Fatal side-effect PDF Print E-mail
Friday, 29 June 2018 04:04
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Sarthak edit

The current shortage of furosemide, a life-saving drug for infants and children with heart disease, should be a metric of the damage the National Pharmaceutical Pricing Authority (NPPA) is causing with its arbitrary price-regulation. As per The Indian Express (IE), the NPPA itself estimated supplies of furosemide, commonly known as Lasix, to have fallen by 40%. But, it is the drug-price regulator’s imposing a ceiling price of `10 for a strip of 10 tablets last November—when the drug was priced at `100-110 a strip—that is to blame. Lasix is used to help drain accumulated fluids from the lungs of babies with heart ailments—such accumulation, left untreated, can cause respiratory distress that could prove fatal. Upon being asked by the NPPA to rush supplies to areas worst-hit by the shortage, the largest producer of the drug in the country said that it is conscious of its duty as a “responsible corporate citizen” and of the fact that it dominates the market, and hence has quickly responded to supply requests from severely hit areas. However, it also clarified that it can’t keep producing if it is forced to sell at a price below its manufacturing cost.

NPPA’s absurd price capping, in the interim, would have likely left many patients more vulnerable to their disease. There have been cases, as per IE, where children were administered the drug by breaking tablets of strengths prescribed for adults; however, medical experts flagged this since dosage errors could occur, endangering patients’ health. NPPA’s ham-fisted approach to price regulation has already seen leading stent-makers withdraw state-of-the-art cardiac stents from the Indian market, leaving Indian patients that much more bereft of quality treatment.


It is indeed ironic that the drug-price regulator—through irrational price-capping—is shrinking access to life-saving medicines and devices, even as the rationale it offers for the caps is that low prices will improve access. With margins left at a pittance, or erased,—and even upended—it is no surprise that drug-/device-makers, as FE pointed out before, are increasingly becoming export focused; in FY17, for instance, the revenue from the Indian market was just 16% of the total revenue for Dr Reddy’s, while it was just 22% and 25% for Lupin and Glenmark, respectively. Amazingly, it isn’t as if the government is unaware of the problem. The draft pharmaceutical policy released last year spells out the link between price-caps and India becoming import-dependent for many crucial active pharmaceutical ingredients (APIs): “the Drug Price (Display & Control) Order 1966 put 18 APIs (raw materials) under price control … from 1996 … imported APIs and intermediates started becoming hugely lucrative as a price cap on drugs forced the manufacturers … to obtain the cheapest raw material with the basic minimum efficacy/quality”. So, it is hard to understand why the government hasn’t yet dismantled NPPA-style price-capping—though the draft pharma policy had talked of certain checks for NPPA decisions.



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