Kiran Mazumdar-Shaw, CMD, Biocon
In
an article published recently, I welcomed India’s progress towards a Universal
Health Policy that aims to ensure essential medicines for all through a
generics-only state procurement regime. With robust IT supply chain systems and
stringent quality control processes – as exemplified by Tamil Nadu – this can
benefit millions of Indians often deprived of life-saving drugs owing to the
high cost.
However,
public health missions must not be confused with the open market.
The
recent directive to impose a ban on branded generics is, to put it mildly,
utterly ill-considered. While states can ensure quality in public health
systems, regulation for drugs sold in the open market is derelict. On pharmacy
shelves, jostling for space with established brands from respected companies
are questionable products from zero-overhead marketers. Painting them all with
the same generics brush will deprive the patient of the quality assured by reputed
brands.
Devaluing
Indian Pharma
It
is not just the health of patients that the government is putting at risk with
this policy; it is also playing with the very life of the entire Indian
pharmaceuticals sector. This US $20 billion industry has over 5000 small,
medium and large manufacturers generating employment for hundreds of thousands
of people. Growing at 17 percent per annum, we top the world in the export of
generic drugs and rank third globally in pharmaceutical manufacturing by
volume.
Driven
primarily by branded generics, the pharmaceuticals sector has built enormous
brand value that directly translates to its robust market capitalization. The
BSE Healthcare (BSEHC) index of 17 leading companies outperformed the Sensex to
touch Rs. 295,724 crore in market cap at the end of September 2012. This
impressive sectoral performance is reflected in the high valuations buyers have
willingly paid for companies such as Ranbaxy, Piramal Healthcare and Paras
Pharma sold at 4, 9 and 8 times their annual sales, respectively. A ban on
branded generics will not only bleed investor net worth but also destroy value
for the pharmaceutical industry.
Despite
margins under pressure owing to an uneven playing field in the face of imports,
rising costs and competition, the Indian pharma sector has been forging ahead.
Innovation-led R&D is increasingly driving the discovery of affordable
breakthrough drugs for life-threatening diseases. A critical component of
India’s struggling economy, this sector is now under threat from a government
that should be nurturing it.
Deplorably,
such attempts on branded generics will further impact margins, erode
profitability and deplete the funds available for research. The cascading
effect downstream will be that pipelines for newer and cheaper drugs dry up,
denying patients access to better and more cost-effective medication.
Way
Forward
While
it is true that drug prices have risen in the recent past, it is also true that
fierce competition in the market place has contained and even driven down drug
prices. The recently-announced National List of Essential Medicines (NLEM) has
348 key drugs. With a weighted average price discovery mechanism, this list
aims to cap the prices of the drugs that cover the major part of India’s
disease burden.
I
would like to sound a note of caution here. Of the 74 drugs covered earlier by
the Drug Price Control Order (DPCO) only 47 are being produced. This highlights
the danger of going overboard with price control. If a product ceases to be
profitable, no business can sustain its supply. The pharma industry is no
exception to the laws of business. Thus there is the grave danger of essential
drugs disappearing from the market if it makes no economic sense for companies
to produce them.
The
move to generics in developed nations is being enabled by across-the-board
quality assurance through effective regulatory implementation. Without such
regulation, as is the case in India, any move to ban branded generics in the
retail market is a dangerous gamble. It is fraught with the risks of
sub-standard medicines flooding the market, value erosion of the pharma
industry, impact on R&D for better and cheaper drugs, and an adverse effect
on the Indian economy. Unless this ban is revoked, the unforgivable casualty
will be the patients who will ultimately
suffer.
Postscript
Soon
after I wrote this article, the government announced that while it will approve
a drug under its generic name, companies can still market branded generics. If
such a system is put in place, the pharma industry will need to undertake an
entirely unnecessary process to register the branded generic after getting
approval for the generic version. This is an exercise in futile duplication;
there is no need to deviate from the present process that accords approval to
both branded and unbranded generics at one go. The uncertainty generated by
such declarations – including the possibility that this may be the first step
toward a blanket ban as previously implied – and the needless bureaucracy they create
are added bottlenecks for the pharma industry, further eroding its value.
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