REVISION OF NLEM

The very purpose of having a drug price control policy is to ensure fair prices for essential and life saving drugs to the people of a country. That is what the government has been trying to achieve in India for the last thirty years. But with the notification of the new Drug Price Control Order of 2013, the government for the first time let down the people of this country by excluding several essential drugs from price control. This is despite a Supreme Court direction, while hearing a case on the National Pharmaceutical Pricing Policy in 2003, advising the government to work out an appropriate criteria to identify essential and life saving drugs and ensure that they are brought under price control. Since then it rook over a decade for the government to announce the new DPCO in May 2013.  And now the government admits in an affidavit filed in court that the market value and share of medicines covered by new DPCO is just 18 per cent of the country's pharma market. Many life saving medicines including anti-cancer drugs, expensive antibiotics and drugs needed for organ transplantation have been left out of price control. In fact, the prices of a number of essential and non essential drugs have gone up after the notification of new DPCO. It seems that the government merely lifted the entire National List of Essential Medicines (NLEM) 2011 comprising of 348 drugs and placed it under price control. The whole exercise has been done without assessing its implications on the patient community. Take for instance the case of paracetamol. A 500 mg paracetamol tablet is under price control but a tablet of the same drug of 650 mg strength is not. Single ingredient anti-TB drugs are under price control but combinations of TB drugs are outside price control. With the current DPCO not covering combinations of drugs, a lot of drugs for diabetes and hypertension and many other conditions will be out of price control as they are used in combinations. In short, almost 50 per cent of all drugs marketed in the country are fixed dose combinations (FDCs). Therefore, the pricing policy followed now undermines the entire objective of making essential drugs affordable to the people. The price control has to be expanded to cover combinations, additional strengths and dosages of all drugs as was the case in the previous DPCO of 1995. Besides, many drugs included in the price control are not in the market for a long time.  All these faults in the current DPCO call for a drastic revision of NLEM. The  Union health ministry is reported to have initiated steps to revise the list considering the existing market conditions and usage of drugs by the patients. But that needs to be done on an emergency basis by the government as the patients are already being penalised by way of huge price increases effected by the National Pharmaceutical Pricing Authority during last six months.