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Hi Price Mart: Cancer drugs available

With technology developing four fold, the pharma industry has been partly true to their promise and discovered a drug for almost each and every disease. Does this mean that they will be delivering redemption from a disease especially a killer like cancer? Arshiya Khan and Nandini Patwardhan pose these questions to the medical fraternity and NGOs.

Cancer is synonymous to death. And all the medicines in the market are doing nothing to change this perception thanks to their prices. People with deep pockets are willing to spend any amount to get cured. Even those who do not have the wallet power try all they can to overcome the disease. In such a scenario, exorbitant prices of cancer products launched have made life costly. While most of the pharma majors with various products in this segment, were unavailable for comment, Dr Haresh Manglani, Consulting Orthopaedic Surgeon, Oncologist and Traumatologist; Dr Nagral Consultant Jaslok Hospital; and Y K Sapru, Founder Chairman and CEO, Cancer Patients Aids Association put forth their views on cancer pricing.

“As a doctor involved in patient care, it is always desirable to have low or competitively priced drugs and consumables so that no one is denied treatment on the grounds of cost”

– Haresh Manglani
Consulting Orthopaedic Surgeon Oncologist and Traumatologist

“With no state health insurance for cancer treatment in existence, it is most important that the anti-cancer drugs are made affordable to the common man in India”

– Y K Sapru Founder Chairman and CEO

Cancer Patients Aids Association

“As a profession, we have an ethical commitment of treating a large number of patients at a low cost. That should be a doctor’s commitment rather than wanting to treat a select few”

– Dr Nagral Consultant

Jaslok Hospital

Price effects

“High-priced drugs affect the treatment outcome adversely,” states Manglani. “Also new generation drugs are high priced, which is comparable to new inventions in any field, which are high priced to begin with. But then, prices come down due to increased supply as more players enter the field,” he adds.

However, Sapru objects, “The net result of the highly priced status of cancer drugs in India is that the vast majority of cancer patients are unable to receive complete and adequate treatment for their disease. This is evident from the very high mortality rates in cancer in India as compared to those seen in advanced western countries.” “Many of the drugs are quite costly and therefore what happens often is that they start the treatment but are unable to finish the course,” explains Nagral.

Sapru puts forth an example of Gleevec, the only life saving drug marketed by Novartis for chronic myloid leukaemia, which is priced at Rs 1.2 lakh per month. Patients feel the pinch because it needs to be taken for life by the patient to remain alive. Thus, the cost per year alone comes to Rs 14 lakh per patient. “If the drugs are not available, there are no options. I mean that they will die,” he asserts. “Thus, those who are really poor, have no other option but to stay out of pocket. Today, almost 80–90 percent of the people find it difficult or almost impossible to afford the cost of chemotherapy because it is just not a four or five-day treatment, but an ongoing treatment with cycle,” he adds.

Ethics of pricing

The issues are very evident but what is to be done to counter the issue? Nagral voices his opinion , “Ideally, the medical profession in India should be raising issues like the cost of drugs. As a profession, we have an ethical commitment of treating a large number of patients at a low cost. That should be a doctor’s commitment rather than wanting to treat a select few.”

Manglani too feels that high prices of life saving drugs like those for treatment of cancer is not justifiable. “As a doctor involved in patient care, it is always desirable to have low or competitively priced drugs and consumables so that no one is denied treatment on the grounds of cost,” declares Manglani. “At the same time, it is also desirable to have newer and better treatment modalities and the research towards the same, which makes the treatment expensive. Hence, newer technologies and drugs are high priced to begin with,” he adds.

Generating support

Cancer Patients Aids Association Patient Care has undertaken various initiatives in the area of rehabilitation, awareness and insurance

Though in the line of fire for making money, pharma companies have not turned a blind eye towards the plight of patients. Novartis, the maker of Gleevec has come up with insurance initiatives. “It is an interesting gesture,” affirms Nagral. He continues to point out that, while insurance is an interesting initiative by Novartis, there are no national health insurance schemes in India today. And whatever is available is the ESI employee state insurance scheme which was active many years back. “So you know all these social insurance schemes that have been there are slowly breaking up,” he laments.

Whereas, Manglani is of the view that the yardstick should typically be the target patient population and data on their socio-economic status. The pricing has to be such that the people who need the drug should be able to buy it. “With no state health insurance for cancer treatment in existence, it is important that the anti-cancer drugs are made affordable to the common man in India. This can prove as an acid test or a yardstick for the assessment of pricing anti-cancer drugs,” emphasises Sapru. It is the turn of NGOs to lend a helping hand. Cancer Patients Aids Association Patient Care, in addition to raising funds for treatment of cancer patients, has undertaken various initiatives in the area of rehabilitation, awareness, early detection and insurance.

Pointers to price

The responsibility of wholesome healthcare should also be a perspective of the government. Govern-ment hospitals in India, which make available all other basic drugs, has not made these (cancer drugs) available. “The government should identify the crucial areas where life saving drugs is required and ensure a mechanism either by which we produce the drugs very cheap or make them available to people through an insurance policy,” says Nagral.

“For diseases which are deadly and life threatening, medicines should be available to everybody irrespective of their ability to pay. Also, in terms of distribution, we should not leave it to individual companies, for the medicines to be made available to everyone,” articulates Nagral.

Pharma companies have an impact on human life like no other company in any other sector.

While business considerations should govern all the decisions to book a profit, the human side should not be completely ignored. With science and technology catching fast pace with investments worth billion Dollars, pharma industry booming at an alarming rate and so many happenings taking place in the industry is just a waste if they cannot fulfil the most important aspect of saving the life of a person.

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