Even as the central government is struggling hard to find an ideal way to contain the prices of essential drugs, Baroda based Low Cost Standard Therapeutics (LOCOST), a public, non-profit, charitable trust has proved how a small establishment can serve the interests of the ailing public by supplying quality drugs at affordable prices. The company, that has been manufacturing drugs since 1983, sells more than 60 essential medicines at a fraction of the price often charged by the brand leader and still manages to stay afloat.

A comparison of LOCOST price list with that of the market price reveals speaks for itself. While Albendazole is costing Rs. 11.0 per 10 tabs from LOCOST, it is sold for Rs 9- Rs.12 per tablet in the market. Similarly Amlodipine is costing Rs. 2.50 per 10 tab (LOCOST) as against Rs. 14 to Rs. 48 per 10 tabs (market price). Some other examples are: Atenolol 50 mg - Rs. 2.80 per 14 tab (LOCOST) / Rs. 4- Rs. 22 per 10 tab (market price), Enalapril 5 mg - Rs. 3.0 per 10 tabs (LOCOST) / Rs. 16- Rs. 23 per 10 tabs (market price) and Fluconazole 150 mg - Rs. 35.00 per 10 tabs (LOCOST) / Rs. 28-32 per 1 tab (market price).

In an exclusive e-interaction with Pharmabiz, S. Srinivasan, managing trustee, LOCOST said that they currently manufacture about 80 medicines, mostly catering to the primary healthcare segment. "We have displayed our complete product list at www.locostindia.com. Over the years, we have come across some committed customers and we are able to cater to institutional buyers including some very respected names," he said.

Asked about the chances small drug units like LOCOST has with the changed Schedule M norms and increasing generic competition, he said that LOCOST has a different approach to drug manufacture and sales. "Our target segment and motivations are different and of course we have some committed customers. A group of us who had been working in rural health were looking into the costs of medicines and we concluded (in 1983) that they were overpriced but at the same time good quality low-priced medicines were not available for those working with the poor. So we thought we should actually do something about it. Our survival has more to do with collective effort and the hard work and support of a lot of others," he said.

According to him, Schedule M is a genuine threat for most SMEs including LOCOST. "We ourselves had to beg and borrow for upgradation and we found many things were cosmetic and not necessary. Does it mean we were making useless medicines all these years without Schedule M? Overnight changing the goal post is at best a trade barrier," he observed.

Srinivasan also felt the need for a total new look at the drug R & D practices. "R &D is a cause for concern for especially the newer medicines and we need newer models of R & D funding. But there is enough demand for the existing ones most of which are out of patent. I do not see demand for these vanishing for sometime. We also need to deconstruct R & D costs as to what are the real costs etc," he explained.

The social commitment of LOCOST also needs mention as it has always been active in pharmaceutical policy advocacy at regional and national levels. In what should come as an eye opener to the pharmaceutical companies who are resorting to manufacture of scores of irrational combinations, Srinvasan says that LOCOST has always stood for rational use of drugs. "Our partnership, as respondents, in an ongoing case in the Supreme Court has resulted in the elimination of several categories of harmful and irrational drugs," he pointed out. LOCOST realizes that mere production of essential medicines is not enough. Irrational prescription starts with the prescriber. It has initiated programmes to educate the prescriber as well as the user and comes out with publications including a Gujarati monthly, Apnu Swasthya, for the general public.

Closely associated with NGOs like All-India Drug Action Network (AIDAN) and Medico Friends Circle (mfc), LOCOST feels that Indian SMEs has a role to play in ensuring affordable medicines in the country. "It is possible to make good quality, and only essential medicines, at reasonable prices. SMEs need to fight the policy trends that are guaranteed to ensure only a few big players in the country," Srinivasan reminded.

LOCOST considers promotion of good quality generic drugs and rational therapy, promotion of health education and influencing national/state level health policy with a priority on drugs as central to its agenda.