By Jayasmita Ray:
Expensive medicines add more hurdles to quality healthcare. Loosened drug regulations have helped cheaper alternatives called generics to boom in India. Our country has now become the “Pharmacy of the developing world”. Despite the obvious advantage of generics, I would like to consider another question – “Why are the big pharma companies still out there?”
The answer lies in the nature of the pharmaceutical product. Medicines to cure illness effectively require a lot of research expenditure. Big companies in the US and Europe spend billions to discover new cures and test their effectiveness. This is a very long and expensive process, particularly for serious illnesses like cancer, HIV/AIDS, etc. Generics simply mimic chemical compositions of these ingredients without including the “extra premium” for the research element. In that sense, wouldn’t it make sense to get them instead?
Generics may have the same chemicals as the original drug but the main active ingredient has ample scope to be tampered with. This affects something called bioavailability — the amount of the drug that is absorbed by the blood-stream. In the case of some medications, small differences can have large effects. Medical practitioners are concerned with specific conditions like hypertension, epilepsy and endocrine disorders that require exact dosing. Minor variations in composition can lead to life-threatening complications. In retrospect, can we really afford to be unsure of the effectiveness of the medicines we take, even though they happen to be cheaper? In a life and death situation, would that be the best course of action? As a result, they prefer to prescribe the standard brands which must necessarily comply with quality regulations. Companies that fail to comply with the rules will face legal action.
The other reason why these big companies still thrive is because of their aggressive marketing strategies. Medical executives pitch the effectiveness of their products to medical practitioners. They also conduct post-marketing surveys which assess the side-effects of their drug on patients after its use. A great deal of funds are devoted to this process. Given this huge marketing and research expenditure, big companies are also promoting more patent rights to protect their businesses. The existence of more generics will continue to threaten their existence and reduce their research efforts. In the long run, we might get cheaper medicines but not necessarily newer cures.
Recently, the Supreme Court rejected the patent appeal by Novartis for a cancer drug called “Glivec” stating that the patent should be based on innovation rather than artful claims by the company. This was hailed as a victory as Glivec costs around Rs. 1.2 lakh a month, while Indian generic was a mere Rs 8000 a month. Such patent issues will continue to crop up over time. One needs a more long-term approach to help the everyday patient’s needs for medicines.
Thus, we need to ensure better regulations for drug companies rather than simply fighting over patents. The real concern isn’t about whether we need the generic version, as it actually benefits the customer. It’s simply the quality controls that needs a great deal of improvement. The Government should also promote more competition in the pharmaceutical industry. This will lead to lower costs and innovations over time. They also need to build more research infrastructure to develop better medicines. There is a great deal of research talent in India that can be effectively utilized. Thus, much remains desired for the future of the pharmaceutical industry and the needs of patients.