In view of the changing conditions in this market, it is imperative that the Ministry of Health, under JP Nadda, takes suitable action to educate the public on the drugs sold in the market
The National Pharmaceutical Pricing Authority (NPPA), from time to time, caps the prices of various medications so that these are as easily available and affordable as possible, to the public. The Drug regulator has mandated all manufacturing companies to seek its approval for every new medicine, including combinations of the existing ones, so that the consumer is not overcharged.
Until recently, the prices of 374 medicines were capped by the Government. The Pharma market is said to be large and estimated to be about Rs79,000 crore and, due to the increased usage and introduction of more expensive drugs, likely to become even bigger in the years ahead. In spite of this, very often, to by-pass the control of the Regulator, manufacturers are known to modify the mixes, combinations and dosages in such a manner that they fall outside the purview of the 374 medicines that are listed and capped by NPPA!
However, NPPA keeps a close watch on these, including the formulations and the new drugs that come into the market to protect the consumer.
Recently, NPPA has revised the prices of some 52 formulations which include basic medicines like antibiotics as well as medications to manage kidney failures. It may be remembered that the manufacturers are free to fix the launch prices of all new medicines outside the list of 374 capped ones, but in order to do so, it is mandatory for them to submit a compliance certificate to the price controller “approving” the new medicine, as a “new drug”. This will have to be obtained from the Drug Controller General of India.
Apart from keeping a close watch on prices of essential drugs and ensuring that, by various “technical” means, manufacturers do not increase prices, as explained above, it is also necessary for NPPA or the Ministry of Health to ensure those of the life-saving drugs that Multi-National Companies have been delaying launch or supply in India, after getting the monopoly rights. It has been reported in the press, that cheaper generic versions of the exorbitantly priced medicines are also going “off-the-shelf” under the product-patent law!
Press reports further indicate that some of the MNCs that can supply drugs to treat serious illness like cancer, HIV hepatitis C and TB are somehow deferring the launch for reasons best known to them. Such moves make artificial shortage in the market.
In the meantime, the Department of Industrial Policy and Promotion (DIPP) has moved a Cabinet note to allow 100% FDI in medical devices as part of a strategy to not only reduce imports but also to promote local manufacture, and supply to the global market. 70% of such medical devices that India needs are imported and India has the potential and capacity to make for export as well. The global market for such devices is said to be huge, estimated to be over $ 400 billion!
In view of the changing conditions in this market, it is imperative that the Ministry of Health, takes the following action:
a) Ministry of Health directs all Doctors, issuing prescriptions, need to give the generic names of drugs that are being prescribed, along with branded names, if given. These are to be written in Capital letters, in English (that the patient may not know English, does not matter, besides being illiterate)
b) Ministry of Health, in all the States, publish advertisements in the local (vernacular) press, as well as in English language, the above (a) fact, and also list out the names of shops, full address details, including phone numbers etc, where, patients can obtain generic medicines
c) Ministry of Health must also direct that all medicines dispensing shops, located in hospitals, need to have list of generic medicines available in the store – experience shows, when patients are admitted in the hospital, more often than not, prescriptions are handed over to the person accompanying the patient to “obtain this or that medicine from shop downstairs”!
d) Ministry of Health must direct all manufacturers to print the generic names of drugs on the packages for easy reference! If some of them already have adequate stocks of such packages, they should be allowed to put “stickers” or rubber stamp the generic names
e) Ministry of Health must direct the manufacturers that it is mandatory for them to list the senior citizen’s discount and clearly state the price applicable in the package itself
Finally, Dr Harsh Vardhan must immediately authorise organisations like NPPA to upgrade their websites and show accessible email addresses so that the public can contact and obtain information from them. NPPA or Drug Controller and other similar related organisations under the Ministry of Health should all be listed in one place, identifying their main functions and identifying the Public Relations officer who should be able to answer public when they get in touch with them.
It is necessary such organizations become easily accessible to the public.
(AK Ramdas has worked with the Engineering Export Promotion Council of the ministry of commerce. He was also associated with various committees of the Council. His international career took him to places like Beirut, Kuwait and Dubai at a time when these were small trading outposts; and later to the US.)
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