Price cap lifts cancer care hopes in NE

The central government approving a cap trade margin of anti-cancer drugs at 30% of their maximum retail price is a much-needed reprieve for the Northeast, where cancer has become a public health crisis. The government’s move follows a sharp observation by the Supreme Court over exorbitant retail prices of anti-cancer drugs. The SC pointed out that a particular anti-cancer drug supplied to retailers for Rs. 2700 carried an MRP of Rs. 27000. The government claims that capping the trade margin at 30% is expected to reduce medicine prices by up to 70%. The capping will help cancer patients save Rs 2,500 crore annually, the government adds. The numbers lay bare the severe and unjustified financial burden imposed on cancer patients, while manufacturers and retailers in the value chain profited at their expense. The situation also explains why cancer treatment pushes many households in the region into debt and eventual devastation. The escalating incidence of cancer in the region pushes more households into the abyss of financial ruin, making it the area with the highest cancer prevalence in the country. An official release confirms that the government has already imposed strict ceiling prices on essential cancer medicines included in the scheduled list. The new decision extends price protection to non-scheduled cancer medicines, which are outside that list, by limiting the margins added before they reach patients. It adds. As informed by the government to the apex court, an expert committee under the Directorate General of Health Services (DGHS) will finalise the list of medicines to be covered and the National Pharmaceutical Pricing Authority (NPPA) will then take a decision and issue the notification. While the government acknowledges that cancer treatment places a heavy financial burden on patients and their families, who often have to pay substantial amounts out of pocket, its decision to allow pharmaceutical companies and retailers to profit at the expense of these patients and families represents a policy failure that cannot be ignored. Pharmaceutical companies and retailers profiting at the expense of patients and their families exemplify a policy failure that demands attention. Official data highlights that NPPA’s analysis of market data found that non-scheduled anti-cancer medicines carry an average price mark-up of approximately 170%, reaching 700% or more in some cases. The SC has raised hopes for patients receiving treatment for various diseases by asking the government to establish modalities for capping the prices of all medicines, not just anti-cancer drugs, thereby reducing the treatment burden. The Parliamentary Standing Committee on Chemical and Fertiliser also highlighted the alarming trade margins, ranging from 600% to 1100%, and warned that the absence of control over these margins, particularly for non-scheduled drugs, creates opportunities for widespread profiteering at the expense of patients. As medicine costs alone account for 70% of the overall treatment cost in India, capping the trade margin of all medicines is critical to reducing the healthcare and treatment burden for patients’ households and making continuing treatment at an affordable cost feasible. The Parliamentary Standing Committee on Health and Family Welfare expressed serious concern over the huge difference between the landing costs of medical devices or drugs and the MRP, although India is considered to be the pharmacy of the world. The Committee in its report strongly recommends that such a gap needs to be reduced to the extent that the quality medical devices and the drugs are made available at an affordable cost to the needy patients. The Committee recommends that the gap between the landing price and the MRP for medical devices and drugs should not exceed 20% to ensure that quality drugs and medical devices are available at an affordable cost. The Committee emphasises that formulating an essential medicine list must ensure that these medicines are available in adequate amounts and in appropriate dosages, with assured quality, which is fundamental to the very rationale behind the, with assured quality, which is fundamental to the very rationale behind compilation of the list. Essential medicines, by definition, are those medicines that satisfy the priority health care needs of any population, based on efficacy, safety, quality and the total cost of the treatment. The NLEM, as recommended by the parliamentary panel, must be basically a list of medicines that are safe and efficacious and collectively address a majority of the public health concerns of India and are cost-effective. Another critical gap flagged by the panel is that while Out-of-Pocket Expenditure (OOPE) is primarily driven by outpatient (OPD) care and medicines, the current Pradhan Mantri Jan Arogya Yojana (PMJAY) framework, which exclusively covers inpatient hospitalisation, remains fundamentally inadequate. The government accepting and implementing the Committee’s recommendations for expanding PMJAY to comprehensively cover OPD treatments and essential medical supplies can bring down significantly the OOPE, especially for needy patients. Reducing treatment cost is critical to increasing accessibility of cancer care, and both judicial and parliamentary interventions have brightened hopes that long-ignored gaps in price regulation of medicines will be bridged with tangible outcomes.