Behind The Times
The prices of some of the drugs are stratospheric. Subhabrata Das, a Mumbai-based BW photographer, recently stumped up over Rs 1,00,000 for injections of Lucentis, a new drug to treat a dangerous eye condition called CNV. Choroidal neovascularisation is the abnormal growth of blood vessels in the eye that, if left untreated, will cause blindness. There were cheaper alternatives, but Das’ doctor felt Lucentis worked best. On the balance, a lakh is a small amount to retain sight. Das, 31, can earn it back. The drug’s maker, Swiss multinational Novartis, supplies it to the eye hospital, thus, cutting out 30 per cent in trader margins. “Still, it’s expensive,” says Das. Like about 900 million Indians, Das had no health cover and had to seek the help of his parents to pay for treatment. Such stories doubtless play out in many Indian homes. But not all end happy.

The NPPA has little say in the pricing of many such life-saving drugs. Like many MNCs, Novartis imports Lucentis (its Swiss parent has the patent). Between 2003 and 2006, around 700 imported finished drugs for diseases ranging from heart disease to HIV to cancer to Parkinson’s had been registered with the Indian drug regulator. But NPPA’s approach as envisaged by the DPCO is limited to setting a mark-up on manufacturing cost for pharma companies. While it routinely calls on local manufacturers to share costs and can verify claims, this is not practical if the producer is from outside the country. All the regulator can then dictate is a margin on the ‘landed cost’ declared by the importer.

One government official told BW on the condition of anonymity that authorities preferred not to ask too many questions. “If we meddle too much, they can cut supplies,” he says. In other words, “There is no control on the pricing of imported drugs,” says Gulhati. This threatens to become a bigger problem than it is currently.

So far, Indian copycats of most MNC drugs have provided relatively cheaper options. Take, for instance, Hyderabad’s Dr. Reddy’s reverse engineered variant of Swiss drug maker F Hoffmann La Roche’s non-Hodgkin’s lymphoma drug MabThera, which at Rs 2,40,000 for a full course costs about half of what the original would. Similarly, copies of Novartis’ chronic myeloid leukemia drug (CML) Glivec, which cost Rs 1,20,000 a month, are priced at Rs 10,000. In their defence, both companies do give some drugs free to needy patients. But that has its limits. Mumbai’s Cipla has been successful at offering cheaper AIDS drugs. However, some key imported drugs still don’t have copies. Also, since January 2005, India has been awarding product patents on drugs. Copycats patented after a cut-off date can launch only after patent expiry. This should encourage MNCs to launch more breakthrough medicines here. But there is no guarantee that these roll-outs would be affordable to ordinary consumers.