Prescription drug prices need to be fixed rationally

A simmering discontent is now prevailing among the members of the public over substantial rise in prices of life-saving and other prescription drugs. Big companies are not giving prior announcement of the price increases. The Drug Administration has also failed to come up with any explanation about how medicine prices could make such quantum jump in two years' time.
In the absence of proper monitoring, the prices of the locally-manufactured and imported generic drugs have risen by 70 to 100 per cent during the last two years. No appreciable reasons could be found for such 'atrocious' rise in prices of the essential drugs. Local manufacturers, however, cited price hike of raw materials in the global market as the reason.
The government has, in fact, control on prices of only 117 essential items, out of a total of 1300 generic drugs, manufactured locally while the remaining drugs are price-decontrolled ones. The government has also no control over prices of the imported generic drugs. Such drugs reportedly account for only 4.0 per cent of the aggregate domestic demand.
Currently, the imports include mainly anti-cancer drugs, hormones, vaccines, bio products, blood products like plasma cells and other fractions and a lot of other different high-tech products used in surgery and for other kinds of treatment. There is a bright prospect for export of such drugs if those could be manufactured locally.
Very recently, some European countries are mulling import of costly medicines from low-cost generic producers to ease the burden on their medical system. According to a report, Greece is now looking for cheaper supplies of these costly medicines from India and Canada.
According to the existing rules, if a drug company wants to increase prices of medicines, it applies to the Director General, Drug Administration (DGDA) and then a committee headed by the health secretary approves it, if the increase is found to be logical. Representatives of the Consumers Association, Bangladesh Medical Association and Bangladesh Association of Pharmaceutical Industries (BAPI) are members of the committee.
A section of dishonest officials of the health ministry, Drug Administration and some pharmaceutical people are allegedly involved in unprecedented hike of medicine prices. Health and Drug Administration officials prefer to remain silent as they allegedly get hefty monthly 'rewards' from the pharmaceutical companies. Nobody is telling the truth as to why the ministry and the Drug Administration are failing to keep the medicine prices under control.
It is surprising to note that same generic medicines are being sold at different prices having different brand names. For instance, 100 tablets of Gliclazide BP 80mg are being sold at Tk 750 in the brand name Gliclid by a company whereas 100 tablets of same Gliclazide BP 60mg are being sold at Tk 1,800 in brand name Diomicron by another company.
The hikes that have been made recently are phenomenal. To cite some examples: the prices of anti-ulcer medicines, such as Pentonix, have increased from Tk 30 to Tk 40, Antacid Plus tablets from Tk 12 to Tk 15 a strip, Antacid Plus syrup from Tk. 65 to Tk 75 a bottle, anti-histamine medicines, including Tofen, from Tk 15 to Tk 20 a strip, and Tofen syrup is costlier by Tk 5.0. The prices of cardiac medicines, including Parinox 40mg, have gone up from Tk 340 to Tk 350 a strip, Parinox 60mg from Tk 525 to Tk 600 and Amdocal Plus 25mg from Tk. 45 to Tk 55.50.
Drug Administration sources maintained that a circular issued by the government in 1991 said the companies that would produce at least 60 per cent of the 117 life-saving drugs with local ingredients could fix the prices of medicines produced by them and enjoy other facilities. But in reality, most of the companies have failed to comply with the terms and conditions in producing those drugs. Rather, they import raw materials and produce medicines mixing other materials available locally and fix their prices as per their own will. Such companies are taking advantage of the government circular without fulfilling the requirements.
Reports say 226 companies are now producing 2200 medicines across the country. Excepting these 117 life-saving drugs, all companies are fixing the prices of all medicines according to their own will. The Drug Administration has nothing to do in this respect. Now the question is: What is the responsibility of this government entity? Fixation of prices is the most important segment of the pharmaceutical industry. If this is transferred to the companies themselves, it is easy to understand what can happen. And the damage has already been done in this particular sector and as usual, the worst sufferers are the common people, who toil hard to earn their livelihood.
However, the manufacturers claim that import of raw materials has become costlier due to taka depreciation. The bottle manufacturers raised their rate by 35 per cent and customs duty hiked by 2.0 per cent. As such, they had to raise the prices of the medicines. But the reality is -- Taka has appreciated for the last couple of years against the US dollar. Last year, the dollar was traded at Tk 83 for a dollar, now it has come down to Tk 78 in the informal market. The prices of raw materials have also decreased to some extent in the global market. In such a situation, the manufacturers' claim is not tenable.
However, the price monitoring by the Office of Drug Administration is hamstrung by the lack of the required number of field-level officers and the non-availability of memos against retail sales. The Drug Administration needs to be strengthened with adequate manpower in order to strictly enforce the rules. The capacity of testing laboratory of the Drug Administration needs to be enhanced for ensuring marketing of quality medicines.
After tobacco, pharmaceutical is the second largest revenue generating industry in Bangladesh. For that matter, the government should take good care of this industry and control the price of every pharmaceutical product in the interest of patients. It is expected that the government would take drastic actions against the price manipulators and bring down the prices to a rational level. The country looks forward to such hard actions.    
szkhan@dhaka.net