Policy support is the prescription that pharma seeks

As Election 2019 draws to a close and the next Government takes charge at the Centre later this month, expectations are rife that the feverish political rhetoric will make way for a stable economic roadmap for growth. And hoping for such an approach is the pharmaceutical industry, often at the receiving end of policy measures that it feels are unsympathetic to the challenges it faces.

In the last five years, authorities have tightened their grip on the price of medicines and a couple of medical devices. A statement from Prime Minister Narendra Modi asking doctors to prescribe medicines using their generic or chemical names and not the brand name caused a flutter in the industry. And controversies over issues involving fixed-dose combination drugs, for instance, continue to simmer.

So what does the pharmaceutical industry want from the next Government?

Sudarshan Jain, the recently appointed Secretary General of the Indian Pharmaceutical Alliance (IPA), calls for supportive policies that will help this knowledge-driven industry build on its competitive advantage and work towards innovation.

The Indian pharmaceutical industry has been “pharmacy to the world” by providing a lion’s share of vaccines, HIV and other drugs, he says, adding that “government and industry need to now move from ‘Made in India’ to ‘Developed in India.” (IPA represents largely domestic drugmakers, some of whom are building their portfolios of complex generic medicines and biosimilar drugs)

There also needs to be a better understanding of value, as opposed to just price, says Jain, who seeks a stable policy environment that allows business to be “remunerative”, not “profiteering”.

Across the world, the pharmaceutical industry has come in for some stick from governments over the high price of medicines. With organisations like the World Health Organization picking holes in the industry’s defence that high prices are warranted by the high cost of research, the pharmaceutical industry has had to rewire its approach by bringing in patient-support schemes and the like.

Jain agrees that drugmakers need to do their bit and invest in quality drugs. But issues involving medicine access — which has to do with healthcare infrastructure — should not be confused with affordability, he says. And that requires increased Government spending on healthcare, he says.

Other key areas needing action include proposals supporting Active Pharmaceutical Ingredients (API) production in India to reduce dependence on China. The Government needs to maintain India’s IP (Intellectual Property) commitment on Section 3 (d) of the Patents Act (that does not allow “evergreening” of patents), data exclusivity, etc, he adds.

Increase spending

Kanchana TK, Director General with the Organisation of Pharmaceutical Producers of India, urges Government to increase public health expenditure to 3 per cent of GDP from the present 1.5 per cent, besides calling for universal and quality healthcare for all Indians. “Increased public expenditures will lead to a sharp decline in the proportion of private out-of-pocket spending on health — from around 60 per cent today to around 33 per cent by 2022 if the increased public spending is implemented in a way that substitutes for much of current private spending,” she says.

The current situation calls for reforms in the healthcare system involving national healthcare programmes and delivery, medical education and training, and financing of healthcare. Pointing out that adequate healthcare can be ensured only by investing heavily in public health infrastructure, she says, “any insurance scheme targeted at private sector can only be a stop-gap approach, not a long-term one.”

The elected Government should allocate funds to make all district hospitals (763 functioning as of 2015) tertiary hospitals and bring them on par with Government Medical colleges. This will boost both capacity for skilled medical workers (more doctors and nurses can be created and offered jobs) plus serve more of the population at large and reduce the slide of millions of people into poverty because of increased health expenditure, she says.

More love

Sujay Shetty, PwC India Partner, wants the Government to engage more with industry and not view it through a negative lens. “They have been getting some tough love from the Government,” he says, calling for more discussions and clarity on policies and implementation of measures like the UCPMP (Uniform Code for Pharmaceutical Marketing Practices).

The next level of Ayushman Bharat, for instance, needs to engage industry to get better services and products, he points out.

The plea for a less combative “activist” approach from Government comes from many industry experts who say a collaborative approach facilitating businesses and better practices would benefit industry and patients.

But that’s a process that will roll out only after May 23, the all-important day of counting votes.

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