Although the National Pharmaceutical Pricing Authority (NPPA) brought in advanced drugs to treat cancer and other oncology related disorders under the National List of Essential Medicines and in the Drug Price Control Order, 2013 and slashed their prices more than 50 per cent, cancer patients are finding it tough to get at lower prices from the retail pharmacy shops.
For instance, the cost of cancer drugs such as trastuzumab and temozolomide, used to treat breast and brain cancer have been included in NLEM and reduced its market price up to 54 per cent, but the same is not reflected in the open market as they are only sold at hospital attached pharmacies.
“Though the government had reduced the prices of the essential drugs to benefit the poor patients, the same is not reflected at the ground level. The overall expenditure is still continues to be very high for the patients. This is mainly because of improper enforcement of price cut orders all the levels. Unless the government comes out with a clear cut regulation to control the hospitals and the costs of their services, it will not be really benefited to the end user,” expressed Dr. Bhaskar, oncologist at Lotus Hospital in Hyderabad.
The expensive drugs to treat patients with immunotherapy or biological therapy which are showing promising results are not found in open market. “The hospitals have a monopoly and insist that all the medicines have to be bought from their pharmacies. The patients do not have a chance to compare the costs of the medicines in the market outside,” said a senior pharmacist on condition of anonymity.
For chemotherapy and radiation therapy, it would cost anything around Rs.5000 for a conventional treatment. However, the same treatment with latest IMRT costs anything around Rs.30,000 to Rs.35,000, while the private hospitals are charging for the same IMRT treatment an amount of Rs.75,000 to Rs.1 lakh.
Newer treatment methods like immunotherapy, cost between Rs.60,000 and Rs.80,000 per month depending on the state of the cancer for the patient.
However, many doctors are advising that to reduce the costs on cancer treatment, the main motto is early screening and detecting the disease at the early state. But the patients, who are presumed to may have contracted cancer, neglect their disease at the early stage fearing the cost of screening. By the time they approach the doctor, it would have been too late as the disease has already crossed the primary stage and the prescribed drugs at this stage may not work due to resistance by the cancer cells. A senior oncologist from a private hospital observed that “it is often the high costs which scare away most patients as they are not sure how they will be able to pay. Most of them are opting for cancer insurance policies and also specialized care packages in their mid-level careers so that they can be prepared to deal with the disease.”