The NDA govt. has announced plans for providing free generic medicines to the masses. Aaamir Khan had taken this up too, within a Healkthcare program. FG has commented on this earlier. Let us take a composite view on the pricing of pharmaceuticals (medicine). This of course could apply to any product that has a generic as well as a branded version - from bread, to soft and hard drinks, and to everything made in Batala! First, it is important to clear a misconception. It is not true that the price of medicine is cheaper outside India. We still remain, even with our ‘branded generics’, one of the lowest priced countries for medicine. As regards the govt plan, it should not just target the poor/under-privileged families. For them the govt. already has an essential drug price policy – consisting of a product list and a fixed price list. However, not unexpectedly, that policy and system for medicine has met the same fate as food has within the PDS (Ration Card) system. It does not beneift the beneficiaries.
India should definitely move towards dispensing generic medicines. This is the way most governments would wish to go – buying and providing low-cost quality medicines as part of their public healthcare programs. The operative word is quality, as just cheap medicine benefits only the ‘manufacturers’. Govts. across the world have very strict guidelines even for generic medicines.
For a generics push to happen in India, we need to ensure that :
a) Doctors write out the generic name also, when writing a prescription;
b) Chemists stock adequate generics, and dispense as per a patient’s choice, and not as per what gives them the best margin (many Indians across the country rely on chemists for dispensing the ‘best’ medicine);
c) Manufacturers develop and manufacture generics as per laid down quality guidelines, and are strictly monitored for this (the current situation is fairly dismal in many locations – apart from the issue of counterfeit and spurious medicine);
d) Govt. procures medicine from quality sources - which should not just be the lowest cost in a tender.
The key issue is that the govt. has not been able to effectively run any basic welfare program. This is true for the PDS (for food), the PHC (for healthcare), and Govt. Schools (for education). Today even the poor would wish to stay away from these facilities. The generic medicine shops would probably go the way of the PDS – degenerating quickly into stinking rooms piled up with inferior quality products and old stocks. New and better quality stock would be sifted and stolen/sold. We can even today see this in operation in most govt. healthcare centres, and even hospitals. An exceptional scenario for medicines is that, even good products, once expired, may provide no benefit. On the supply side we have thousands of pharma manufacturing companies, many operating under inconsistent product development and manufacturing processes – in terms of Standards, Schedules and Good Practices. Upgradation is seen as a costly business. And there is mostly lip service to the Environment, Safety and Health standards, which require a further level of investment – and a different attitude.
A proposal had earlier been given to the govt., whereby the leading pharma companies could provide low-cost non-branded generics to the State, as part of an overall pricing policy framework. There has been no progress/decision on this. This is where the answer still lies. The Indian Pharma industry (private sector) is a global benchmark. It contributes significantly to the supply of affordable generic medicine globally. The govt. should shortlist 25 companies nationally, based on strict development and manufacturing capabilities, and ask them to supply an agreed volume of non-branded generic medicine (as per an expert recommended list) at a specified negotiated price. This medicine will then be sold preferably through ‘generic pharmacists’ in all cities. It would be imperative to ensure that this program does not go the PDS way; and there should be strict monitoring for counterfeit products. Of course, doctors would need to necessarily add the generic name, alongside the brand name, in the prescription – to give the customer the choice. Those wishing to continue with branded generics (at higher ‘global’ prices) would still obtain them, just like they do today. This is a win-win-win for the consumers, the State and the pharma industry (manufacturer to retailer).
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