Uffordable drugs

The stupendous rise in prices of some drugs used to treat major diseases like cancer, AIDS, diabetes, heart problems and tuberculosis, has caused much dismay in the country. It has also given the Congress and other opposition parties a handy stick to beat the NDA government with. The Assam Pradesh Congress Committee recently flayed the rendra Modi government’s ‘surrender’ to multitiol pharmaceutical companies when it comes to setting the prices of life-saving drugs. After all, it was the Central government’s decision to decontrol prices of 108 drugs, used to ‘treat lifestyle diseases and considered not essential’, which has triggered the price rise. In some cases, the price rise has been unbelievable. Glivec, an anti-cancer tablet, which used to cost Rs 8,500, is now selling at a shocking Rs 1.08 lakh. The price of Plavix, used to treat blood pressure and heart conditions, has risen nearly twelve-fold from Rs 147 to Rs 1,615. Another anti-cancer drug Geftinet is now priced at Rs 11,500, nearly double its earlier price of Rs 5,900. In general, there has been 300-400 percent rise in prices of several other drugs. Likewise, the prices of some baby food formulations have also risen sharply. In a country where the majority of the people are below poverty line, such exorbitantly priced drugs are beyond the reach of the middle and even upper middle classes. As per official figures, there are 4.7 crore corory heart disease, 4.1 crore diabetes, 25 lakh HIV/AIDS, 22 lakh tuberculosis and 11 lakh cancer patients in India.

With the Northeastern states having a proportiotely larger share of cancer patients, a situation of totally uffordable drugs is heart-breaking. Families are either forced to sell off land or pull out the patient from treatment midway. The timing of the Central government’s circular, directing the autonomous tiol Pharmaceutical Pricing Authority (NPPA) to withdraw its May 2014 guidelines on drug price control, just before Prime Minister Modi’s visit to the US in September last — has raised suspicions of New Delhi bending to the interests of the powerful US drugs industry. Let us remember that even in the US, where most people are covered by medical insurance, lawmakers are questioning why the prices of some generic drugs (belonging to a class and non-branded, hence supposedly affordable) have risen over 1000 percent in recent years. They have coined a term ‘price gouging’ to denounce this phenomenon. The curious fact that even off-patent drugs there are getting costlier by the day, point to monopolistic tendencies and clandestine price setting by US drug firms. It is a fact that in India, the NPPA had capped the prices of 108 ‘non-essential’ drugs, along with the already listed 800 ‘essential’ drugs, in a bid to make them more affordable. The Central government has however denied any underhand deal with the big pharma lobby; rather, it is arguing that the powers of NPPA have been taken over so that the government will itself negotiate with pharma companies to keep prices low, while encouraging investment and research. In any case, the circular covers only limited and non-essential drugs, the government has claimed. But the suspicions refuse to go away, considering that the share prices of some pharma companies perceived to benefit from much costlier drugs, reportedly shot up in the wake of the controversial circular. And if the Central government keeps negotiating powers with itself, will some pharmaceuticals be favoured above others for ulterior reasons?

In May 2013, the then UPA government had allowed the NPPA to regulate the prices of life-saving drugs. The NDA government last year went a step further, extending the price regulation to cover lifesaving drugs for cancer, HIV, cardiovascular diseases, diabetes, malaria, tuberculosis, and asthma. This considerably reduced prices of 489 listed drugs. Then why did the government withdraw its guidelines this year? The manner in which the NPPA chairman Injeti Srinivas was removed in April last, reinforced suspicions of the government giving in to the pressure of the big pharma lobby against the drug regulator. The reason the NPPA took a tough stand on controlling drug prices was the reported 40 per cent surge in all drug prices between 1996 and 2006. During this ten-year period, while the prices of controlled drugs rose by less than 1 per cent, prices of listed essential drugs increased by 15 per cent. As for drugs whose prices were not capped, as well as those that were not listed — the average rise in prices was a whopping 137 per cent. Will the government now be responsive enough to the drugs market and swiftly negotiate prices with every pharma company over every lifesaving drug? This is literally a life and death question for the common patient, with the shelves of government hospital dispensaries mostly empty. A disease is a disease, ‘lifestyle’ or otherwise; allowing its medicil treatment to be totally uffordable through private healthcare is not something a government in this country can afford to ignore.