Affordable medicines
THE alleged drug firms’ lobby fund only highlights the need for congressional action to bring down the prices of medicine. How to reconcile the Biron bill (House) with the Roxas version (Senate) soonest is what our people expect.We always look up to India, with more than a billion population, providing affordable medicines and consequently appropriate health care, for its people. In fact, studies reveal that Indian manufactured drugs are 1,000 to 4,000 percent cheaper compared to US brands. For instance, 2006 price records show that Hytrin (an anti-hypertension drug) sells for $ 4.20 for a month supply of the tablet in Bombay while the same drug from the same company costs $ 44.48 in Boston!
Why are medicines priced so low in India? This immense difference in prices of medicines, according to studies, may be attributed to some "discriminatory’’ features of the Indian Patents Act of 1970 which "provides for the grant of only ‘process’ and not ‘products’ patents in the pharmaceutical and chemical sectors.’’ Salil Panchal of Morpheus Inc. in Mumbai, in an article "Just what is a Patent?’’ (April 6, 2005), differentiates "process’’ from "product’’ patent by stating that: "A product patent allows rights (including exclusive manufacturing and marketing rights) relating to the object, while process patent relates to a means.’’ In other words, even if drugs have existing patents in the United States, Indian drug manufacturers can utilize the process of reverse-engineering to come up with a drug that is as effective as the patented one, bear the same brand name and manufacturer and yet may be sold at very low costs, and still maintain the legality of their acts under Indian Law. It is perhaps for this same reason that the Indian Pharmaceutical Industry is currently one of the world’s fastest growing industries that has expanded 30 percent more in the last 15 years. Data from the Community Development Medicinal Unit reveal that there are 15,000 pharmaceutical companies that are registered in India and that such growth has provided jobs for three million people in the fields of production, research and marketing. "Currently, the global output of the pharmaceutical industry ranks fourth in terms of volume and 13th in terms of value. . . The total size of the industry is estimated at $ 7 billion, with exports accounting for $ 2.5 billion.’’ (Patents Era: How Will Pharma Firms Cope by Salil Panchal – Mumbai, April 7, 2005).
In the introductory pages of the study conducted by Voluntary Organization in Interest of Consumer Education (VOICE) entitled "A Study on the Availability and Prices of Medicines in India’’ during the first quarter of 2002, it was stated that pharmaceutical industries in India were largely developed due to the "need for achieving self-sufficiency in medicines and ensuring abundant availability of essential medicines at reasonable prices.’’ This need paved the way for the formulation of the Indian Drug Policy of 1986 titled "Measures for Rationalization, Quality Control and Growth of Drugs Pharmaceutical Industry in India’’ and aimed at ensuring the availability and affordability of good quality, life-saving drugs, especially for the greater number of Indian living below poverty line.
According to the same source quoted above, even before the formulation of the Indian Drug Policy, the Indian government had declared a Drug (Price Control) Order in 1970 (the same year the Indian Patents Act was enacted) that was succeeded by similar orders in 1979, 1987 and 1995, adding more liberalized views with each amendment. "DPCO controls the domestic prices of major bulk drugs and their formulation with an aim to provide patients with medicines at affordable prices.’’ In August 29, 1997, the Indian government also established the National Pharmaceutical Pricing Authority (NPPA) as an independent body tasked among others to: "Fix/revise prices of pharmaceutical products, enforce the provisions of the Drugs (Price Control) Order; monitor the prices of controlled and decontrolled drugs in the country; and, recover the amounts overcharged by the manufacturers for controlled drugs.’’ All these policies and agencies have largely contributed to keeping the prices of medicines in India as one of the world’s lowest, not only for the benefit of combating diseases within the country but as well as for the rest of the world’s sick and poor nations.
Now that India has taken its initial steps towards a market economy that is guided by World Trade Organization policies, and as it shifts from a process patent regime to a product patent one (to meet its 2005 WTO deadline), the question of whether availability and affordability of life-saving medicines can still be assured (not only for India’s 1,080,264,388 [July 2005 estimate] people but for all the other communities around the world that depend on cheap drugs for disease treatment and survival) arises as a global concern. In a recently published article in the Asia Times written by a New Delhi-based journalist Siddharth Srivastava, the writer expresses a similar concern when he wrote: "The question is: While one understands the exigencies of multinational pharmaceutical companies needing to protect their patent right as well as profits, why shall medicines, whether in India or anywhere, be inaccessible to those who need them.
The Indian government has reportedly assured the public (and the world) that there would be no "tragic" in drug prices as "97 percent of the drugs sold in India are off-patent’’ and the "remaining 3 percent covered by the new patent regime all have alternatives that may be purchased at their previous cost.’’ Considering that the patent shift in India would have an impact in two years time, Indian pharmaceutical companies have now diverted their investments to research and development activities to keep abreast with multinational drug companies.
Drug price regulations would probably work, even in short-term horizon just as importation of cheaper drugs from India would, as the House and Senate versions would want to accomplish. But following the Indian model, we need to devote more resources to research and development including the upgrading and support to our cheaper herbal medicines such as ampalaya or even coconut oil. Perhaps Mr. Roxas and Mr. Biron can both study the creation of a state-owned national pharmaceutical company to focus on research and development as well as the importation of cheaper drugs. That is, if they can get their acts together.
