local agents registered for Meropenem 1g on the NMRA database are being bypassed.
But after months of controversy over so-called “emergency supplies”, the State Pharmaceutical Corporation (SPC)—through whom the procurement is being attempted—has referred the latest order to the tender board with a request for further instructions.
The SPC Chairman has also flagged the quantities already available; and the fact that other orders from a registered supplier named Ceyoka (Pvt) Ltd are pending. A consignment of 450,000 vials was separately delivered earlier this month.
An attachment to SPC Chairman Dr Ajith Mendis’s letter shows that the standard cost per vial for Meropenem is Rs. 1,262.87. But the order that the Director of the Health Ministry’s Medical Supplies Division (MSD) has instructed him to place orders with Slim/Gufic at the cost Rs. 1,895.50 per vial—a steep difference of Rs. 632.13 from the cited standard price. This works out to a margin of Rs. 568,917,000.
Therefore, without going ahead with the order, Dr Mendis has referred the matter to the tender board. He has additionally asked for directions on a number of other drugs the MSD has requisitioned, flagging that stocks were already available and that there were also pending orders.
The Sunday Times saw documents related to Meropenem. Without full transparency in the procurement of drugs and medical devices, papers related to the other medicines were not immediately available.
With regards to the Meropenem 1g, documents show that the MSD received 450,000 new vials during the second week of September, raising its total stock to 566,573 vials as at yesterday morning. Another 300,000 vials have been ordered through Ceyoka and are pending.
While there had been a tender for Meropenem dated 2022, it was not immediately clear how Slim and Gufic were identified for an order of 900,000 vials.
The antibiotic is usually administered to critically ill patients who don’t respond to other antibiotics and, therefore, requires strict regulation.
The paper trail shows that the MSD Director wrote to the SPC Chairman last month instructing him to double orders for eight high-priced drugs, in a circular titled “Enhancement of Emergency Orders”. This was based on a decision of the ‘Medical Supplies Meeting’ chaired by Health Minister Keheliya Rambukwella and SPC officials on August 21, 2023 at the Minister’s office, he said.
Included in the list was Meropenem. Dr.
Mendis’s subsequent letter to the tender board—the Health Sector Emergency Procurement Committee—reveals that the “enhanced” order was to be granted to Slim Pharmaceuticals “at the same price of LKR 1895.50 per vial as instructed by the Director, Medical Supplies Division”.
The same document states the total price of this order will be Rs. 852,975,000.000. The first order of Meropemen was placed with Slim/Gufic in January 2023 at the same price per vial and the same total amount. The MSD requisition number for this initial tender is 2022/SPC/E/C/00724. It was not immediately clear if this consignment was ever completed.
The MSD Director’s excuse for instructing a doubling of orders for eight drugs is “to enhance the continued supply of the above-mentioned items for emergency orders to avoid an out-of-stock situation”. The SPC is asked to “deliver the enhanced orders as soon as possible”.
Meanwhile, it has been decided at Health Ministry and SPC meetings this week that there will be no more emergency purchases, only annual orders. It was not immediately clear how the latest attempted procurements will fare under the new policy which is likely to be announced at a press conference tomorrow.