The 29-day notice: how a compounding wind-down works in India

A request to reinstate the dulaglutide shortage listing in India has been declined. The regulator’s published reasoning is that reported supply now meets forecast demand at the presentation level, which is a narrower test than the one the applicants argued for.

The determination rests on manufacturer-reported supply against forecast demand at the level of individual presentations rather than the molecule as a whole. That distinction matters: a market can be adequately supplied in aggregate while a specific dose strength remains constrained, and the notice acknowledges as much without treating it as grounds for continued listing.

Patients are the constituency with the least notice and the fewest options. A person stabilised on a compounded preparation who is told to transition to an approved product faces a different dose presentation, a different device, a different price and, frequently, a prior-authorisation process that takes longer than the wind-down period allows.

Marek Doležal, analytical chemist and former QC laboratory manager, was blunter about the commercial position. "If your model depended on a shortage list, your model was a bet on scarcity. That is a legitimate bet and it has now lost."

The next instalment in the series follows one wind-down through to its conclusion: the pharmacy, the prescriber, the patients and the six weeks between the notice and the last dispensing.