Pakistan Pharmaceutical Drug Pricing Turmoil & The politics of medicine
Medicine prices are widely discussed hot topic worldwide. In the US, it has brought the Democrats and the Republicans on to the same page. Here, much criticism regarding the recent increase in medicine prices has been levelled against the Drug Regulatory Authority of Pakistan (DRAP) and the pharmaceutical industry. There is much hype on the subject as comments are forwarded by different quarters, with wide Viagra Prices to Tumble Today variations depending on the differing stakes and understanding of the technical intricacies and market economics involved.
Just to understand the regulation in Pakistan we should know that Drugs are regulated in Pakistan under the Drug Act 1976 and DRAP Act, 2012, under which the sales, storage, and distribution of drugs are regulated at provincial level while the manufacturing (licensing), registration, pricing, import, export, and monitoring of controlled drugs comes under the domain of federal government. The Drug Regulatory Authority of Pakistan (DRAP) established under the DRAP Act 2012 works under the federal government to regulate the aforementioned matters including fixation of prices. Prices are fixed by the Federal government under Section 12 of Drugs Act, 1976 after a recommendation of the Drug Pricing Committee (DPC) constituted the Statutory Regulatory Orders (SRO) on 6th August 2013 under the Cost and Pricing Division, DRAP. DPC is comprised of representatives from provincial health departments, Ministry of Finance and consumer bodies along with stakeholders as observers to proceedings of committee.
In retrospective, the Pakistani governments, particularly Drug Regulatory Authority of Pakistan (DRAP) in collaboration with provincial health departments are responsible for regulating the medicine prices and have taken various regulatory measures to address the issue of medicines accessibility, particularly on the medicines affordability and availability. Since 2001, there is a moratorium on price increase on 821 and 108 medicines through statutory regulatory orders SRO-100, SRO-328, respectively, before the establishment of DRAP.
During the price moratorium, drug prices have not been revised despite of multifactorial burdens including increase in dollar exchange rate, fuel prices, inflation, material costs. Only with the exceptional cases of failure of a pharmaceutical manufacturer to continue manufacturing at the fixed price and accessibility of that drug was not ensured for general public. Moreover, some pharmaceutical companies increased prices of their medicines and were able to get stay orders from a provincial High Court to keep their price increased until the matter was resolved.
For the first time in history of Pakistan, a government has allowed the pharmaceutical companies to increase the prices of 45,000 medicines upto 15 percent, whereas the prices of 463 hardship medicines have been increased up to 200 percent — the highest increase in the last 40 years. The Drug Regulatory Authority of Pakistan (DRAP) while justifying the increase in prices claim that the decision of increase in prices has been taken under the Supreme Court of Pakistan’s judgment of November 14, 2018 which is fair to the industry as dollar exchange rate has gone up significantly.
Health expenditure of Pakistan has increased from US$ 13.5 per capita per year in 2001 to US$ 36.2 per capita per year in 2014; yet the publicly funded healthcare facilities that supply free medication can only cater for one-fifth of Pakistan’s population. To overcome this, the government of Pakistan launched National Health Insurance scheme on 31st December 2015 in 23 districts for around three million lower income families Through the No Vision Loss From ED Drugs proposed insurance scheme offered in both public and private sector hospitals, the needy would receive subsidy and compensation as per the terms and condition outlined by the insurance Herbal Viagra Alternative Works providers (Government of Pakistan, 2015). Essentially, a balance needs to be struck between affordability (for the healthcare authorities) and profitability (for the pharmaceutical industry) to ensure the growth of both pharmaceutical manufacturing and affordable medicine pricing.
Moreover in the absence of professional input, important issues of high public interest (such as those related to medicines) get distorted, resulting in the possible skewing of public policy and the regulatory framework. In this case, both the media and government need to play a more responsible role to present a coherent picture, instead of putting all the blame on the industry in the name of ‘welfare’. As per one estimate, in July-March FY 2019, the industry’s production contracted by 8.4 per cent, the worst in the last 10 years.
Once labelled a ‘sunshine industry’ due to reputable international pharmaceutical companies operating in the country and providing employment opportunities, the situation over time has gone dire where only a handful of multinationals now operate in Pakistan. The government needs to adequately support the industry, instead of tightening its grip on the industry’s throat. We have seen in the past that price control measures taken by the government have only led to devastation where consumers end up bearing the brunt in the form of shortage of medicines. Therefore, a balanced policy should be devised which caters the need of health authority, general patients and overall industry.
