Contracted drug companies to make up ARV shortfall

THE National Health Department has contracted extra pharmaceutical manufacturers to address the critical shortage of the antiretroviral tenofovir across the country.

HIV clinicians and doctors warned last week that tenofovir being continually out of stock, and the failure to advise health workers on how to deal with it was a looming disaster.

Reports of stock-outs go back as far as October last year.

The explanation given is that the drug suppliers Aspen Pharmacare and Sonke Pharmaceuticals were not able to meet the demand.

It emerged this week that the department had directed provinces to order tenofovir from two additional suppliers.

Dr Anban Pillay, cluster manager for Financial Planning and Health Economics in the National Health Department, confirmed that Adcock Ingram Pharmaceuticals and Cipla Medpro Pharmaceuticals were now also supplying tenofovir to provinces.

Aspen Pharmacare and Sonke Pharmaceuticals were initially contracted to supply tenofovir to the public sector antiretroviral programme, but they have struggled to meet the demand.

“The split between Aspen Pharmacare and Sonke is 70-30, meaning 70 percent of the volume comes from Aspen and 30 percent from Sonke. But Sonke hasn’t been able to ramp up its production to meet demand,” Pillay said.

The department estimates that tenofovir is dispensed to about 1.2 million patients a month. Aspen Pharmacare was only able to increase its production to the 70 percent tender requirement in recent weeks.

With Sonke Pharmaceuticals not being able to supply its quota of the tender, supplies from Aspen were not enough, resulting in the shortage.

Production of the drug has now started to improve with Aspen Pharmacare ramping up its production since April and now providing more than 1 million tenofovir units a month.

Sonke, however is still unable to make a significant contribution.

“(Sonke) is able to produce about 200 000 units maximum a month. The operation is very small and it’s more difficult to get a sense from Sonke of what its actual supplies have been month on month,” he said.

Stavros Nicolauou of Aspen Pharmacare said the company was committed to meeting the increased demand.

Sotse Segoneco, chief executive of Sonke Pharmaceuticals, failed to respond to requests for comment.

Mark Heywood, director of Section27 and executive member of the Treatment Action Campaign, said the drug manufacturers were not entirely to blame for the shortage. Some blame should be laid at the door of the Health Department.

“The suppliers are part of the problem, but the scale of the antiretroviral programme has grown immensely with 600 000 people newly enrolled.

“The Health Department is the custodian of this programme. It should identify and address the problem before it escalates.”