Delhi cancer institute missing cancer drugs, doctor to prescribe them

New DelhiSeveral essential medicines, including key chemotherapy drugs, cancer-targeted therapies, pain medications, antibiotics and intravenous fluids (IV), are currently unavailable at the government-run Delhi State Cancer Institute (DSCI), as per records accessed by HT

New Delhi

As per the institute’s Essential Drug List (EDL) for September 21, accessed by HT, 48 key medicines of 178 listed drugs were out of stock. (Representative photo)

Several essential medicines, including key chemotherapy drugs, cancer-targeted therapies, pain medications, antibiotics and intravenous fluids (IV), are currently unavailable at the government-run Delhi State Cancer Institute (DSCI), as per records accessed by HT.

As per the institute’s Essential Drug List (EDL) for September 21, accessed by HT, 48 key medicines of 178 listed drugs were out of stock. The list of unavailable medicines extended form commonly used IV fluids and pain relievers to targeted cancer treatment medicines.

Hospital director Dr Savita Arora, in a written response to queries raised by HT, said, “The medicines in question are quite costly. Therefore, the administration is exploring procurement through GeM and other government approved routes to obtain them at better rates. Direct purchase from local chemists is generally not preferred under government procurement procedures.Supply orders after scrutiny have been issued for some medicines in the above list.”

The DSCI in Dilshad Garden has 236 beds, comprising 169 inpatient beds, 29 observation beds and 38 chemotherapy recliners. The government hospital’s official website reads, “institution by government of NCT of Delhi for providing comprehensive management facilities”, which the hospital website claims is “at par with some of the best such institutions in the country as well as at international level.”

Officials at the hospital, however, said that the facility does not have a medical oncologist, due to which medicines are not being provided to the patients, due to lack of patient monitoring.

Targeted cancer medicines missing from the stock include tamoxifen, an oral medication that blocks oestrogen in breast tissue to treat and prevent hormone-receptor-positive breast cancer; abiraterone, a prescription hormone therapy medicine used to treat advanced prostate cancer; leuprolide injections, given for treatment for prostate cancer; irinotecan injection, used as a chemotherapy medication primarily to treat metastatic colorectal cancer; lorlatinib and osimertinib, used to treat lung cancer, and bevacizumab, which is used to treat multiple cancers.

The missing list also included medicines commonly used in supportive care of cancer patients, such as morphine (pain relief), fentanyl (pain relief for severe, acute cancer pain), cefoperazone-sulbactam (antibiotic to treat serious infections in cancer patients), and iron sorbitol (anaemia).

HT found that the essential drugs list dated September 10 also listed the unavailability of 46 drugs routinely used in cancer treatment.

A hospital official aware of the matter, requesting anonymity, said that patients are forced to buy these drugs from outside the hospital or, in some instances, even go without buying these drugs due to non-affordability.

In a retail market, a leuprolide injection costs ₹1,600 to ₹23,000 per vial in Delhi, depending on the brand, a lorlatinib tablet costs between ₹7,500 and ₹9,500— ₹1,00,000 to ₹1,46,000 for a box of 15 to 30 tablets—and abiraterone tablets typically cost between ₹6,000 and ₹15,000 per pack of 120 tablets, depending on the brand.

HT reported in August that the Delhi government issued an order directing government hospitals to obtain medicines and medical equipment on their own to avoid delaying treatment for the patients.

Hospital director Dr Savita Arora said that the hospital is currently looking to fill the medical oncologist vacancy.

“The second-line drugs mentioned in the list require strict monitoring by a Medical Oncologist. At present, Medical Oncologist is not available at the institute and the recruitment process is under process. Dr Pragya Shukla,HOD, Clinical Oncology, DSCI is currently involved in framing the recruitment rules in consultation with other experts in the field. DSCI administration’s approach is therefore aimed at ensuring both appropriate procurement and adherence to specialist led treatment protocols with regards to the rational use of these costly and toxic medicines,” the director’s response read.

Recently, the DSCI hospital has also been under scrutiny over expensive medical equipment lying unused due to a shortage of trained personnel.

Health minister Pankaj Singh said, “We are looking into the matter currently.”