http://scroll.in/pulse/820756/indians-may-have-to-pay-more-for-medicines-as-drug-pricing-policy-is-set-for-overhaul

PAYING THE PRICE

Indians may have to pay more for medicines as drug pricing policy is
set for overhaul

Pharmaceutical industry will guide changes, says head of government committee.

6 hours ago
Updated 2 hours ago

Jyotsna Singh

Medicines may become more expensive in India as a result of the major
overhaul of the drug pricing policy that is being planned, activists
fear. The changes in the prices of medicines are being considered by a
government committee set up about a month ago. "We are working with
the aim of 'ease of doing business' and 'Make in India'," said health
secretary CK Mishra, who heads the committee. "The new pricing policy
of drugs will be in tune with this."

Mishra indicated that the demands of the pharmaceutical industry will
guide the overhaul of drug pricing policy in India. "The National
Pharmaceutical Pricing Authority will stay, but it can be renamed or
its form might change," he said.

These discussions within the government have upset health activists
working on drug pricing. "It is clear that the policy shift is geared
towards one-sided promotion of the industry," said Malini Aisola from
the All India Drug Action Network, a network of non-profits that are
working to increase access to essential medicines. "All the gains that
were made over past years in reducing prices of medicines will be
reversed."

At a meeting on October 19, Mishra, NITI Aayog chief executive officer
Amitabh Kant, secretary of the pharmaceutical department Jai Priye
Prakash and secretary of Department of Industrial Policy & Promotion
Ramesh Abhishek discussed delinking the National List of Essential
Medicines from the Drug Price Control Orders. These orders are issued
by the government to fix an upper limit for the prices of drugs that
the government deems essential.

Activists who are the privy to the proceedings at this meeting say
that the government is planning to put the independent National
Pharmaceutical Pricing Authority under the Department of
Pharmaceuticals so that the right to regulate drug prices is vested
with the government.

The NPPA's autonomy
As it stands now, the National Pharmaceutical Pricing Authority has
been an autonomous body with experts from various fields like
pharmaceuticals, economics and cost accountancy. It was established
through in 1997 because the government believed that the prices of
bulk drugs and formulations should be simplified and fixed by experts.

Over the past seven months, the authority has fixed the ceiling prices
of nearly 500 medicines. For example, Hepatitis B drug Entecavir was
being sold by Bristol Myers Squibb was selling for Rs 230 per tablet
of 0.05 milligrams. But the same drug, manufactured by Zydus and
Cipla, was being sold at Rs 75 per tablet. In March, the authority
decided that no company could sell Entecavir for more than Rs 72.98
per tablet.

The authority chairperson Bhupender Singh had said that prices of all
essential medicines, of which there are nearly 350, will be fixed by
the end of this year. The Drug Price Control Order was last issued in
2013.

Rush to revamp
On November 7, the various parties involved in the debate will gather
in Delhi to attend a consultation called by the secretary of the
department of pharmaceuticals. Participants will discuss drug pricing
and industry-related schemes and issues.

Activists say that the meeting seems to have been planned to pre-empt
a Supreme Court hearing on essential medicine prices due for November
9. The hearing relates to a public interest litigation filed by the
All India Drug Action Network in 2008 asking the court to fix the
prices of essential medicines.

The Supreme Court has consistently ruled in favour of public health
programmes, said Aisola from the drug action network, but the
government's new proposals will disrupt the process. "The proposed
changes in policy are in violation of Supreme Court directions to
ensure that all essential and life saving medicines do not fall
outside price control. Price controls are a vital policy tool for
bringing essential medicines closer to the reach of the most needy,"
she said.

Some slow progress
The movement to provide cheaper medicines has gained some ground in
India over the last few years. All state governments have agreed in
principle to provide essential medicines free of cost in government
facilities, though only five states have actually started implementing
this scheme.

Dr Narendra Gupta, secretary of Prayas, an NGO in the Rajasthan town
of Chittorgarh, said that the ideal way of providing cheap medicines
is through bulk procurement, mainly by the government. “We have seen
that prices fall heavily when governments buy for their free medicine
schemes," said Gupta, referring to the Rajasthan Medical Services
Corporation Limited and the Tamil Nadu Medical Services Corporation
Limited that are provide free medicines in government facilities. "In
states like Tamil Nadu and Rajasthan, many medicines are procured at
one-hundredth the price in market.”
An example is the drug Imatinib Mesylate used to treat leukemia. When
the market price by of the multi-national corporation Novartis was
more than Rs 1 lakh, the Rajasthan Medical Services Corporation
procured it for Rs 1,200 from Indian generics companies. “Such huge
difference is possible only by buying medicines in large quantities
and through a transparent system of tenders,” said Gupta.

However, few states have such a mechanism in place. Delinking Drugs
Price Control Orders and essential medicines in states that do not
have a bulk procurement mechanism will dramatically increase the
prices of medicines.

Until all states are able to buy drugs in bulk, price control through
Drug Price Control Orders and the National Pharmaceutical Pricing
Authority will be vital, he said.


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