Affordable Healthcare -Role of pharmaceutical industry

Dr. Ajit Dangi, President & CEO, Danssen Consulting opines that the pharma industry should re-prioritise and cocus more on delivering affordable healthcare in India

The Indian pharmaceutical industry has made commendable progress in the past few years. It has crossed $ 20 billion in domestic and export sales both growing at double digit. With highest number of Abbreviated Dew Drug Applications (ANDAs) and US FDA approved manufacturing facilities, it is recognised the world over as a reliable supplier of quality medicines at affordable prices. Since medicines play an important role in health care delivery, pharma industry can play a pivotal role to improve healthcare. Despite the progress made by the industry, access to medicines continues to remain one of the most important challenges.

According to WHO and many internal reports less than 40 percent population of our country has access to essential medicines and over 80 percent pay from their own pocket. There are two major barriers to access and these are affordability and inadequate health infrastructure such as diagnostic facilities, hospitals, nursing homes, availability of medical professionals like doctors and nurses and pharmacies, high transaction costs due to cascading taxes and dealers` margins. Even if the drugs are given free, they will not reach the needy due to poor infrastructure. For instance, according to WHO 20 -25 percent of vaccines lose their potency before they reach patients in developing countries due to lack of cold chain facilities in the supply chain.

How do we correct this situation? One way is for the pharma industry to re-set its priorities. Traditionally the industry is focussed on the following key result areas:

• Intellectual property protection
• Pricing policies
• Research & Development pipe line
• Regulatory issues
• Competition and
• Cost containment

The time has now come to focus our attention on access to medicines and healthcare. While the need for modern medicines for a developing country like India is understandable, more than medicines, we need preventive healthcare like vaccination, immunisation, good sanitation and hygiene, clean drinking water, cessation of bad habits like tobacco chewing and smoking, nutrition, physical exercise, pollution control, safe sex habits etc. The pharma industry, with its vast reservoir of knowledge, can play a major role in making healthcare affordable through various innovative initiatives. Some of these are suggested below:

• Deploying its large and well trained field force of medical representatives to spend a little time on educating the public at large on various preventive measures.
• Earmarking a certain percentage of profits for research on diseases of the poor such as HIV /Aids , TB, malaria etc.
• Providing quality generics at modest profit to government initiatives like` Janaushadhi stores and healthcare NGOs.
• Reducing wasteful expenditure on sales promotion by adopting ethical marketing practices as recommended by industry associations like Organisation of Pharmaceutical Producers of India (OPPI) and Indian Drug Manufacturers' Association (IDMA).
• Promoting responsible Self Medication for minor ailments through safe and effective over-the-counter (OTC) drugs
• Adopting villages with a planned and a focussed strategy to reduce/ eliminate prevalence of at least one disease.
• Tying up with health insurance companies for either reimbursement or co-payment of drugs for chronic diseases.

The industry has started many such initiatives. Below is an illustrative list:

• Astra Zeneca R&D centre in Bangalore conducts focussed research on TB.
• Novartis Institute of Tropical Diseases, Singapore, works on dengue and other tropical diseases and leprosy eradication in India
• Lupin, the largest manufacturer of anti-TB drugs in the world has adopted several villages to eradicate TB
• WHO -Pharma CEO roundtable - Malaria Pathfinder Initiative
• Aventis and BI donating patent rights of drugs for Trypanosomiasis (African sleeping disease ) and HIV/Aids respectively.

Given the socioeconomic conditions, level of illiteracy and inadequate disposable income in our country, initiatives like those mentioned above will go a long way towards making healthcare affordable and inclusive to our large and diverse population.