Indian pharma industry and social responsibility

This year’s Indian Pharmaceutical Congress focuses on India becoming a  pharma power house by 2020. The Indian pharmaceutical industry is estimated to be worth $55 billion by 2020. It is the third largest in the world in terms of volume and 14th in terms of value accounting for around 10 per cent  of world’s production by volume and 1.5 per cent by value. Indian exports are destined to more than 200 countries including the highly regulated countries like USA, West Europe, Japan and Australia. In fact, India is known as ‘Pharmacy of Third World’ due to our generic supply. Looking at the present scenario, the Vision 2020 is not a myopic vision. This is achievable and in fact, India is marching forward to it.

But  despite  all achievements in the pharma sector,  India has poor accessibility  to essential medicines. Only 33 per cent  of the population of the country has the access to essential and quality medicines against the world average of  66 per cent. Apart from this,  there are other serious issues like rampant irrational use of medicines throughout the country. Economic constraint is one of the main factors for poor access to medicines. Though the prices of medicines are  low  in absolute terms, they are not easily affordable. Many studies have proved that. While discussing medicine price, purchasing power of the poor should be considered. The irrational use of medicines not only contributes to economic wastage but significantly impacts public health. Irrational use of antimicrobials leading to antimicrobial resistance is now a major worldwide public health threat. Excessive use of injections is a threat of HIV infection.

The just concluded world summit, Third International Conference on Improving Use of Medicine 2011 at Antalya, Turkey, raised the  serious issue  of  lack of access to essential and quality medicines for  over two billion people in the world. More than 600 world experts from over 80 countries took part  in this  event . This unique event is organized once in every seven years to discuss the misuse of medicines especially in low and middle income countries and find ways  to tackle  the issues impacting  the welfare of  mankind. “Worldwide more than 50 per cent of all medicines are prescribed, dispensed, or sold inappropriately, while more than 50 per cent of patients fail to take them correctly”, a World Health Organization’s (WHO) estimation echoes. An alarming situation!

While there could be many reasons for irrational use of medicines, the pharmaceutical industry is  often blamed for the aggressive promotion. In the 3rd India Pharma Summit, the issue of pharmaceutical marketing and pricing of medicines were focussed. The pharma industry’s demand for lesser  control on pricing has been viewed as a hindrance to improve accessibility. It is a fact that the pharmaceutical industry is a regulated industry and the profit too regulated through price monitoring. The pricing authority, National Pharmaceutical Pricing Authority (NPPA), does not allow the increase of a pharmaceutical product more than 10 per cent a year.  The price control or monitoring is to ensure the medicines are not going beyond the reach of the people of the country. The variation in price between the price of most expensive brand and the cheapest brand of the same drug can be as high as 1000 per cent. The price differences range from 100 to 5600 per cent between the government procurement price and the retail market price. Even the two products of the same drug from the same manufacturer have different price tags. This shows the complex pricing system of pharmaceutical products and the good profit margin.

While on the  one side we see  a robust growth of the pharma industry,  on the other,we see  a bleak  picture of poor access and irrational use of medicines. The Indian pharma industry can contribute significantly in bridging this gap by making it a part of its corporate social responsibilities.

The Corporate Social Responsibility has been defined as a concept whereby organizations consider the interest of the society in all aspects of their operations by taking responsibility for the impact on customers, employees, share holders, communities and the environment. This is beyond the simple legal compliance. The foundation of Corporate Social Responsibility is  reasonably  rooted  in India. Here it will be worthwhile to recall Jamsetji Tata’s remark “One  must give back to the society many times over what one gets from them.”

Indian pharma is merging ahead as generic supplier to the whole world. But we have numerous brands in the market often with confusing names leading to medication errors. The Maharashtra State Pharmacy Council has done a great job in  compiling these Sound Alike and Look Alike (SALA) brands. In reality, there is no data base for  these names in the country. The quality of the generics in Indian market are often questionable as there is no bioequivalency requirements as in regulated market. The Indian pharma can consider making quality generics available at affordable price. Some initiatives are already on in this aspect. But marketing generics with good drug promotion practices would help the people.

Another important aspect is empowering the consumers. In our present health system, hardly the doctors or pharmacists have time to explain the use of medicines to the customers. The doctors just spend few minutes in outpatient clinic examining and writing prescription and the pharmacists spend less than a minute with each patient while dispensing. In such situation, the consumer education materials made available as package inserts would be useful. The patient education would improve adherence and ultimate therapeutic outcome. These packet inserts should be in a readable font size and in lay man's language not as the present day inserts that basically address service providers.

The cut throat and unethical marketing of medicines in India is always a concern. This definitely adds costs to the medicines which the poor consumer has to bear. The adherence to good drug promotion practice helps cutting down this cost which would benefit the consumers. The draft guidelines of the Department of Pharmaceuticals, MCI guidelines and OPPI guidelines on marketing practices can be the guiding force.

These are just a few strategical options which the pharmaceutical industry can consider exploring as a part of their responsibility to the society which has given enough impetuous for its growth. This would give a win-win situation both for  the pharma industry as well as for the consumers.

The WHO representative to India, Dr. Nata Menabde, while addressing the 3rd Pharma Summit and emphasizing pharmas’ role rightly quoted the Father of the Nation, Mahatma Gandhi, “The Industries -----should regard themselves as Trustees and Servants of the Poor.”

Let the fundamental philosophy of the  Indian tradition and culture “Sarve Bhavantu Sukhina, Sarve Santu Niramayah” prevail.