Events & Issues
New Delhi, 3 May, 2017
Cheap Generic Drugs
VITAL TO TACKLE
DISEASES
By Dr. Oishee
Mukherjee
The Government’s bold decision recently whereby doctors have
to write the generic names of drugs and the Medical Council of India (MCI)
issuing a circular to all medical college principals, hospital directors, State
medical councils and health secretaries avowing any doctor violating these
provisions could face “suitable disciplinary action”.
Importantly, Prime Minister Modi made plain legal arrangements
would be made to make prescription of generic medicines compulsory, given that
though mandatory doctors are not following it.
Notwithstanding the MCI ethics code which made this compulsory for
doctors October last.
Shockingly, pharmaceutical companies were bribing doctors to
prescribe their high cost drugs as the Uniform Code of Pharmaceutical Marketing
Practices (UCPMP) to prevent such unethical practices, has been hanging fire
for two years.
Also, there is a need to reduce generic drugs prices as an Indian
Journal of Pharmacology study found that though generic variants were less
expensive than branded ones, the retail margin on these was much higher --
sometimes more than 1000 per cent of the manufacturer’s price!
While this move would help the poor and economically weaker
sections get relatively low-cost generic drugs, the Government’s plans to overhaul
the drug policy and ease regulatory framework impacting access to affordable
medicines. Already, the existing price control system has been watered down,
obviously due to pressure from the industry. Bluntly, essential drugs have to
be made available to the poorer sections at affordable prices.
Public health experts aver that diluting price controls on
essential medicines would mean ignoring high out-of-pocket spending on
medicines that would impact the common man. Wherein, delinking essential
medicines from price regulation would result in prices surging of commonly used
drugs. In rural India,
around 70 per cent of out-of-pocket expenses are on medicines while it is 60
per cent in urban areas.
Obviously, the move towards dismantling price controls on
essential medicines and winding up the National Pharmaceutical Pricing
Authority (NPPA) are being done at the behest of industry lobbies under the
pretext of removing regulatory controls or the ‘ease of doing business’ in
India.
Currently prices of over 400 essential medicines are capped
by the Government whereas on all other medicines companies are allowed to hike
prices by only 10 per cent annually. But, even with this control most
pharmaceutical firms including multi-nationals make huge profits.
Every year the profitability of pharma companies goes up as
the sector is considered quite lucrative. Moreover in a country with a huge population
and living standards unsatisfactory, there is a great demand for medicines which
is expected to increase in the coming years.
Although a section feels that stringent regulation is
hampering 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 20
per cent, the pharma sector has no rigid regulation resulting in this industry being
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 expected to benefit
patients suffering from several critical diseases. The NPPA reduced prices in
drugs that are used in treatment of diabetes, cancer, asthma, cardio-vascular
diseases, mental disorders and kidney failure.
However, medicine brands with an MRP lower than the ceiling
cannot upwardly revise their prices. In fact, since March the NPPA fixed prices
of 540 essential medicines resulting in a saving of around Rs 3400 crores,
according to Government sources.
Given that demand for medicines is increasing at a fast pace
and to ensure profitability would not be affected, price control needs to be regulated.
This is all the more necessary to ensure that the weaker sections are able to
buy drugs needed for their treatment.
A recent Brookings India study revealed that the
percentage of persons impoverished by health expenses (during 2004-14) remained
unchanged at 7 per cent meant a huge increase in the number of households (from
about 77 million in 2004 to over 88 million in 2014 due to population rise). It’s
akin to a population larger than Germany being pushed into poverty
because of health expenses. Pertinently,
Health Minister Nadda informed Parliament recently that as per NSSO Health
& Morbidity Survey data analysis in 2014 “about 23.66 per cent rural
households faced catastrophic expenditures”.
Another example of the Government’s commitment to set up a
single window approval system which will clear in 30 days --- what four
different committees took 3-4 years --- is a major boost to innovation in
medical research of India’s
sagging reputation in the area of ease of doing business.
Niti Aayog has already 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.
Undoubtedly, the main challenge before the Government is to
ensure health care which includes affordable medicines to poorer sections. Indeed,
the question of increasing manufacturing is 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 people across the country are able to get access to
drugs -- and not see family members dying due to high cost of medicines, the
Government’s whole exercise be it pharma research or has no meaning. The
benefits of innovation have to reach the grassroots.
Besides, there is need to evolve an action plan which should
be formulated by a national committee comprising industry representatives,
doctors, economists and social activists to delve deep into the question of
drug pricing and whether regulation is at all needed.
Furthermore, the question of how medicines at low cost can
be given to people not just below the poverty line but also those from
economically weaker sections has to be examined by the committee. True, the Administration has taken bold steps
but to achieve the objective of ‘health for all’.
But it needs to keep a check on the profitability of pharma
companies and their unethical practices. This is all the more necessary as all
facilities like various subsidies (if units are set-up in select areas) are
still in vogue and may be continued.
In sum, health is a big challenge before the Government. According
to the World Health Organization the massive economic burden of non
communicable diseases is estimated at nearly $6.2 trillion between 2012-2030. Noticeably
to tackle this problem, apart from increasing the percentage expenditure of GDP
on health care from the current 1.1 per cent to at least 2.5-3 per cent by
2025, drug availability at affordable prices is imperative at this juncture.
---- INFA
(Copyright,
India News and Feature Alliance)
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