Skewed drug prices

Last week National Pharmaceutical Pricing Authority (NPPA) brought  42 non-scheduled anti-cancer drugs under government price control. As announced by the drug price regulator, the prices of 390 medicines containing one or more of the 42 drugs have been slashed by up to 87%, capping the trade margin at 30%. 

On the face of it, the translation of the move into action can curb large scale profiteering by chemists and drug wholesalers and will bring major relief to cancer patients stressed more by hefty treatment cost than the disease.

Speaking specifically in the context of J&K State, the cut in the prices of drugs that are used to treat different types of cancers is a shot in the arm of cancer patients. The state, according to an official data, has witnessed 87 per cent increase in cancer cases in 7 years. Most of the families while looking after cancer patients have been facing traumatic situation and the only thing that has been making it worst for most of them is managing the expenses of treatment of the illness.

Instance galore here in abundance when even a financially sound family had to sell-off their assets to meet treatment expenses. Any savings become first casualty when it comes to availing of healthcare facilities – be it diagnostic tests or purchase of medicines. Not only savings go, money is also borrowed to foot the medical bills.

Think of the plight of a family whose monthly income is Rs10,000 and they have to shell out five times more for medicines and for each round of chemotherapy and radiation of an ailing family member suffering from cancer. This is the scenario which forces many cancer patients to a fatalistic surrender to destiny.

I’ve come across dozens of cancer patients struggling for want of finances and succumbing to the disease midway of the treatment protocol. There are innumerable instances when the high cost of anti-cancer drugs consumed the life of a cancer patient more than the disease itself. Every unit responsible for the pricing and distribution of anti-cancer drugs like stockists, retailers, carrying and forwarding agencies and other liaison agents are involved in the loot.

The daredevilry of the traders can be gauged from the fact that even those drugs, whose prices are capped as per the Drug Pricing Control Order (DPCO) decided by the National Pricing Pharmaceutical Authority, are being sold at two to ten times of the original cost whereas DPCO rules state that they cannot be sold at a profit margin of more than 16%.

Actually, the issue is uncontrolled cost of medication In other words, the current medicine pricing is only condemning patients to death. Even as you see cost of the medicine plainly displayed on its cover, the actual cost price of the drug remains invisible. It’s wrapped in so many layers like maximum retail price (MRP) that almost no one understands what’s really happening. The maximum retail price (MRP) printed on most of the drugs or a healthcare item is already loaded with unbelievable margins ranging from 100 to 1000 percent!

Why the anti-cancer medicines are so expensive at our place? An acquaintance dealing in pharma trade shared an interesting, but thought provoking point. ‘In our state contraceptives are tax free, while as life-saving drugs are sleeved with multiple taxes. Thus, making the drugs costly. Notably, many states in India have exempted anti-cancer drugs from tax net.

So, the state government should make anti-cancer drug affordable by reviewing tax mechanism. Let all life-saving drugs are made tax-free as these are more important than contraceptives.

Lastly, it’s to be seen whether the drug price regulator’s announcement of slashing price of anti-cancer drugs percolates down to prevent out of pocket expenditure on medicines, which is otherwise believed to be the single largest contributor to pushing families beyond poverty threshold in the country. Bringing down the overall healthcare expenses, particularly in case of patients fighting cancer will go a long way to achieve the overall goal of affordable healthcare for all. Thus, implementation of the NPPA’s cut in prices of the anti-cancer drugs is a big challenge for the authorities on the ground.

(The views are of the author & not the institution he works for)