Expanding the list of essential drugs

The government is reportedly planning to include some more medicines on its list of essential drugs the prices of which are fixed by it taking into cognisance the paying ability of the common men. The reason behind the government move is that the pharmaceutical companies are found to be more interested in producing, marketing and promoting new generic items that are not on the list of essential drugs. Manufacturers fix the prices of the same. When the government has not been that attentive to inclusion of a few more drugs on the list of essentials, the manufacturers have introduced hundreds of new drugs in the market since the introduction of the National Drug Policy (NDP) in 1982. That is why the number of essential drugs stands at only 117 as against several thousand generic items that are being locally produced and imported.

The planned move to expand the list of essential drugs would mean that the government would fix the prices of new generic items to be put on the list concerned. There is no denying that controlling price by the government of anything produced by private sector is against the principles of free-market economy and it also creates distortions in the market. But a government worth its name can hardly ignore the welfare of a large segment of the population who cannot afford expensive life-saving and essential medicines. So, the government, for the sake of the poor and low-income people, is required to exercise its power and authority in critical areas that may not otherwise conform to the stereotypical principles of a market-driven economy. This is more so particularly when the government does not have enough resources to support health insurance for the poor.

However, the local pharmaceutical companies have received allout support from the government since the introduction of NDP and they are now meeting more than 95 per cent of the domestic need for medicines as against only 5.0 per cent in 1982. The pharmaceutical market size has grown to nearly US$1.5 billion now and a good number of companies have been exporting drugs even to some European countries. So, it would not be too much to demand from them some pro-active moves in favour of the poor and low income people, in terms of marketing of essential drugs. But the companies tend to avoid production of essential drugs, leading to serious scarcity of the same in the market and consequent rise in their prices.

So, the proposed expansion of the list of essential drugs by the government does not necessarily guarantee the drug manufacturers' willingness to produce and sell the same in right quantities and at fair prices. But the companies, particularly the large ones in most cases, can certainly afford both. At least, 30 out of a total of 250 drug manufacturers do spend a substantial amount of money on the promotion of their products and a few of such promotional activities allegedly do not conform to healthy marketing norms. Physicians, particularly of large public sector health facilities, are literally bribed by major drug producers for promotion of new generic items. Thus the inclusion of a few more new generic items in the list of essential drugs will be a job half-done if the ministry of health fails to reach its benefit to the target population. High prices not only concern essential drugs but also all other medicines and as such, deserve a priority attention of the government. The unabated hike in the prices of medicines for the past few months has really hit the consumers hard.