Who is the boss of Indian Pharma ? Doctor or Government 

By Dr. Ankit Om

In this era of connectivity, Every person do have some piece of information but honestly only apt and accurate information can be converted into wisdom. Wisdom aspires knowledge and Knowledge is the power. This is true in the current scenario, when Nation is repeatedly facing rapid change in the society. And perhaps parameters of the development are completely shifted and different now for us.

We are thriving for information rather than knowledge and our so called intellectual section are keeping mum over such sensitive and responsible issue, which is ultimately not only weakening foundation of this noble profession since ages but also misleading the youth for their vested interests. Today I would like to divide this article into four parts for easy understanding, and these are introduction and current status of Indian pharma, history and role of government, crucial key role of Indian doctors and conclusion with letting open debate in public domain respectively.

YES ! medical is the profession which must be discussed over every single platform irrespective of any discrimination. ”Health is Wealth” thus being Indian citizens all deserve to understand the basics of Pharmaceuticals that reflects wealth from health.

Here I am writing not to target only medicos as audience but I must try to generate the thought process among all aware citizens who are concern for the health care system of India, specially India journals that are persistently covering health sector without any research and development initiatives or considerations in media.

Now, if I say, pharma is too functioning in the same pattern of Indian media that is without adequate R&D reports, like important life saving drugs are in the market without adequate trials based on parameters,amazing but true in today prospective. We must admit quack journalism is empowering such quack pharma to flore up likewise quack medicos who are the persistently demeaning and harming the dignity and pride of the medico profession with the help of quack policies of Indian quack ministers deliberately emphasized the word ‘Quack’ as they do exist in every system in India because of lack of professionalism.

We must understand the basics before we speak about health care system related with pharma,as issue is very sensitive and linked with the health of mass citizens of India.

Lets begin with some amazing facts about pharma to assist our journalist friend for their better insight into the issue. Current market size of pharma is almost $27 billion which will reach up to $55 billion by the year 2020 at the CAGR of 15%.

It can touch $55 billion with some strategic and aggressive efforts. Interestingly, Indian pharma is growing at the rate of 9-10% annually since last few years and trust me, in the world, no developed country is growing in this sector with two digit growth but India is enjoying this status and it is having 3rd position in volume worldwise. India accounts for 20% exports of generic medicine as per FY 2016. Yes we are leading in export globally.

Apart from current status, lets have a brief look of history which reveal how Indian pharma could achieve this amazing platform globally. We can say, evolution of Indian pharma may be set into four stages.

First stage, is the period before 1970 in which Foreign pharma dominated Indian market with little support of domestic participation. Second stage is the period from 1970-90. As Indian Patent Act enacted during this time and several domestic companies started operations in the field of R&D.

Third stage is 1990-2010, Liberalization led Indian companies to launch operations in foreign countries. Indian Patent act amended in 2005 which led to adoption of patents. Fourth stage 2010 on wards, is the current stage when pharma is leading and now India has become major hub for generic manufacturing.

Prominent reason of its remarkable growth are low cost operations, adequate availability of skilled resources,organised infrastructure and big consumer market in comparison of US.

Now you must be thinking, on one side you were repeatedly told that India is facing crisis of doctors since long, then is it possible that despite being less in number,doctors could make this wonderful achievement for Indian pharma? and second if India is hub for generic and even branded drugs then what may be the reason that any government could not make effort to provide free or low cost medicines to Indians.

Only few states are providing free drugs for the patient despite knowing the fact the we are biggest generic exporter in the world. It clearly indicates that faulty policies and irregularized pharma sector by the government, citizens are not getting adequate health care benefits. Every government was the back up of pharma sector but rather than patient’s prospective, they let the sector organised for the benefits aspects at the stake of health care model. We must understand the role of government, I am emphasizing some technical information on the part of regularization of sector.

Both central and state govt play a crucial role from molecule level to launching a single drug. Central Drug Standards and Control Organisation under the Ministry of Health and Family Welfare control the measures of efficacy, safety, quality of drugs. New drug authentication, license and supervision of trials are also their dedicated duties. Drug Controller General of India performs this duty.

Apart from it National pharmaceutical pricing Authority was instituted in 1997 and performs their duties under dept of Chemical and Petrochemical Ministry, GOI. It maintains and revise price of a drug at periodic intervals based on parameters. It also controls production, export, import of a molecule to a drug.

Other ministries which work in the coordination are, Ministry of Environment, Finance, Commerce, Science and Technology Department. Such a huge representation of government for the Indian pharma and surprisingly in the recent past Many prominent politicians, renowned journalist and many intellectuals are persistently playing blame game and demoralizing Indian doctors for their failure of regularization and inadequate policies.

Now we should focus on the role of doctors in the pharma, which is recently a hot topic of discussion after controversial statement of honourable Prime Minister in London about Medical conferences.

Very important and sensitive issue and personally I feel that all intellectuals must think and start debate as the statement made an irreversible damage to that fraternity which is working in such a corrupt and inadequate health sector of India at the stake of their lives and careers.

Life Expectancy has been increased from 55 years to 66 years of a common citizen on the other side a decline of 7 years for doctors as per recent data reveals.its unfortunate. We all know that our country lack infrastructure in health care system and one third doctors are serving for 75% population while two third are working for 25% of population.great unequal distribution.

Situation worsen when govt don’t have their own research and development department developed. Indian pharma spend their 4-9% over R&D and treatment protocols depend on such basis. Without help of govt functionaries doctors has to play their technocrat role in pharmaceuticals that is to provide standards and measures for drug safety, efficacy and quality but being doctor you have no role in monitoring and surveillance of drug sector. These conferences are meant to deliver the healthy protocols and India is rapidly growing economy with these challenges.

In a simple way, any conference medical or political, they have one design. As Indians are fond of politics thus I am using this comparison for easy understanding. A conference has its agenda, keynote speaker, sponsors and target delegates. Similar like political rallies which spend crores of money for branding and endorsement. But key difference is money.

What pharma sponsors do is a investment to make a profit in monetary terms. On the other side what a political conferences spend is coming from the taxes of Indian citizens in direct and indirect way to endorse a leader or party. Which is more harmful, I don’t need to mention but do remember when a doctors write a prescription, it cures the disease although the money you spend for your health go ultimately to the government through pharma companies directly or indirectly from your pockets.

Doctors are charging for their knowledge and skills not for that drug. It depend on marketing of pharma companies which is targeting their zone when central and state Govt. are failing to deliver low cost and free medicine to their tax payers. Govt are biggest buyers of these pharma not doctors.

Even doctors are not owner of these pharma except few exception which are manufacturing generic for mass public. In such circumstances when govt is not coming with adequate and appropriate policies, honourable Prime Minister made that statement which not only demoralizing but also misleading to the mass.

Although this statement was structured to allow rapid shift of Indian pharma from brand to generic drugs and ultimately Indian pharma will get it in the best way to attain same growth rate annually.

Unfortunately Many doctors were who serving for the country in such a limited resources, are feeling discouraged and depressed with the gesture of prominent leaders. Indian doctors are performing great outside India but youth of India is not seeing any charm more in this hard working fraternity. This is an alarm.

Faith is the best healer and nobody should ever try to break this for their vested interests.After statement of honourable Prime Minister, personally I feel, it gonna be difficult to practice in India. Where your leaders don’t have respect for your fraternity, followers will never recognize your hard work being Indian doctor. Rather than making derogatory remarks, Govt. must bring focus on monitoring and surveillance to encourage good clinical practices. Only effective policies can deliver the best for Indian health care system. Mutual respect and coordination is the key of Healthy India.

Author: Dr. Ankit Om, Chairman, United RDA, India

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