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Extensive chronic medications headache

Cape Town – A shortage of inter alia, a hormone replacement pill for which there is no substitute, an antidepressant and a blood pressure pill are related to a licence transferred late last year from Adcock Ingram to another pharmaceutical company.

Sake24 has investigated complaints about various products which Adcock previously distributed and which people have been unable to get hold of anywhere. Pharmacists have also complained about poor communication about the shortage.

Adcock referred some of the enquiries to MSD, a subsidiary of global pharmaceutical company Merck & Co.

The list of products is as follows: Adco-Atenolol, Adco-Zopimed, Covomycin, Covomycin D, Livifem, Mayogel, Medigel, Mercilon, Remeron, Synapause vaginal cream and Synaleve.

Livifem is a hormone replacement product used by menopausal women and for which there is apparently no available alternative.

Adcock Ingram spokesperson Dudu Ndlovu says the licence and marketing of some of these products was transferred to MSD, the original manufacturer, in the fourth quarter of 2011.

MSD head of communications Dorothy Mwangu said Adcock previously had a cooperation agreement with Organon BioSciences in the Netherlands to manufacture certain of its products locally.

These included women’s products like Livifem, Marvelon, Mercilon and Synapause.

In 2007 Organon BioSciences was taken over by Schering-Plough, which merged with Merck & Co in 2009. As a consequence Schering-Plough’s products had to be registered to Merck, and in August these became MSD products.

According to Mwangu, certain global procedures have to be followed when a product is transferred from one pharmaceutical company to another before marketing is allowed to proceed.

These include changes to the packaging and labels, as well as quality control issues.

She said the result was a shortage of these products for about five months, and she declared that the healthcare sector had been informed.

Livifem is already back on the market, she said.

Complaints from women who were suddenly unable to obtain the products streamed into consumer website Hellopeter.com.

In November “Gloria” declared it scandalous that Adcock had withdrawn the essential hormone replacement product without any warning. She had used it for 10 years and could not find a substitute.

MSD believes that by the end of April or early May Marvelon, Mercilon and Synapause will again be available.

Challenging environment

As for the antidepressant Remeron, Mwangu said they were still liaising with the Medicines Control Council to have its relaunch approved. “We expect this to happen only early in 2013.”

Ndlovu attributed the shortage of Adco-Atenolol, Adco-Zopimed, Covomycin, Mayogel, Medigel, and Synaleve to a lack of raw materials.

She believes this and the scarcity of finished products is an unavoidable problem for a pharmaceutical enterprise of its size, which is often influenced by the South African market being so small in a global context.

She said letters have been sent to doctors and pharmacists about the products, as well as when they will again be available. “Wherever possible, clients have also been advised of alternatives.”

She said legislation prohibits public communication about prescribed medicines.

The South African pharmaceutical industry has had a fairly difficult year.

According to Investec Asset Management portfolio manager Neil Stuart-Findlay, much of the industry has been affected by regulations on single-exit pricing, in terms of which the minister of health determines price rises on certain products each year.

Prices did not go up last year and for this year a small increase of just over 2% was all that was permitted.

Stuart-Findlay said industry players had had little scope to raise prices last year, while operating costs such as wages and electricity prices had continued to go up.

The weaker rand late in 2011 had also inflated the prices of imported products. “It was no surprise that operating margins were put under pressure,” he said.

He said Adcock Ingram had also experienced these problems and discontinued some products. The consumer environment was also more difficult with regard to over-the-counter products, with consumers buying fewer or cheaper items.

As a consequence Adcock’s share price had remained around R60 for the year.
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