Regulate retail pharma industry to ensure health for all in India

The absence of stringent regulations for the retail medical sector exacerbates the difficulties faced by the economically disadvantaged social groups. From counterfeit medications to exorbitant prices, the implications of an unregulated medical retail market are profound

It is difficult indeed to ascertain what stops powers-that-be from regulating retail pharmaceutical industry, selling drugs and medical devices, across the country, with a huge hiatus between the maximum retail price (MRP) and the price at which life-saving essentials are sold. It is the million-dollar question for which answers remain elusive. Many experts claim that the hands of policy makers are tied, while others put the blame on the network of pharma lobbies and their agents, who ostensibly wield undue clout in the corridors of power and call the shots.

Since the truth will perhaps never be out in the open, let us try to decipher some known facts to understand how people are fleeced day in and day out and no one gives a damn. The capping of medical devices prices remains a huge issue in the country despite the fact that several attempts have been made by the government in this regard. The ultimate sufferers are the general public. The colossal gap between the MRP of medicines and the discounted price is agonizing since the benefits of discounts are not passed on to the buyers evenly. Giving discounts or not is in accordance with the whims and fancies of the retailers. One cannot ask for a discount as a matter of right.

As one wonders why concerted efforts are not made to check the rampant loot in the name of MRP, what leaves one perplexed is that many chemists put up boards or banners, offering discounts of up to 30 per cent on various medicines.

Recently I bought a strip of medicine where the discount was an exorbitant 60 per cent. It was, otherwise, 15 per cent on other medicines. When I asked the man at the cash counter about the story behind MRP and the game of discounts, pat came his reply “We have not been able to regulate the retail pharma industry. It is all chaotic.”

If he is to be believed, the average margin for a retailer is not less than 20 to 25 per cent, depending on the overall running costs. If a retailer’s margin is 20 per cent after giving 15 per cent discount to customers, then MRP will certainly be on the higher side. And what if the retailer doesn’t pass on the benefits of discount to customers, which is the real scenario? Well, the buyers stand extorted, which is an everyday irony.

In a country where accessing healthcare is already a big challenge for many, the absence of stringent regulations for the retail medical sector exacerbates the difficulties faced by the economically disadvantaged social groups. From counterfeit medications to exorbitant prices, the implications of an unregulated medical retail market are profound. Counterfeit drugs, substandard medications, and unchecked price hikes plague the market, leaving vulnerable populations at the mercy of unscrupulous vendors. Unchecked pricing practices further enhance financial burden on the poor. For those already grappling with meagre incomes and limited resources, the soaring costs of medications represent an insurmountable barrier to accessing healthcare, perpetuating a cycle of poverty and ill health.

On the other hand, the pharmaceutical industry in India is expected to reach $ 130 billion by 2030. India is also a major exporter of pharmaceuticals, with over 200 plus countries served by its pharma exports. It supplies over 50 per cent of Africa’s requirement for generics, around 40 per cent of generic demand in the US and not less than 25 per cent of all medicines in the UK.

India is the largest provider of generic drugs globally and 80 per cent of the anti-retroviral drugs used worldwide to combat AIDS are supplied by Indian pharma companies.

According to the Indian Retail Druggists and Chemists Association, there were around 10,000 distributors and 1.25 lakh retail pharmacies in the country in 1978. Today, the total number of stockists is estimated to be around 65,000 and the number of pharmacies is about 550,000, an increase of around six to four folds, respectively.

There is, however, a silver lining. The Department of Pharmaceuticals in its year-end review released on December 29, said that ‘Pradhan Mantri Bhartiya Janaushadhi Pariyojana’ (PMBJP) has achieved the target of opening 10000 retail outlets, which provide quality generic medicines at affordable prices to the poor and underprivileged.

As on November 30, India had 10,006 Pradhan Mantri Bhartiya Janaushadhi Kendras (PMBJKs). The product basket of PMBJP comprises 1965 medicines and 293 covering major therapeutic groups such as anti-infective, anti-diabetics, cardiovascular, anti-cancers and gastro-intestinal medicines, among others. In 2022-23, PMBI registered sales of Rs. 1,235.95 crore, which led to savings of approximately Rs. 7,416 crore to the citizens. It is fine but should the government sell medicines and devices through retail outlets or effectively regulate the retail pharmaceutical industry to ensure that the needy are not fleeced by the market hawks is what one wonders.

If PMBJKs are opened in every nook and corner of the country, making its presence ubiquitous with the majority of medicines and medical equipment being made available, then there will certainly be no problem at all. But the question is: Will the government do so?

One will strongly recommend mustering courage to regulate the medical retail market. A multi-faceted approach that prioritizes regulatory reform, consumer education and equitable access to healthcare should be adopted. Strengthening regulatory frameworks to enhance oversight of the medical retail sector is paramount. Implementing stringent quality control measures and cracking down on counterfeit medications are essential to safeguard public health and restore trust in the healthcare system.

Furthermore, empowering consumers through education and awareness campaigns will enable them to make informed choices about their health. We cannot afford to be oblivious of the implications of an unregulated medical retail market in developing countries like India.

From jeopardizing public health to perpetuating cycles of poverty, the consequences of unchecked practices within the medical retail sector are far-reaching. By giving a boost to regulatory reform, promoting consumer empowerment, and ensuring equitable access to healthcare, we can strive towards a future where quality healthcare becomes a fundamental right for all in reality, irrespective of their socio-economic status.

Only then can we truly fulfill the promise of health and well-being for all citizens, leaving no one behind.

(The writer is a senior journalist, author and columnist. The views expressed are strictly his personal)