[Ip-health] Big pharma is cut out by India's plan to bring medicine to masses

Ira Glazer ira.glazer at gmail.com
Fri Jul 6 13:21:44 PDT 2012


ndia is planning a multibillion-dollar push to bring free medicines to the
hundreds of millions of its citizens who, despite the country's economic
revival, still languish without access to the very basics of health care.

The $5bn initiative, which is slated to be rolled out by the end of this
year, will offer 348 essential drugs to patients across the country. In a
blow to the West's big pharmaceutical firms, the planned scheme will
largely cut out branded drugs, opting instead for cheaper generic

News of the plan comes as the Congress-led administration in Delhi attempts
to shore up public support after a raft of corruption scandals and crushing
electoral losses in state polls. A recent report confirming a slowdown in
economic growth has only served to sharpen criticism of the government.

Now, Delhi is plotting a multi-billion dollar health-care drive, using its
network of government-funded hospitals and clinics to deliver free drugs
across a country where, despite the much-vaunted boom of recent years, more
than two million young children die every year from preventable infections,
according to Unicef.

Infant mortality stands at 63 per 1,000 live births, while a recent paper
in the Lancet medical journal said that of the nearly five million children
under five who succumbed to preventable diseases such as pneumonia,
diarrhoea and malaria in 2010, almost half had come from five countries:
Nigeria, the Democratic Republic of Congo, Pakistan and, notably, China and

All the while, the Indian state spends so little on health care as a
proportion of GDP that only a handful of countries fare worse, according to
the OECD.

The bulk of the cash for the free medicine plan will come from central
coffers, while state governments will be asked to shell out an additional
third of the required funds. The Ministry of Health and Family Welfare said
it had put forward proposals worth around $3.64bn. The additional funding –
from the states – will boost the investment to around $4.9bn, signalling,
if approved, "a giant step in vastly expanding the access to medicines",
the Ministry said. A template already exists in the western state of
Rajasthan and Tamil Nadu in the south, where health schemes are reported to
have been successful.

The focus on generic medicines chimes both with the need for affordability
and the dynamics of India's pharmaceutical market. Generics – or cheaper
copies of expensive branded medicines whose patents have run out –
accounted for around 90 per cent of the total drug sales in the country in
2010, according to Reuters data.

The gulf between the cost of branded drugs and generic alternatives is
often vast. The Rajasthan state government, for instance, buys the generic
version of a popular cholesterol drug for just over 6 rupees (7p) for a
strip of 10 tablets, according to official figures quoted by India's
Economic Times newspaper. In contrast, consumers opting for a branded
alternative face costs of 103 rupees.

Although reports indicate that doctors participating in the planned scheme
will be able to use 5 per cent of the sanctioned funds to buy medicines
absent from the approved list of 348 generic drugs, the initiative presents
a fresh challenge for global pharmaceutical giants such as GlaxoSmithKline
and Pfizer....

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