Local pharma cos entering cancer drug manufacturing at a slow pace

Country's pharmaceutical companies are reluctant to manufacture cancer drugs considering the Bangladeshi market a small one, even though the number of cancer patients is on the rise.
Experts and pharmaceutical industry insiders have attributed the high prices of cancer drugs to overdependence on imported raw materials. Also arbitrary service charge of various therapies by the private hospitals makes the cost of cancer treatment higher.  
Many patients and their family members have alleged that there is misuse of chemotherapy in the country and wrong treatment has also limited the market to a great extent as people have lack of confidence.
National Institute of Cancer Research and Hospital (NICR&H) director Dr Moarraf Hossain told the FE that even five years ago, 100 per cent drugs were imported and some were brought into the country illegally.
He said Beacon Pharma and Techno Drugs have been manufacturing 90 per cent of the total locally-produced cancer drugs, both oral and injectable, and fulfilling demand for more than 50 per cent. Some other companies like General and Beximco have been manufacturing such drugs on a limited scale, he added.      
Prices of cancer drugs have decreased to a great extent due to locally manufactured drugs.
"About 250,000 new cancer patients are detected every year, but only 50,000 come under treatment. Earlier, an injectable chemo which would cost Tk 25,000 to Tk 30,000 is now available at Tk 7,000 to Tk 8,000 locally," said Dr Moarraf.   
Now Food and Drug Administration (FDA) of the USA has been giving permission for production of bio-similar drugs that will cost about half the price of original drugs. If bio-similar drugs come to Bangladesh, the cost will come within the reach of the Bangladeshi patients.
The prices of many cancer drugs will come down to one-fourth of the original prices, once the patent right is phased out, Dr Moarraf added.   
He said radiotherapy for breast cancer patients is Tk 14,200 at NICR&H. The same treatment costs Tk 150,000 to 300,000 in a private hospital.
Beacon Pharma sales manager Dr Mahbubur Rahman said many pharmaceutical companies are not enthusiastic about manufacturing cancer drugs as they find the market quite small and the lack of people's capacity to buy the high-priced drugs.
He said the cost of locally-produced drugs is much less than those manufactured in the developed countries. The market is still unregulated here, he said, adding that 20 per cent of the total drugs available here are illegal.
"The prices of Indian cancer drugs are cheaper, but the country is a haven of most substandard cancer drugs. That's why those don't get approval," said Dr Mahbub.
He advised the patients to notice the Drug Administration (DA) registration number and MRP seal before buying any cancer drug.
Seeking anonymity, a DA official said Indian drugs don't have certification of seven developed countries including the UK, the US, Canada, Japan, Singapore and Switzerland for which Bangladesh doesn't give permission for importing Indian drugs.
DA director (current charge) Ruhul Amin said comparatively prices of Bangladeshi cancer drugs are cheaper. As the companies import raw materials, the prices become higher for poor patients, he added.    
In Bangladesh, cancer is the second deadliest killer in the non-communicable disease category and the scope for being exposed to various cancerous elements is increasing day by day.
Lack of confidence is also common in case of diagnosis and taking treatment here as most of the physicians maltreat patients by advising wrong diagnosis, resulting in deterioration in cancer situation.
Mr Abdul Karim (80) was diagnosed with esophageal cancer in 2013 at stage 2 at Square Hospital in Dhaka. He was moved to Bumrungrad Hospital in Thailand for further investigation.
After receiving the same result in Thailand, the family went to Tata Hospital in India for treatment plan. The patient had to take radiotherapy five times a week and saline chemo in every 21 days along with four oral chemos the same day.
He also had to take neofil injection for increasing white blood cell (WBC). All these treatments required a huge amount of money every month.
Mr Karim's son said they always preferred foreign chemo for his father, although it was costlier compared to that of local chemo.
"We have gone to Thailand for diagnosis two times and treatment in India six times as we have lost our confidence due to various stupid advices by doctors and their greed for money and ignorance about the disease," said his 45-year-old son.
Regarding the treatment, Dr Moarraf Hossain said sometimes surgery is done for treating some cancer types. But chemo is also used considering there is chance of spreading it in other lymph of body.
"More than 50 per cent cancer patients need chemotherapy as there is chance for the cancer to return," he said.
Drug sellers said people having money don't use locally- manufactured cancer drugs despite availability and lower prices largely due to lack of confidence.
An assistant manager of ABC Pharma at Green Road said they keep chemo of Beacon and Techno company and few foreign cancer drugs except for Indian drugs.
The demand for cancer drug is increasing day by day as they now sell two or three chemo every day which was earlier one or two in a week, he added.
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