On Generics and Drug affordibility in India.

I had previously written about compulsory licensing of expensive anti cancer drugs in India and the expected benefits to the patients. Just after this news came out, there was reaction from the Govt. sources  stating that no they had no plans for such measures as cancer was not an “epidemic or national emergency”.
There is an interesting interview with Ranjit Sahani, country president of Novartis in India  who is arguing for better IP protection and pointing out that generics do not solve the issues as they remains out of bound to most of the patients.

But here, generics alone do not solve the issue. Generic versions of Glivec are far too expensive for the poor in India. Furthermore, generic-makers in India have yet to come forward with an access program for generic imatinib mesylate (Gleevec’s generic name). For example, in India the cost of a one-year treatment with generic imatinib is $2,100, or 4.5 times the average annual income. Even our critics recognize that generic versions of Gleevec are not the solution for the poor in India. This is why approximately 99% of patients on Gleevec receive it free. There is no market for Gleevec in India…

You can read the whole article here. (via Pharmalot).

He also discusses the issue of epidemic and national emergency as regards to HIV and Diabetes

There continues to be some ambiguity around what constitutes an epidemic situation. In 2007, India reported 2.5 million HIV infections, a prevalence rate of 0.36%, with less than 15% of HIV-positive people receiving [antiretroviral] treatment. That said, India has about 60 million diabetic patients [30 million diagnosed and another 30 million undiagnosed]. By sheer volume, wouldn’t that constitute an emergency? If examined carefully, limited cases would qualify as a national emergency, an epidemic, for example. HIV and cancer by the very nature of these illnesses are an emotive issue, which is why they get the volume of publicity.

Most Indian practitioners are aware of the huge disease burden in our country and the dismal situation here but the figures he quotes is sobering.

He also talks of differential pricing of drugs but I think it will be hard to put in practice or prevent misuse. Another point he makes ( naturally being a pharmaceutical seller) that the price of drug is fraction of the total cost of treatment.

Despite a significantly higher cost for the private sector, an analysis of the cost structure shows that the amount spent on medicine is a fraction of that spent on diagnosis and doctors’ fees.

I feel that were it not so, the number of patients completing their treatment/ patient compliance will go down even more. The fact is physician compensation/procedure costs are also rock bottom. For example where in world you get a cholecystectomy for Rs 3000/- or an abdominal ultrasound for Rs 300? Unless the economic condition improves the return on medicines will remain around the present levels.

Interesting read over all.