Putting a price to health

Tuberculosis, once known as a poor man’s illness, today shows no class discrimination. Bollywood super stars, top performing super sales men, upper middle class well heeled socialites, IIT toppers: every one knows someone touched by TB, only the degree of infection differs. We are facing the fact that the tubercle bacillus lies in wait, in its latent state, like a crouching tiger, till it finds the chink in our armour. The trigger could be high stress levels, poor nutrition, etc. It could also be any other infection like HIV /AIDS which compromises the immune system. For instance, the resurgence of TB in the US is linked to HIV/AIDS infection.

As our cover story in this issue, ‘Beyond the Ban’, points out, TB incidence in India has gone to the next level, with multi drug resistant (MDR) TB strains making it tougher (and more expensive) to treat. The Government of India will have to go beyond banning test kits giving misleading results and really look at how it can influence the price of testing and promote the right testing methods. Over the years, India’s pharmaceutical industry has achieved sufficient economy of scale to provide the government affordable medication for infectious diseases like TB, but unfortunately India’s medical diagnostics industry is today nowhere near this level of maturity.

And in the case of TB, easy access to affordable medicine has actually backfired to some extent. The indiscriminate use of TB medication, with patients stopping medication mid way through the course, is one of the main reasons why cases of MDR TB are worrying public health authorities.

So, low priced medicines is not the solution to India’s disease burden. That is also the point being made by the industry in another lead story, ‘Drug pricing norms: Cost or market-based?’. Debating the pros and cons of the cost-based and market-based pricing formulae, industry experts make the point that the former system might make medicines so cheap that companies will find it unviable to invest in making these medications better. The latter method might result in slightly more expensive medicines, but competition will keep the prices low, while ensuring a certain level of profits to sustain the industry in the long term.

It is indeed ironical that while India exports medicines to the rest of the world in its avatar as the ‘pharmacy of the developing world’, accessibility to medicines within the country is less than 40 per cent, lower than even some developing countries/ according to WHO reports. A market-based pricing approach seems to be the best bet to ensure that India becomes the pharmacy not just to the developing world but to the developed nations as well, where the accent is not just on improved but innovative medicines.

Viveka Roychowdhury
Editor

viveka.r@expressindia.com