ACI discontinues producing anaesthetic drug Halothane, surgery cost rise feared

ACI Pharmaceuticals Limited has discontinued the production line of the widely used anaesthetic drug Halothane, a move that is expected to impact the cost of surgeries across Bangladesh.

Production of Halothane, a cost-effective sedative used during major surgeries, has been stopped by the API manufacturer as its worldwide demand has been reduced significantly. ACI Pharmaceuticals, the manufacturer of Halothane under the brand name Halosin, has consequently halted its production in Bangladesh.

Mohammad Muhsin Mia, Director, Marketing Operations, ACI Pharmaceuticals, said, "We will not be able to produce the drug anymore as API manufacturer will not supply Halothane anymore". We informed all the stakeholders through official letters about the situation few months ago. Now we are planning to produce alternative drugs for Halothane, but it will take time."

The discontinuation of Halothane production has now forced medical professionals to turn to alternative anaesthetic drugs, which are costlier, hospital sources said.

However, making matters worse, the necessary machines for administering these alternatives are not readily available in most hospitals, causing disruptions in major surgeries, they added.

Meanwhile, to mitigate the impact of Halothane shortage, the government has initiated the procurement of anaesthetic vaporiser for government hospitals. Additionally, the Directorate General of Health Services (DGHS) has decided to incorporate Halothane alternatives in the procurement list for the upcoming fiscal year.

Dr Abu Hussain Md Moinul Ahsan, director (Hospitals and Clinics) at DGHS, also said machines for using alternative drugs are being purchased and will be gradually installed in all hospitals.

Doctors are concerned regarding the potential rise of treatment costs for patients in private hospitals due to the higher expenses associated with alternative anaesthetic drugs.

Dr Shoman Aniruddha, an anaesthetist at Mugda Medical College Hospital, said the hospital is currently relying on its remaining Halothane stock. He highlighted the challenges associated with alternative drugs, citing their higher prices and the unavailability of necessary machines in many hospitals.

In Bangladesh, the price of Halosin 200ml was Tk1,400, while the prices of Isoflurane and Sevoflurane, the alternative drugs, are Tk3,000 and Tk12,000, respectively. Some government hospitals have reportedly asked patients to purchase alternative anaesthetics themselves due to the lack of procurement in the current fiscal year.

Dr Harun Or Rashid, caretaker, Jashore 250-bed Hospital told The Business Standard that they have Halothane stock for one or two months. The decision on whether patients will bring their own alternative anaesthetic drugs or if the hospital will purchase substitutes at a subsidy is pending. Additionally, new machines are needed for using alternative anaesthetic drugs.

Meanwhile, Md Nuruzzaman Shonchoy, principal of M Abdur Rahim Medical College Hospital in Dinajpur, said their Halothane stock ran out two months ago. Surgeries are currently running on Isoflurane, but they need to replace the equipment, which will take time.

AM Akhtaruzzaman, assistant director of Rangpur Medical College Hospital, also said the hospital has been performing surgeries using Isoflurane for a month now.

In contrast, Shaheed Ziaur Rahman Medical College Hospital in Bogura has ample reserved Halothane. Its Deputy Director Abdul Wadud said the stock would last 15 to 20 days, and Isoflurane is also available as an alternative.

DGHS Director Dr Abu Hussain Md Moinul Ahsan said, "Halothane has been purchased by government hospitals until now, but since its production has been stopped, alternative drugs will be added to the purchase list in the next fiscal year."

He also said hospitals will be instructed not to charge patients for the cost of anaesthesia drugs.