A Note on Health Services and Drug Market in India

A survey conducted by the India office of the international non-governmental organisation, Transparency International, reveals that, according to people’s actual experiences, the health service is the most corrupt service sector in India. It ranks India as one of the 30 most corrupt countries in the world. Indifferent treatment of patients, unofficial payments to providers, lack of patient privacy, and inadequate provision of medicines and supplies are some of the most common demerits and malpractices prevailing in the health services in India.

The survey, conducted with private marketing research company ORG-Marg Research, interviewed some 5000 citizens in a household survey to assess the public’s perception of corruption. It covered 10 sectors with a direct bearing on people’s lives, including education, health, the police, the judiciary, and power utilities.

Too high medicinal cost accompanied by doctor’s consultation fees has made the proper medical treatment to become out of the reach of Indian common man, especially in the rural areas where neither licensed medical stores nor qualified doctors are available and malpractices of the Primary Health Centres, available generally in rural towns only, are well known and are practically forfeiting the veritable purpose of PHC’s there. As a result thereof, not only the market of non-qualitative and banned drugs and medicines is flourishing day by day, but the unqualified doctors also are emerging fast and plundering the poor mass. On account of insufficient availability of generic medicines (patent based medicines which are cheaply produced by another process) the patients are compelled to purchase high priced branded medicines.

An analysis of drug market in India by the ‘World Health Organisation’ (WHO) also reveals that Indian pharmaceutical companies are charging very high prices of medicines from patients. In India, the pharmaceutical companies are earning profits even up to ten times or more of the production cost in case of both branded and unbranded medicines. Not only is this, but the companies, by printing high retail price, are letting the sellers too to earn abnormal profits. Like the ratio between production cost and whole sale price, in many cases the retail price also is ten times or more of the whole sale price. The anti-allergic tablet named as ‘Citrazine’ of ‘Cipla Pharmaceuticals’ is an example. High retail prices of patented and generic medicines are making the general mass to resort to unauthentic and duplicate medicines produced by unlicensed pharmaceutical units. That is why the influence of unauthentic, unlicensed and duplicate medicine producing units in Indian drug market is day by day increasing whereby the people are being badly hit on account of low effectiveness and severe side-effects of the medicines produced by these companies. Many times the doctors too, having been affected by the commission based and gift based sale strategies of the companies producing duplicate medicines, prescribe these medicines without paying heed to the compositions and the bad effects on health on account of the use of these medicines. In some cases the sellers (chemists) let aside the prescription of doctor and sell these medicines especially to the illiterate or docile customers. Not only is this, but the manufacturing companies of these medicines also establish their links even to the government medicine purchasing authorities and seek supply orders. Not only the substandard medicines but even those harmful medicines are being produced and sold in bulks in the Indian market which stand banned at international level.  

Medicines are very precious for human life and have become at present a good part of trade. Therefore, the government should take strong and effective steps to make the qualitative and cheap medicines easily available to the people. The government also should take proper measures against malpractices prevailing in the market of medicines and should instil awareness of medicine consumers against these malpractices. Such organisations should be encouraged which manufacture medicines according to the international standards but at low cost so as to make cheap medicines available in the market. The ‘Low Cost Standard Therapeutics (LOCOST)’ trust at Baroda is a good example of such an organisation. This trust is making cheap production in 90 formulations of about 60 necessary medicines to cater the need of poor and needy patients. Moreover, The launching of the ‘public use medicines easy availability programme’ by the Department of Pharmaceuticals of the central government through 100 public stores of generic drugs, planned to be opened up to December 2009, is worth appreciation.

To solve the problems like that of substandard medicines, harmful and banned medicines and unjustified profit margin a central drugs regulatory system has now become acutely and pressingly needed. The issue of permission as regards to the trading of imported medicines also will be settled by such regulatory system.

The government is encouraging and helping the establishment of small pharmaceutical units. Similar cooperation should be extended to the market extension of their products. The condition of minimum turnover should be relaxed in case of small units. In the present period of prevailing depression the small and medium pharmaceutical industries should be helped through stimulus package to protect them in big market. This type of measures will protect the poor and general medical consumers against their being plundered through high prices by providing them cheap medicines. Moreover, it will help making India a medicine hub.

Studies have shown that health care utilisation has been a long standing concern for most of the developing countries and is sensitive to user perceptions of quality. Patient perceptions of health services thence form an important part of health care quality assessment.  Therefore, ways and means should be found out to give potentiality to important elements of making the health system adequately effective to make health services fully responsive to people’s needs and expectations.

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