Health action groups in India are pressing the government to regulate the entire pharmaceutical supply chain rather than just retailer margins on cancer drugs. The All India Drug Action Network welcomed the National Pharmaceutical Pricing Authority's 30% cap on hospital and retailer margins but said manufacturer pricing remains the biggest source of profiteering. AIDAN members cited average trade margins of 170%, with some reaching 700%, and warned that about 204 medicines, or 32%, will see no reduction or a cut of only up to 10%. The group is calling for cost-based price control and compulsory licensing for patented anti-cancer medicines.
According to timesofindia.indiatimes.com, the All India Drug Action Network (AIDAN) has welcomed the National Pharmaceutical Pricing Authority’s 30% cap on hospital and retailer margins for anti-cancer medicines, but says the measure leaves the largest source of profiteering untouched: manufacturer pricing.
The network of non-governmental organisations and health action groups said the cap, issued after Supreme Court directives, may bring relief for some formulations but excludes the costliest originator brands, patented medicines, brand premiums and marketing-driven pricing. AIDAN argued that the entire pharmaceutical supply chain, not just retailer margins, needs regulation.
Dr Anant Phadke, a member of AIDAN, said wholesale and retail pharma dealers, along with some hospitals, have been earning average trade margins of 170% on these medicines, with some reportedly reaching 700%. He said the NPPA acted only after the Supreme Court castigated the exorbitant profiteering.
Relief uneven across the price list
AIDAN estimates the average reduction will apply to 51 medicines, while about 204 medicines — 32% of the total — will show no reduction or a meagre cut of only up to 10%.
“Wholesale and retail pharma dealers, along with some hospitals, have been earning huge trade margins on these medicines, on average 170%, with some reportedly reaching up to 700%. NPPA has acted only when the Supreme Court castigated this exorbitant profiteering. The average reduction will be on 51 but about 204 medicines (32%) will show no reduction or meagre reduction only up to 10%.” — Dr Anant Phadke, member of AIDAN
Phadke said the margin cuts would also curb the unethical practice of marketing to doctors. Multinational companies selling top brands promote them heavily by encouraging physicians to prescribe them, keeping high maximum retail prices to cover marketing expenses and earn monopoly profits, he said.
According to AIDAN, the Trade Margin Rationalization (TMR) by the NPPA will not affect originator brands, and there is no reduction in the prices of the costliest anti-malignancy medicines costing from Rs 2 lakh to Rs 10 lakh.
Demand for cost-plus pricing across all medicines
AIDAN demanded that prices of anti-cancer medicines could be reduced to one-fourth if the government addresses effective price regulation of all anti-cancer medicines and excessive profiteering by manufacturers, especially multinationals.
Dr Gopal Dabhade, another AIDAN member, pointed to the government’s own Janaushadhi shops as a model. He said the government has set up a system to procure quality medicines from manufacturers through open, competitive tendering and to supply them to Janaushadhi shops, where medicines are sold only under generic names and their MRP is set by the government with a reasonable profit allowed for the manufacturer and traders.
“The govt should extend the principle of ‘cost plus defined margin’ to all medicines sold in the market and not restrict it only for Janaushadhi shops and make the necessary amendments in the Drug Price Control Order 2013, which governs the prices of medicines in India.” — Dr Gopal Dabhade, member of AIDAN
Under Supreme Court pressure, the government brought the Drug Price Control Order-2013 (DPCO-2013), which regulated prices of 348 ‘essential medicines’ listed in the National List of Essential Medicines (NLEM) out of about 1,000 medicines. Of these, just 63 anti-cancer medicines were brought under price control.
Dabhade said exclusion from the list does not mean a medicine is non-essential for patients with cancer, adding that all anti-cancer medicines recommended in standard medical literature but outside the NLEM are essential for some patient or another and should therefore be under price regulation.
Patents and compulsory licensing
AIDAN demanded that the government step in to regulate manufacturers’ profits rather than only trade margins, and introduce cost-based price control for all medicines with a reasonable profit margin added, arguing that existing market prices are already inflated by aggressive promotion, brand premiums and excessive margins.
Phadke said about 55 anti-cancer medicines in the NPPA order are under patent protection and see no price reduction. In these cases, he said, the government should invoke compulsory licensing under Section 84, 92 or 100 of the Indian Patents Act 1972.
“This is essential to protect the patients from predatory monopoly pricing. Invoking such provisions would allow an Indian company to manufacture and sell the patented medicine concerned 90% cheaper than the price of the originator.” — Dr Anant Phadke, member of AIDAN
Source: timesofindia.indiatimes.com
Compiled from international media by the SCI.AI editorial team.
