Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 150
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Code Context


        trigger_error($message, E_USER_DEPRECATED);

    }
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 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.'
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deprecationWarning - CORE/src/Core/functions.php, line 311
Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421
App\Controller\ArtileDetailController::index() - APP/Controller/ArtileDetailController.php, line 150
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Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51
Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98

Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 151
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Code Context


        trigger_error($message, E_USER_DEPRECATED);

    }
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 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.'
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deprecationWarning - CORE/src/Core/functions.php, line 311
Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421
App\Controller\ArtileDetailController::index() - APP/Controller/ArtileDetailController.php, line 151
Cake\Controller\Controller::invokeAction() - CORE/src/Controller/Controller.php, line 610
Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120
Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94
Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 97
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51
Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98

Warning (512): Unable to emit headers. Headers sent in file=/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php line=853 [CORE/src/Http/ResponseEmitter.php, line 48]
Code Context
            if (Configure::read('debug')) {

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        LATEST NEWS UPDATES | A short-sighted cap-Chandra M Gulhati    </title>
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-The Indian Express





The government&rsquo;s proposal to price-control certain drugs will create more problems than it will solve





From clothes to cars, prices of consumer products the world over are determined taking into account input costs, margins and competition, popularly called the..."/>
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-The Indian Express





The government&rsquo;s proposal to price-control certain drugs will create more problems than it will solve





From clothes to cars, prices of consumer products the world over are determined taking into account input costs, margins and competition, popularly called the..." />
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                            <div style="text-align: justify">-The Indian Express</div><div style="text-align: justify"><br /></div><div style="text-align: justify"><em>The government&rsquo;s proposal to price-control certain drugs will create more problems than it will solve</em></div><div style="text-align: justify"><br /></div><div style="text-align: justify">From clothes to cars, prices of consumer products the world over are determined taking into account input costs, margins and competition, popularly called the cost-based pricing system. Departing from this sound, fair, tried and tested principle of commerce, the government&rsquo;s new drug pricing policy, approved by the Group of Ministers headed by Sharad Pawar, has come out with an unusual methodology: market-based pricing.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Under this system, the weighted average price of branded medicines with sales over 1 per cent of the market share will be the benchmark for price fixation. Unlike other consumer items, in the case of medicines, the decision-maker is the doctor who selects the drugs and the brands. Manufacturers fix the price and patients are obliged to pay. How can the government, whose duty it is to protect the interests of consumers, be party to such an unfair system of price allocation of life-saving medicines? This irrational system of price fixation is not the only flaw; loopholes have been left so that the drug industry can profit. Some examples:</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Partial list of medicines: In all, products containing just over 900 basic salts are marketed in India. The price control policy will apply to just the 348 drugs that appear in the National List of Essential Medicines (NLEM). NLEM includes only those drugs that are needed most of the time by most patients. The list is meant for governments to buy and provide medicines to public healthcare facilities such as primary health centres, hospitals and tertiary institutions.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">More than two-thirds of patients in India depend on private healthcare, where all 900-odd medicines are prescribed. Hence, restricting price control to just 348 medicines is inadequate and leaves the door wide open for manufacturers to migrate from price-regulated to unregulated drugs. For example, if the price of blood pressure drug enalapril is controlled, manufacturers will simply migrate to other agents in the same class, such as captopril, lisinopril, ramipril and trandolapril.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">The policy counters this argument by stating that drug manufacturers will be compelled to produce medicines in the same quantity that were being manufactured before the price control system came into force. This is legally untenable and practically impossible. Once manufacturers stop promotion of a particular medicine, prescriptions and, consequently, demand will go down. If forced to produce the drug, companies will simply ask the government to buy the same. Will the government agree to do so?</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Pruned list of dosage forms: Not all products containing the 348 drugs are supposed to come under price control. Each drug has many dosage forms, such as tablets, syrups and injections in various strengths. For example, the antibiotic Augmentin has tablets that are marketed in several strengths: 375 mg, 625 mg and 1,000 mg. Yet, only the 625mg tablet will be price controlled, leaving manufacturers to decide the price of the other strengths. An estimated half of all dosage forms will be out of price control.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Combination products: While prices of products with one ingredient will come under price regulation, combination medicines with two or more ingredients will be excluded from price control. This means that if the prices of drugs A and B are individually controlled, the combination of A+B will not be regulated. This will mean that manufacturers will be free to determine the prices of approximately 40 per cent of all the drugs in the market.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Hike in prices of cheaper brands: Once the maximum permitted price of drugs in the NLEM is determined, prices of some brands will be above while others will be below the permitted levels. Producers of drugs falling above the permitted price will be required to reduce the prices. Instead of reducing prices, manufacturers of such brands will either migrate to alternative drugs outside price control or shift to unspecified dosage forms. On the other hand, manufacturers of cheaper products will hike prices to benefit from &ldquo;government-determined&rdquo; levels. Thus, the patient will be the ultimate sufferer.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Automatic price hike: Irrespective of input costs, drug manufacturers will be free to hike the prices of all products at the same rate as the increase in the Wholesale Price Index (WPI) for manufactured goods year after year. WPI never comes down; so prices will go only in one direction, up and up.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Patented, imported products: The gloomy part of the new policy is that it will not tame the exorbitant prices of patented medicines of foreign manufacturers. Another committee, in existence since 2006, will take a decision in &ldquo;due course.&rdquo; Till then these companies can make hay.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Unbranded &ldquo;generics&rdquo;: There is also a proposal to compel doctors to prescribe cheaper unbranded drugs. Such a provision can hardly be part of a pricing policy. Doctors in private practice, who account for over 90 per cent of total practitioners, cannot be legally forced to follow official dictat. This provision is merely a ploy to divert attention from the main issue of price control. Besides, over 40 per cent of medicines are combination products where the brand name is essential.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Jan Aushadhi stores: The policy also refers to the role that Jan Aushadhi stores can play in selling inexpensive unbranded medicines. There are more than four lakh retail chemists in India. So far, only 112 Jan Aushadhi stores have been opened, out of which five have already closed down due to poor sales. There is not a single store in UP, Bihar, Gujarat, Maharashtra, Karnataka, Tamil Nadu, Kerala and many other states. This system can hardly meet the needs of the people.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">The proposed policy, if approved by the cabinet, could end up serving the interests of the pharmaceutical industry, rather than the needs of poor patients.</div><div style="text-align: justify"><br /></div><div style="text-align: justify"><em>Gulhati, a doctor, is editor of &lsquo;Monthly Index of Medical Specialities&rsquo;</em></div>                                                           
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    <br><a href="http://www.indianexpress.com/news/a-shortsighted-cap/1014357/0" class="re" target="_blank">The Indian Express, 10 October, 2012, http://www.indianexpress.com/news/a-shortsighted-cap/1014357/0</a><div class="clear"></div>
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        LATEST NEWS UPDATES | A short-sighted cap-Chandra M Gulhati    </title>
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-The Indian Express





The government&rsquo;s proposal to price-control certain drugs will create more problems than it will solve





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    <h1 class="cat-box-title">A short-sighted cap-Chandra M Gulhati</h1>
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                            <div style="text-align: justify">-The Indian Express</div><div style="text-align: justify"><br /></div><div style="text-align: justify"><em>The government&rsquo;s proposal to price-control certain drugs will create more problems than it will solve</em></div><div style="text-align: justify"><br /></div><div style="text-align: justify">From clothes to cars, prices of consumer products the world over are determined taking into account input costs, margins and competition, popularly called the cost-based pricing system. Departing from this sound, fair, tried and tested principle of commerce, the government&rsquo;s new drug pricing policy, approved by the Group of Ministers headed by Sharad Pawar, has come out with an unusual methodology: market-based pricing.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Under this system, the weighted average price of branded medicines with sales over 1 per cent of the market share will be the benchmark for price fixation. Unlike other consumer items, in the case of medicines, the decision-maker is the doctor who selects the drugs and the brands. Manufacturers fix the price and patients are obliged to pay. How can the government, whose duty it is to protect the interests of consumers, be party to such an unfair system of price allocation of life-saving medicines? This irrational system of price fixation is not the only flaw; loopholes have been left so that the drug industry can profit. Some examples:</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Partial list of medicines: In all, products containing just over 900 basic salts are marketed in India. The price control policy will apply to just the 348 drugs that appear in the National List of Essential Medicines (NLEM). NLEM includes only those drugs that are needed most of the time by most patients. The list is meant for governments to buy and provide medicines to public healthcare facilities such as primary health centres, hospitals and tertiary institutions.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">More than two-thirds of patients in India depend on private healthcare, where all 900-odd medicines are prescribed. Hence, restricting price control to just 348 medicines is inadequate and leaves the door wide open for manufacturers to migrate from price-regulated to unregulated drugs. For example, if the price of blood pressure drug enalapril is controlled, manufacturers will simply migrate to other agents in the same class, such as captopril, lisinopril, ramipril and trandolapril.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">The policy counters this argument by stating that drug manufacturers will be compelled to produce medicines in the same quantity that were being manufactured before the price control system came into force. This is legally untenable and practically impossible. Once manufacturers stop promotion of a particular medicine, prescriptions and, consequently, demand will go down. If forced to produce the drug, companies will simply ask the government to buy the same. Will the government agree to do so?</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Pruned list of dosage forms: Not all products containing the 348 drugs are supposed to come under price control. Each drug has many dosage forms, such as tablets, syrups and injections in various strengths. For example, the antibiotic Augmentin has tablets that are marketed in several strengths: 375 mg, 625 mg and 1,000 mg. Yet, only the 625mg tablet will be price controlled, leaving manufacturers to decide the price of the other strengths. An estimated half of all dosage forms will be out of price control.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Combination products: While prices of products with one ingredient will come under price regulation, combination medicines with two or more ingredients will be excluded from price control. This means that if the prices of drugs A and B are individually controlled, the combination of A+B will not be regulated. This will mean that manufacturers will be free to determine the prices of approximately 40 per cent of all the drugs in the market.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Hike in prices of cheaper brands: Once the maximum permitted price of drugs in the NLEM is determined, prices of some brands will be above while others will be below the permitted levels. Producers of drugs falling above the permitted price will be required to reduce the prices. Instead of reducing prices, manufacturers of such brands will either migrate to alternative drugs outside price control or shift to unspecified dosage forms. On the other hand, manufacturers of cheaper products will hike prices to benefit from &ldquo;government-determined&rdquo; levels. Thus, the patient will be the ultimate sufferer.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Automatic price hike: Irrespective of input costs, drug manufacturers will be free to hike the prices of all products at the same rate as the increase in the Wholesale Price Index (WPI) for manufactured goods year after year. WPI never comes down; so prices will go only in one direction, up and up.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Patented, imported products: The gloomy part of the new policy is that it will not tame the exorbitant prices of patented medicines of foreign manufacturers. Another committee, in existence since 2006, will take a decision in &ldquo;due course.&rdquo; Till then these companies can make hay.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Unbranded &ldquo;generics&rdquo;: There is also a proposal to compel doctors to prescribe cheaper unbranded drugs. Such a provision can hardly be part of a pricing policy. Doctors in private practice, who account for over 90 per cent of total practitioners, cannot be legally forced to follow official dictat. This provision is merely a ploy to divert attention from the main issue of price control. Besides, over 40 per cent of medicines are combination products where the brand name is essential.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Jan Aushadhi stores: The policy also refers to the role that Jan Aushadhi stores can play in selling inexpensive unbranded medicines. There are more than four lakh retail chemists in India. So far, only 112 Jan Aushadhi stores have been opened, out of which five have already closed down due to poor sales. There is not a single store in UP, Bihar, Gujarat, Maharashtra, Karnataka, Tamil Nadu, Kerala and many other states. This system can hardly meet the needs of the people.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">The proposed policy, if approved by the cabinet, could end up serving the interests of the pharmaceutical industry, rather than the needs of poor patients.</div><div style="text-align: justify"><br /></div><div style="text-align: justify"><em>Gulhati, a doctor, is editor of &lsquo;Monthly Index of Medical Specialities&rsquo;</em></div>                                                           
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    <br><a href="http://www.indianexpress.com/news/a-shortsighted-cap/1014357/0" class="re" target="_blank">The Indian Express, 10 October, 2012, http://www.indianexpress.com/news/a-shortsighted-cap/1014357/0</a><div class="clear"></div>
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        LATEST NEWS UPDATES | A short-sighted cap-Chandra M Gulhati    </title>
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-The Indian Express





The government&rsquo;s proposal to price-control certain drugs will create more problems than it will solve





From clothes to cars, prices of consumer products the world over are determined taking into account input costs, margins and competition, popularly called the..."/>
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-The Indian Express





The government&rsquo;s proposal to price-control certain drugs will create more problems than it will solve





From clothes to cars, prices of consumer products the world over are determined taking into account input costs, margins and competition, popularly called the..." />
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                            <div style="text-align: justify">-The Indian Express</div><div style="text-align: justify"><br /></div><div style="text-align: justify"><em>The government&rsquo;s proposal to price-control certain drugs will create more problems than it will solve</em></div><div style="text-align: justify"><br /></div><div style="text-align: justify">From clothes to cars, prices of consumer products the world over are determined taking into account input costs, margins and competition, popularly called the cost-based pricing system. Departing from this sound, fair, tried and tested principle of commerce, the government&rsquo;s new drug pricing policy, approved by the Group of Ministers headed by Sharad Pawar, has come out with an unusual methodology: market-based pricing.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Under this system, the weighted average price of branded medicines with sales over 1 per cent of the market share will be the benchmark for price fixation. Unlike other consumer items, in the case of medicines, the decision-maker is the doctor who selects the drugs and the brands. Manufacturers fix the price and patients are obliged to pay. How can the government, whose duty it is to protect the interests of consumers, be party to such an unfair system of price allocation of life-saving medicines? This irrational system of price fixation is not the only flaw; loopholes have been left so that the drug industry can profit. Some examples:</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Partial list of medicines: In all, products containing just over 900 basic salts are marketed in India. The price control policy will apply to just the 348 drugs that appear in the National List of Essential Medicines (NLEM). NLEM includes only those drugs that are needed most of the time by most patients. The list is meant for governments to buy and provide medicines to public healthcare facilities such as primary health centres, hospitals and tertiary institutions.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">More than two-thirds of patients in India depend on private healthcare, where all 900-odd medicines are prescribed. Hence, restricting price control to just 348 medicines is inadequate and leaves the door wide open for manufacturers to migrate from price-regulated to unregulated drugs. For example, if the price of blood pressure drug enalapril is controlled, manufacturers will simply migrate to other agents in the same class, such as captopril, lisinopril, ramipril and trandolapril.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">The policy counters this argument by stating that drug manufacturers will be compelled to produce medicines in the same quantity that were being manufactured before the price control system came into force. This is legally untenable and practically impossible. Once manufacturers stop promotion of a particular medicine, prescriptions and, consequently, demand will go down. If forced to produce the drug, companies will simply ask the government to buy the same. Will the government agree to do so?</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Pruned list of dosage forms: Not all products containing the 348 drugs are supposed to come under price control. Each drug has many dosage forms, such as tablets, syrups and injections in various strengths. For example, the antibiotic Augmentin has tablets that are marketed in several strengths: 375 mg, 625 mg and 1,000 mg. Yet, only the 625mg tablet will be price controlled, leaving manufacturers to decide the price of the other strengths. An estimated half of all dosage forms will be out of price control.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Combination products: While prices of products with one ingredient will come under price regulation, combination medicines with two or more ingredients will be excluded from price control. This means that if the prices of drugs A and B are individually controlled, the combination of A+B will not be regulated. This will mean that manufacturers will be free to determine the prices of approximately 40 per cent of all the drugs in the market.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Hike in prices of cheaper brands: Once the maximum permitted price of drugs in the NLEM is determined, prices of some brands will be above while others will be below the permitted levels. Producers of drugs falling above the permitted price will be required to reduce the prices. Instead of reducing prices, manufacturers of such brands will either migrate to alternative drugs outside price control or shift to unspecified dosage forms. On the other hand, manufacturers of cheaper products will hike prices to benefit from &ldquo;government-determined&rdquo; levels. Thus, the patient will be the ultimate sufferer.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Automatic price hike: Irrespective of input costs, drug manufacturers will be free to hike the prices of all products at the same rate as the increase in the Wholesale Price Index (WPI) for manufactured goods year after year. WPI never comes down; so prices will go only in one direction, up and up.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Patented, imported products: The gloomy part of the new policy is that it will not tame the exorbitant prices of patented medicines of foreign manufacturers. Another committee, in existence since 2006, will take a decision in &ldquo;due course.&rdquo; Till then these companies can make hay.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Unbranded &ldquo;generics&rdquo;: There is also a proposal to compel doctors to prescribe cheaper unbranded drugs. Such a provision can hardly be part of a pricing policy. Doctors in private practice, who account for over 90 per cent of total practitioners, cannot be legally forced to follow official dictat. This provision is merely a ploy to divert attention from the main issue of price control. Besides, over 40 per cent of medicines are combination products where the brand name is essential.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">Jan Aushadhi stores: The policy also refers to the role that Jan Aushadhi stores can play in selling inexpensive unbranded medicines. There are more than four lakh retail chemists in India. So far, only 112 Jan Aushadhi stores have been opened, out of which five have already closed down due to poor sales. There is not a single store in UP, Bihar, Gujarat, Maharashtra, Karnataka, Tamil Nadu, Kerala and many other states. This system can hardly meet the needs of the people.</div><div style="text-align: justify"><br /></div><div style="text-align: justify">The proposed policy, if approved by the cabinet, could end up serving the interests of the pharmaceutical industry, rather than the needs of poor patients.</div><div style="text-align: justify"><br /></div><div style="text-align: justify"><em>Gulhati, a doctor, is editor of &lsquo;Monthly Index of Medical Specialities&rsquo;</em></div>                                                           
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    <br><a href="http://www.indianexpress.com/news/a-shortsighted-cap/1014357/0" class="re" target="_blank">The Indian Express, 10 October, 2012, http://www.indianexpress.com/news/a-shortsighted-cap/1014357/0</a><div class="clear"></div>
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Home हिन्दी

A short-sighted cap-Chandra M Gulhati

Published on Oct 10, 2012   Modified on Oct 10, 2012

-The Indian Express The government’s proposal to price-control certain drugs will create more problems than it will solve From clothes to cars, prices of consumer products the world over are determined taking into account input costs, margins and competition, popularly called the cost-based pricing system. Departing from this sound, fair, tried and tested principle of commerce, the government’s new drug pricing policy, approved by the Group of Ministers headed by Sharad Pawar, has come out with an unusual methodology: market-based pricing. Under this system, the weighted average price of branded medicines with sales over 1 per cent of the market share will be the benchmark for price fixation. Unlike other consumer items, in the case of medicines, the decision-maker is the doctor who selects the drugs and the brands. Manufacturers fix the price and patients are obliged to pay. How can the government, whose duty it is to protect the interests of consumers, be party to such an unfair system of price allocation of life-saving medicines? This irrational system of price fixation is not the only flaw; loopholes have been left so that the drug industry can profit. Some examples: Partial list of medicines: In all, products containing just over 900 basic salts are marketed in India. The price control policy will apply to just the 348 drugs that appear in the National List of Essential Medicines (NLEM). NLEM includes only those drugs that are needed most of the time by most patients. The list is meant for governments to buy and provide medicines to public healthcare facilities such as primary health centres, hospitals and tertiary institutions. More than two-thirds of patients in India depend on private healthcare, where all 900-odd medicines are prescribed. Hence, restricting price control to just 348 medicines is inadequate and leaves the door wide open for manufacturers to migrate from price-regulated to unregulated drugs. For example, if the price of blood pressure drug enalapril is controlled, manufacturers will simply migrate to other agents in the same class, such as captopril, lisinopril, ramipril and trandolapril. The policy counters this argument by stating that drug manufacturers will be compelled to produce medicines in the same quantity that were being manufactured before the price control system came into force. This is legally untenable and practically impossible. Once manufacturers stop promotion of a particular medicine, prescriptions and, consequently, demand will go down. If forced to produce the drug, companies will simply ask the government to buy the same. Will the government agree to do so? Pruned list of dosage forms: Not all products containing the 348 drugs are supposed to come under price control. Each drug has many dosage forms, such as tablets, syrups and injections in various strengths. For example, the antibiotic Augmentin has tablets that are marketed in several strengths: 375 mg, 625 mg and 1,000 mg. Yet, only the 625mg tablet will be price controlled, leaving manufacturers to decide the price of the other strengths. An estimated half of all dosage forms will be out of price control. Combination products: While prices of products with one ingredient will come under price regulation, combination medicines with two or more ingredients will be excluded from price control. This means that if the prices of drugs A and B are individually controlled, the combination of A+B will not be regulated. This will mean that manufacturers will be free to determine the prices of approximately 40 per cent of all the drugs in the market. Hike in prices of cheaper brands: Once the maximum permitted price of drugs in the NLEM is determined, prices of some brands will be above while others will be below the permitted levels. Producers of drugs falling above the permitted price will be required to reduce the prices. Instead of reducing prices, manufacturers of such brands will either migrate to alternative drugs outside price control or shift to unspecified dosage forms. On the other hand, manufacturers of cheaper products will hike prices to benefit from “government-determined” levels. Thus, the patient will be the ultimate sufferer. Automatic price hike: Irrespective of input costs, drug manufacturers will be free to hike the prices of all products at the same rate as the increase in the Wholesale Price Index (WPI) for manufactured goods year after year. WPI never comes down; so prices will go only in one direction, up and up. Patented, imported products: The gloomy part of the new policy is that it will not tame the exorbitant prices of patented medicines of foreign manufacturers. Another committee, in existence since 2006, will take a decision in “due course.” Till then these companies can make hay. Unbranded “generics”: There is also a proposal to compel doctors to prescribe cheaper unbranded drugs. Such a provision can hardly be part of a pricing policy. Doctors in private practice, who account for over 90 per cent of total practitioners, cannot be legally forced to follow official dictat. This provision is merely a ploy to divert attention from the main issue of price control. Besides, over 40 per cent of medicines are combination products where the brand name is essential. Jan Aushadhi stores: The policy also refers to the role that Jan Aushadhi stores can play in selling inexpensive unbranded medicines. There are more than four lakh retail chemists in India. So far, only 112 Jan Aushadhi stores have been opened, out of which five have already closed down due to poor sales. There is not a single store in UP, Bihar, Gujarat, Maharashtra, Karnataka, Tamil Nadu, Kerala and many other states. This system can hardly meet the needs of the people. The proposed policy, if approved by the cabinet, could end up serving the interests of the pharmaceutical industry, rather than the needs of poor patients. Gulhati, a doctor, is editor of ‘Monthly Index of Medical Specialities’

The Indian Express, 10 October, 2012, http://www.indianexpress.com/news/a-shortsighted-cap/1014357/0

Tagged with: medicines Health

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