The Hindu Business Line : Unhealthy prescription

THE PRICE OF MEDICINE has always been an emotive issue. And when a political agenda gets tagged on, it becomes a bitter pill. A recent task force on affordable medicines suggested that select drugs be promoted sans brand names. But this may not help the United Progressive Alliance Government achieve what it set out to do — make medicines affordable and accessible. Even if undisputedly among the cheapest in the world, many medicines are still beyond the reach of a large section in India. But de-branding dangerously transfers the decision-making responsibility from the doctor to the street-corner druggist.

Notwithstanding any unethical promotional arrangement between pharma companies and doctors, there still may be medical reasoning behind a drug prescribed by a doctor. But if the doctor merely prescribes the generic drug, the chemist is sure to give the patient a medicine from the company that gives him the maximum margin. Drug companies mother their brands. They circulate information on the medicine and keep doctors updated on the latest in the segment. This involves a cost. But they may stop all such initiatives if they find all their labour benefiting generic companies that clone the original medicine.

Besides keeping prices in check, the Centre's initiatives to promote generic, or me-too, drugs is to nip mis-branding. To leverage a popular brand-name, companies have introduced a different composition of medicine, even as they drop the original formulation — a strategy adopted to skirt price control. For instance, some years ago a company replaced its aspirin formulation with a paracetamol. And consumers taking aspirin for its blood-thinning properties were not aware of the change. Of course, the company rectified the anomaly later. The recent floods in Maharashtra also highlighted the side-effects of price-control, when supplies of the antibiotic doxycycline ran dry; for a drug under price control, there were not too many manufacturers. For some 300 instances of errant branding and pricing, as pointed out by the task force, it is unfair to malign the entire industry of about 3,000 brands. Promote generics, yes, but also allow branded drugs, so that people who can pay do not get subsidised by the initiatives for those who cannot afford them.

With quality a primary concern in the healthcare system, the task force needs to ensure that sub-standard drugs do not get into the supply pipeline in the name of promoting generics. Access to affordable drugs can be provided through a well-oiled delivery machinery, combining formal procurement practices, hospital involvement and supportive health insurance. A ceiling on the price of all medicines, calculated through the weighted average of the top three brands in a therapeutic category — as proposed by the task force — may be detrimental to drug companies. Better may be a system where medicine prices are monitored for trends of monopoly or cartelisation. Else, the Centre may just end tripping up the country's pharmaceutical industry, when it needs a spring-board to take-off.

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