A probing report published recently in this newspaper, reveals that the government controls prices of only 117 medicinal drugs, while the pharmaceutical industry sets the price of 1,700 drugs. Of the 117 medicines, 70 are essential drugs, 47 are vaccines and the rest belongs to different categories of medicines. In India, the number of medicinal drugs that fall under the government's control is 800. In Bangladesh, more than 90 per cent of drugs' prices are controlled by the pharmaceutical industry itself. That goes a long way to explain why the price of some drugs has reportedly seen as high an increase as 120 per cent! What is most concerning is that the majority share in the market is controlled by 20 large companies.
With near monopolistic control of the medicinal drug market, large pharmaceutical can understandably revise prices upward at will. Although it is a fact that cost of production has risen due to pricier raw materials and increased import expenditure (thanks to devaluation of Taka and paucity of bank LCs), it does not justify the latest market price. Indeed, it is sad to learn that although "under an order of DGDA in 1994, the number of price-controlled medicines should be raised to 219", nothing has transpired to make that order effective in nearly two decades.
What has happened, however, is the increase in medicine prices putting consumers at a disadvantage. No wonder, out-of-pocket expenditure is to the tune of 69 per cent in this country. What health practitioners are pointing out is that this unregulated price increase will force millions of people, particularly the elderly who belong to low-income or fixed income groups, to dispense with their regular medicines. Discontinuation of medication, particularly when it involves antibiotics, poses a grave threat to patients. Many may simply die. What are people supposed to do in such a situation? In many cases it may be a choice between putting food on the table for the whole family and buying medicine that is becoming more expensive for a sick member of the family. Drugs are not like any other commodity including essentials. Prescribed medicine has to be administered as directed by the doctor. Price increase in the region of 120 per cent of medicines prescribed for certain communicable and non-communicable diseases, will put thousands of families into the dilemma over continuation or skipping medicines.
To rub salt into wound, most medicine shops have stopped offering discounts of up to 5.0 or 7.0 per cent on drugs they used do earlier. Some well known pharmacies still maintain the practice, but most drug stores have done away with the practice. The report delves deep and finds that citizens, senior among them in particular, complain about the price hike of basic medicines like 'Orsaline' (used to treat dehydration following stomach upset). Drugs used for treating blood pressure, another essential drug for millions of patients have become costlier as well. These are just two examples out of many that are seeing hike in prices. When in a typical household one or more patients suffer from various ailments, these uncontrolled and unexplainable price hikes cause economic hemorrhage and upset family budgets.
Unlike prices of consumable essentials like grains, onion, garlic, salt, sugar and spices, the silent inflation in medicine prices do not generally hog headlines. In the absence of a serious regulatory pressure from the DGDA, it is understandable why the pharmaceutical industry can basically make upward revision of prices on its own. Why the government-controlled basket of essential medicines has not increased in numbers over a two-decade period remains a mystery to many, because with the passage of time many more ailments have evolved and the medicines to treat these ailments are now considered to be essential drugs in other countries, but not in Bangladesh.
It is important to know how the nation deals with the emerging drug market following the price hike. The lack of regulations and regulatory oversight is a good point to start. It is essential that the government strictly monitor medicine prices. There cannot be any arbitrary price increase! Medicine has no alternative. Patients needing drugs to treat a certain ailment will have to pay for it, no matter what the cost, if they seek cure. While the middle class and the more affluent sections of society will be able to manage somehow, the same cannot be said of the poor and ultra-poor.
At a time when hyper inflation is the new norm, the last thing people need is a fresh round of increase in medicine prices. While people may consume less protein, cut back on vegetables, it is inhumane to expect them to cut back on intake of medicines that may make a difference between life and death, between staying healthy or perpetually sick. One can only hope that the authorities will start formulating rules and laws that will protect the ailing humanity from this sort of arbitrary price setting.
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