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Medicines for All!
Prices of medicines keep rising. Why is this so? Is the government's policy on medicine and pharmaceuticals effective in keeping prices within the reach of the consumer? Or should something more be done?
Do we need a pharma pricing policy in India at all?
Yes, we do, because: • Medicines are unaffordable even for the middle class. • Medicines account for 40-80 % of the treatment costs. • We have no health insurance, no social security or other “safety nets”. • Many in India are below or near poverty-line: expenditure on medicines is a very important cause for indebtedness before and after hospitalisation. • Our public health systems do not function. • And when they do, they do not have sufficient stocks of medicines.
Is a leading producer and supplier for the world?
• That precisely is the tragedy. Our vast pharma industry is rightly celebrated in international circles for making medicines very affordable and low-priced. But within India, it is a scenario of one of unaffordability and poor access amidst plenty. • India has the largest number of people, an estimated 649 million, without access to essential medicines. (World Medicines Report 2004, WHO)
Will competition not take care of all these problems of access?
Competition does not work, most of the time, in India’s pharma formulations market, not in the consumer’s favour. Or in any open economy market for that matter. The notion of a free market in pharma and health services is a contradiction in terms. We have a “free” market in a different sense for a long time one could make all kinds of irrational drugs from fresh human placenta, animal liver and cattle blood as also arbitrary combinations of different kinds of medicines and sell them at arbitrarily high prices.
Give me some more data to convince me.
Well, consider these facts, which go against the grain of free market and healthy competition: • In India, the same drug is sold at vastly different prices by equally reputed companies and often by the same company. • Brand leader and volume leaders are often the price leader! That is the most popular brand of a drug is also often the highest priced (whereas if competition worked, it should be the other way around).
With so many medicines in the market consumers have a choice. What's wrong with that?
• There is no choice for the consumer in this market. Unlike in other commodities the buyer of medicines is extremely vulnerable as he/she is seeking immediate relief from suffering. How can you make reasoned choice in such distress? • Medicines are the only commodity in which the paying patient does not decide what to buy and at what cost. The doctor prescribes and the patient pays. In addition, in India every doctor decides on his/her own which brand of which medicine to prescribe.
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