India is known as the "pharmacy of the world", as various essential medicines required around the world are manufactured in India. But the paradox lies in the fact that despite low manufacturing costs, essential medicines remain unaffordable or unavailable for many citizens of India itself. The question of drug affordability directly impacts the average Indian, as everyone at some point in their lives has consumed a prescribed drug to treat a health condition or has bought medication for someone in their family. The growing burden of non-communicable or lifestyle diseases also means that long-term prescribed drug consumption also impacts the average Indian's wallet. And let's not mention expensive injectables, cancer drugs, etc required for the most serious of health issues.
A recent comprehensive, government-commissioned study has delivered a sobering assessment of India's current drug pricing system, concluding that the framework is plagued by a lack of transparency and instability. The report, conducted for the National Pharmaceutical Pricing Authority, warns that while the policy has succeeded in keeping common medicines affordable, it is fundamentally failing patients battling rare and serious diseases.
Why The Price Caps On Medicines Are Failing?
The current system of drug availability has multiple price caps under the National List of Essential Medicines to reduce the profit margins of drug companies. Here are some issues that signal why price caps on medicines are failing and their impacts on everyday people:
Issue 1: The Availability Problem
But the gaps lie in how pharmaceutical companies strategically shift their focus on marketing unregulated drugs and formalities, leading to scarcity and non-availability of essential over-the-counter medications for common health conditions. There is a lack of availability of the cheaper, essential variants of medications that could ease the burden on everyday people. The report pinpoints the 2013 transition to a market pricing system under the Drug Price Control Order (2013) as a critical area of concern. While this shift was intended to bring clarity, the study states that "data opacity and inconsistencies persist" in the market-based price calculation.
Manufacturers often lack clarity on how the National Pharmaceutical Pricing Authority arrives at the final ceiling price, creating a complex and unpredictable environment. The lack of transparency and consistency in the data makes it particularly challenging for new pharmaceutical companies to enter the market, thereby reducing competition. This means reduced accessibility for everyday people who are looking to treat their health conditions.
Issue 3: The Failure In The Case Of Rare And Serious Diseases
The most critical failure highlighted by the research is the treatment of rare and serious diseases. The current pharmaceutical pricing system, designed for mass-market medications, has proven inadequate for specialized, high-cost treatments. As noted by the policy analysts involved, addressing the treatment gap for rare and serious diseases remains one of India's biggest public health challenges. Without an effective pricing and subsidy mechanism for these niche drugs, many patients are left struggling to afford life-saving therapies, negating the policy's goal of universal accessibility.
Issue 4: Regulation Overload
The study points out that the National Pharmaceutical Pricing Authority is overstretched, dealing with a list of constantly changing list of essential medicines and struggling to monitor the price of thousands of unregulated drugs effectively. This directly impacts common people who are suffering and spending a great deal to afford needed medication.
Prescribing Structural Reform
To mend the systemic flaws, the study strongly advocates for a multi-pronged approach of structural reform. The study, a collaborative effort by Delhi-based policy think tanks and academic institutions (including Bridge Policy Think Tank, Bangalore Bio-Innovation Centre, and Gujarat National Law University), emphasizes the need for immediate structural reform to ensure true universal healthcare access in India.
Key recommendations include:
- Enhanced Transparency: Making the market-based pricing mechanism clearer and more consistent to build trust among industry stakeholders.
- Improved Market Access: Taking active steps to ease market entry for new pharmaceutical players to increase competition and potentially drive down prices.
- Boosted Subsidies and Coverage: Significantly increasing government subsidies and expanding health insurance coverage to ensure that patients can afford high-cost medications required for specialized and chronic treatments.
The National Pharmaceutical Pricing Authority commissioned report serves as an urgent call to action for the Union Health Ministry and the pricing authority itself. The findings necessitate an immediate overhaul of the existing framework to ensure that life-saving drugs for all illnesses, common or rare, are equitably priced and accessible across the nation.
Please Note: The study in question is yet to be published but its findings have been outed, which has led to suggestions for afforable drug pricing to ease overhead healthcare expenditure.
Disclaimer: This content, including advice, provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
