According to the World Health Organization’s World Medicines Situation report of 2004, India has the dubious distinction of being the country with the largest number (649 million) of people without regular access to essential medicines. Concerned physicians’ groups have highlighted this critical issue and called for, government regulation of drug prices. Here are a few reasons:

•  The purchase of drugs is a unique situation.

To argue against government regulation, the pharmaceutical industry portrays medicines as consumer goods and patients as consumers. In the case of medicines, however, a doctor makes the choice for the patient /consumer, who is often ignorant of the salient features of the medicine.

• The need for medicines is often immediate, could be life-long, and could have life and death implications.

Governments all over the world regulate prices of all medicines, and impose safety standards. However, India has one of the most privatized systems of healthcare. A staggering 83% of healthcare related expenditure is borne out-of-pocket, most often by the poor.

• Free market anarchy: the reality of drug prices outside the government’s price-controlled list.

Only some drugs are regulated in the government’s price-controlled list. For example, while Ibuprofen is price-controlled, Nimesulide is not. Therefore companies have a high incentive to market Nimesulide. A common antibiotic costing Rs. 6.8 from Cipla costs Rs. 95 from Aventis. Such anarchy has raised healthcare costs and led more people to avoid seeking health care at all, lest they fall into medical poverty, a key cause of rural indebtedness.

Jan Swasthya Sahyog (JSS) calls for a rational drug pricing policy which has firm guidelines on conduct of clinical trials, limits new drug approvals to entities which clearly confer a therapeutic and cost advantage, bans hazardous drugs, evolves stricter codes on pharmaceutical promotion and improves availability of drugs in the public health system.

Anurag Bhargava, JSS, as told to Srinadh Madhavapeddi, AID Dallas. Jan Swasthya Sahyog is a group of doctors working in tribal and rural areas of Chhattisgarh. AID supports JSS work with leprosy patients in Bilaspur district, using generic drugs made by LoCost (Baroda).