Open Forum
New
Delhi, 8 December 2016
Overhauling
Drug Policy
AIM FOR AFFORDABLE
MEDICINES
By Dhurjati
Mukherjee
The Union Government’s plans to overhaul
the drug policy and ease regulatory framework may well be prescription of
trouble for the common man. The change is going to impact access to affordable
medicines, specially for the economically weaker sections and the lower income
groups. The existing system of price control has been watered down, obviously
due to pressure and lobbying from the pharmaceutical industry.
According to public health experts,
diluting price controls on essential medicines would mean ignoring high
out-of-pocket spending on medicines that would impact the aam admi. It was stated that delinking essential medicines from
price regulation would result in a surge in prices of commonly used drugs. In
rural India,
it is estimated that around 70 per cent of out-of-pocket expenses is on
medicines, whereas it is around 60 per cent in urban areas. It needs to be
reiterated that essential drugs have to be made available to the poorer
sections at prices they can afford.
The move towards dismantling price
controls on essential medicines and winding up of the National Pharmaceutical
Pricing Authority (NPPA) are obviously being done at the behest of industry
lobbies under the pretext of removing regulatory controls or the oft-used
phrase to aid ‘ease of doing business’ in India. Currently prices of over 400
essential medicines are capped by the Government, whereas all other medicine
companies are allowed to hike prices by only 10 per cent annually.
Even with this control, most
pharmaceutical companies make huge profits and not just the multinationals in
this sector. Every year the profitability of the companies goes up as the
pharma sector is considered quite lucrative. Moreover, in a country with a huge
population of a billion plus and living standards quite unsatisfactory, there
is a great demand for medicines and this is expected to increase in the coming
years.
Though a section feels that stringent
regulation is hampering the growth of the country’s drug manufacturing
industry, which incidentally is one of the largest export revenue churner for
the government, this is not the case. Except for control on few drugs, which
may not exceed around 20 per cent or so, the pharma sector has no rigid
regulation. It is because of this that this industry is currently pegged at
over Rs 1 lakh crores.
Meanwhile, the Government recently announced
slashing of prices of 43 essential drugs by up to 35 per cent, a move that is
expected to benefit patients suffering from several critical diseases. The NPPA
reduced prices in drugs that are used in treatment of diseases such as diabetes,
cancer, asthma, cardiovascular diseases, mental disorders and kidney failure.
However, medicine brands with an MRP lower than the ceiling cannot be upwardly
revised viz their prices. In fact, since March this year, the NPPA fixed prices
of 540 essential medicines resulting in a saving of around Rs 3400 crores,
according to Government sources.
Given the fact that the demand for
medicines is increasing steadily and that profitability is not expected to be
affected, price control needs to be regulated. The weaker sections should not
be deprived of drugs needed for their treatment, must always remain the goal.
A recent study by Brokings India revealed
that the percentage of persons impoverished by health expenses (during the
period 2004 and 2014) remained unchanged at seven per cent. This meant a huge
increase in the number of households (from about 77 million in 2004 to over 88
million in 2014 due to the rise in population). That’s like a population larger
than Germany
being pushed into poverty because of health expenses. Even Union Health Minister
Nadda recently informed Parliament that as per NSSO Health & Morbidity
Survey data analysis in 2014, “about 23.66 per cent rural households faced
catastrophic expenditures”.
One may mention here another
development--the Government’s commitment to set up a single window approval
system that will clear in 30 days what four different committees took three to
four years viz research. This is a major boost to innovation in medical
research and may help prop up India’s
sagging reputation in the area of ease of doing business. The NITI Aayog has written to the Health Ministry to
restructure the approval process for innovation in medical research as part of
the Government’s move to make the country a hub for manufacturing.
Can then it be expected that medical
innovation may boost up manufacturing and bring down costs? While time will
only tell, there is a projection that increased manufacturing would make
available more drugs both in the domestic and exports market and shall accomplish
the twin objectives of affordability and revenue generation.
The main challenge before an
inclusive government is to ensure health care which includes affordable
medicines to the poorer sections. The question of increasing manufacturing is no
doubt important but the main objective of this exercise has to be to ensure
that masses are able to get necessary health care and buy the prescribed
medicines. Unless the people across the country are able to get easy access to
drugs -- and not witness family members dying due to high cost of medicines and
health care– the whole exercise of the Government, whether it is pharma
research and manufacturing, will have little meaning.
The benefits of the country’s
innovation must reach the grassroots. There is need to evolve a plan of action
which should be formulated by a national committee comprising representatives
of industry, doctors, economists and social activists to delve deep into the
question of drug pricing and whether regulation is at all needed. Also the
question of how medicines at low cost can be given to people not just below the
poverty line but also those from the EWS must be examined by this
committee.
While the Government claims to have
taken some bold steps in various fields, “health for all” is an objective which
cannot be left at the mercy of pharma companies, which would obviously think of
profitability alone. Moreover, facilities like subsidies, if they set up units
in select areas, which are in vogue could be continued.
Health for all is indeed one of the
biggest challenges before the Government. The massive economic burden of non-communicable
diseases (NCDs), which has been estimated by the World Health Organization to
be around $6.2 trillion between 2012 and 2030, needs to be addressed. Obviously
to tackle this problem, apart from increasing the percentage expenditure of GDP
on healthcare from the current 1.1 per cent to at least 2.5-3 per cent by 2025,
if not earlier, drug availability at affordable prices is equally imperative.
The Government needs to tread slowly and cautiously. ---INFA
(Copyright,
India News and Feature Alliance)
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