A LEADING Nicosia gynaecologist yesterday lambasted the Health Ministry for failing to secure sufficient quantities of a drug used to stop premature labour in pregnant women.
Dr Andreas Papapetrou told the Cyprus Mail the tocolytic agent ritadrine had been out of stock for the past two to three weeks, jeopardising the welfare of unborn babies.
“Women need the drug and instead of being able to give it to them we are forced to look for alternative solutions,” he said.
Tocolytic agents can inhibit labour, slow down or halt the contractions of the uterus. They are widely used today to treat premature labour and permit pregnancy to proceed, thus allowing the foetus to gain in size and maturity before being born.
Up until two years ago ritadrine had been available at private pharmacies, but following the Health Ministry’s introduction of a new pricing policy as well as new procedures it had adopted to approve new medications it was is now only available at state pharmacies.
Makarios hospital, which usually suppliesd the drug, yesterday confirmed it was out of stock and were expecting more sometime after Easter. In the meantime it could provide pregnant women with ritadrine injections.
“This business of being in and out of stock from one month to the next has been going on for about two years,” said Papapetrou, who is also a United Democrats parliamentary candidate.
“What are we supposed to tell expectant mothers? ‘Hold off on those labour pains for another two weeks because that’s when the drug will next be available?’
“ They need it now before it’s all over.”
He said many women had come to him in need of ritadrine in the past two weeks and alternative solutions had had to be found. Some went to Greece to buy the drug and others were admitted to private hospitals or clinics and put on a drip, he said.
“We still have some of the same medicine, in stock in intravenous form due to the large quantities we purchase as private clinics. Nevertheless these supplies are also starting to run out.”
When he was told the Pharmaceutical Services said they had only recently placed another order for ritadrine, Papapetrou said: “They are always placing orders. The point is they don’t order enough to cover the needs of the population… We are out of stock. Why?
“Because with this new medicine policy the drugs no longer come here. The government imported the drugs twice but the stock lasted for a month and then they were out of stock again and who cares?”
The Health Ministry has repeatedly come under attack from doctors, private pharmacies and pharmaceutical companies regarding the question of importing medications. Criticisms include delays in placing orders, drug supply shortages and the loss of popular brand names from the market after applying its low pricing policy to already low priced as a result of the systematic under-pricing of medications.
Acting Pharmaceutical Services head Panayiota Kokkinou said: “Ritadrine is only used in the private sector. It has not been authorised for use in the state sector.
“Instead wWe have an alternative solution for the same treatment in the form of the active ingredient salbutamol of which we have copious amounts in stock. However because doctors have specified the importance of this drug – ritadrine – we purchase it, and then it can be bought from the state by the private sector,.”
acting head Panayiota Kokkinou told the Mail.
But Papapetrou said salbutamol – a bronchodilator used for the treatment of asthma, chronic bronchitis, and other breathing disorders – was less effective than ritadrine.
He said: “Ritadrine has much more specific action on the muscle of the uterus. Salbutamol is not a tocolytic agent… It has some effect on the uterus but is not as specific as the other (ritadrine).”
He added: “When they import drugs can they not calculate the country’s needs and cover those needs for six months or a year? They bring the drugs just to show that they have and to shut us up by saying the medicine’s here and when they run out, – tough… It is a Health Ministry, not an Agriculture Ministry and they are responsible for the health of these people.”
But Kokkinou said the state could not be expected to stock large supplies of a drug which was only used in the private sector.
“What if it’s not used? We can’t act as reserve just because doctors complain once in a while. We purchase small amounts to cover the need. If large orders are necessary they should make the request in writing… We do not feel patients are endangered,” she said.
Asked what happened if a pregnant woman was allergic to salbutamol, Kokkinou said her doctor should inform the Pharmaceutical Services and the drug would be supplied without interrupting her treatment.
Easter in labour – and in hospital
Twenty-six-year-old ANNA TSAMPALIS is lying in a clinic bed with a drip in her arm until her gynaecologist says it’s safe for her to give birth.
She The 26-year-old has been there since last Thursday and due to the drug shortage will be spending Easter there too.
Her husband Tasos, 36, told the Cyprus Mail his wife had been prescribed ritadrine by her doctor on Tuesday but that he had been unable to find the drug anywhere.
He said: “She was put on the drip because she had not yet entered her ninth month (of pregnancy) and it was important to hang on to the baby so that its lungs could develop more. The doctor then decided she could take the capsule form of ritadrine so that she could be more relaxed, move about more, and have a shower. However when I went to the general hospital they didn’t know what the drug was and when I went to Makarios hospital, they knew what it was, but said they were out of stock.”
Due to this shortage Anna’s doctor was unwilling to take his patient off the drip until next week at least when was safer to give birth, said Tasos.
Tasos said: “On Sunday she entered her ninth month and her doctor said that next week he might take her off the drip and let her have the baby. We’ll have to see.”
Because this is the couple’s first child they don’t know how to react about not finding the drug which would make their life easier.
“Unfortunately she won’t be out for Easter but since we can’t find the capsules we don’t have much of a choice; she’ll have to stay on the drip.”
