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Albumin drug paucity leaves patients in the lurch

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 The entire country, including Mumbai and Pune, are reeling under an acute shortage of a life saving drug – Human Albumin Serum. The paucity of the drug has been persisting for the past three months in pharmacy stores of hospitals. Also it is not available with most wholesalers, distributors or retailers. Families of patients have been running from pillar to post to procure the drug.

What is Human Albumin Serum?

It is a protein in human plasma of the blood which is produced in liver. It maintains levels of calcium in the body and transports nutrients or drugs effectively in the blood stream. The body can suffer a shortage of albumin if a patient is affected by liver disease, kidney failure, burns, malnourishment. After any supra major surgery such as a kidney or a liver transplant the body does not produce adequate albumin. Transfusion of human albumin is required in process of healing or to reduce water retention and swelling conditions caused in the body due to an infection or a disease.

How is scarcity of Human Albumin Serum putting lives of patients in a lurch?

When 55-year-old Savita Pradhan (name changed) was in critical need of albumin, it was hard for her relatives to procure. She was admitted to private-run Kaushalya Hospital in Thane after she suffered a bout of Viral Hepatitis. "The hospital was in no position to procure Albumin. Their in-house pharmacy store did not have stocks. Neither did any chemist shop had it. A few well wishing chemist shop friends from Parel procured it from a shop near KEM Hospital in Parel for us," said Anand, a relative of the Pradhan's.

How severe is the shortage of Albumin in city hospitals?

While small hospitals, nursing homes and distributors have run out of supplies in India, major hospitals have started feeling the heat recently. In near future, doctors fear they will run out of stocks entirely.
The largest civic-run hospital in Mumbai, KEM in Parel is rationing stock of Albumin. At least two to three liver patients in KEM require a daily dose of 1000 ml worth Albumin every day. "We are using our stock of Albumin very judiciously as there is an acute shortage. The pharmaceutical companies which manufacture Albumin have stopped supply in domestic stores," said Dr Chetan Kantharia, liver transplant surgeon at KEM Hospital.

What is the situation in private hospitals?
For the past one week, private-run Global Hospital's in-house pharmacy in Parel does not have stocks of Albumin. "The store in-charge called me and informed me of the shortage. In kidney transplants, when the blood group of the donor and the recipient does not match, plasma content in the recipient's blood has to be drained and albumin has to be transfused so that the donated kidney may not be rejected," explained Dr Bharat Shah, nephrologist at Global Hospitals.

Why triggered the shortage?

The prices of 50 ml and 100 ml Albumin vials have been slashed from upto Rs6,500 – Rs4,000 to Rs2,500 – 1,600 under the latest Drug Price Control Order (DPCO) for essential medicines issued by the National Pharmaceutical Pricing Authority (NPPA) under the Government of India. Albumin is an essential life saving drug which should be priced reasonably, according to NPPA.

What are the chemists saying?

"It is a country wide issue. Shortages have been reported in hospitals of Delhi and Chennai too. Three pharmaceutical companies – Reliance, Intas and Baxter were major manufacturers and suppliers of Albumin in Indian markets. After slashing of prices, they have stopped supply to domestic markets. The stocks may have been diverted to export market on higher prices for attractive prices," said Hakim Kapasi, president of North West Chemist Association in Mumbai.
Premal Mehta, owner, Shiraz Chemists, Andheri West said, "There is a shortage of the Albumin injection. It is not available in small hospitals and therefore we are getting retail inquiries from desperate families of patients. I had four to five patients inquiring last month, all of whom I turned away as I have not been able to procure stocks of Albumin from pharma companies."

The pharma companies could not be contacted in order to shed light on the issue of the shortage.

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