For quite some time now, Mumbai-based diabetologist Dr Pradeep Gadge has been campaigning to bring glucometer strips under the Government’s price control net.

And after the Government-promoted Jan Aushadhi initiative launched low-cost glucometers and strips, Dr Gadge shot off a flurry of letters, including to Prime Minister Narendra Modi and Maharashtra Chief Minister Devendra Fadnavis, urging them to make these affordable products more accessible.

Presently they are available only at Jan Aushadhi stores, where generically similar medicines are sold at prices lower than the market.

Maharashtra has about 19 such stores, says Gadge, and the newly launched glucometers and strips are in “short supply” even there.

The Government-launched device is priced at ₹480 and strips at ₹225, substantially lower than the market prices of these products at about ₹1,000-plus and ₹800-odd. The glucometer is a one-time cost, usually with a lifetime replacement promise from the company, but the strips are a recurring cost, depending on the use of the person with diabetes.

Gadge says his petition to bring down the price of the strips was triggered by patients who would not monitor their blood sugar regularly at home because they could not afford it. A box contains about 25 strips and they come with a six-month shelf life in some cases.

For a person who needs to check blood sugar twice a day, it means over ₹1,500 a month, every month, just for testing. And then come the other costs, including medicines, insulin, doctor consultation, etc.

The diabetologist’s contention is that the market price of the gluco-test strip is about ₹25 per strip, while its production cost is “about 0.50 paise to one rupee.” Companies can make a reasonable margin at even half that price, he contends, an observation that the companies did not respond to.

The campaign echoes a similar one on cardiac stents, where the National Pharmaceutical Pricing Authority’s data revealed massive distribution and trade margins that was eventually bundled into the market price paid by the patient. The revelation led to the Government slashing prices on stents, with the express intent of looking at other devices through the same lens.

Room for error?

Diabetologist Rajiv Kovil, though, is not convinced about the campaign. High-quality test strips are produced to be ultra-sensitive to take the correct blood glucose readings, he says, adding that any error at this stage would lead to treatment going awry. The price of reputed products reflects their cost of research, he explains.

While some doctors call Gadge’s price-cut campaign a publicity move, there unfortunately is another reality in India. It is home to about 70 million people with diabetes and another estimated 70 million on the border line, say diabetologists, referring to the “silent” stage where people either don’t know or are on the threshold before it becomes full-fledged diabetes — a clear case that interventions are required at many levels if the rising graph of diabetes needs to be stopped in its tracks.

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