Killing me Softly.....

Major multi national drug companies are killing us softly and surely even as debates about TRIPS, intellectual property rights , the Mashlekar committee report and other such concerns sail over our head. These and other hens will come home to roost when their implications hit us in real life. Let me share an instance:

A few weeks ago, I got an e mail from some one practising medicine in China. He had come to know of me through a mutual friend. This doctor in china had a patient who was suffering from chronic myeloid leukaemia and needed a drug called Imatinib. The drug was a product of the Swiss drug giant (Glivec) and at the price at which it was available in China, it was going to cost his patient a whopping Rs. One Lakh per month for an indefinite period, given the nature of cancer treatment. But the doctor had heard that in India, generic versions of the drug were available which were available at much lower prices and could I please check about the actual cost and availability.

I did some background research on the net as I had not been acquainted with the drug before though it would be in the news soon enough. My surfing revealed that Indian firms like Ranbaxy, CIPLA and others were indeed manufacturing it although the prices could not be discerned. So to get specific information, I went along to the near by chemist and found that generic versions were indeed available and the prices wee negotiable. But at Rs. 70 per capsule of Imatinib 100mg, though not exactly cheap, the price gap between the Novartis product and the Indian variants was yawning. Glivec is priced at Rs 1, 20,000 per month by Novartis when generic versions manufactured by Indian companies are available for Rs 8,000.

Although the drugs were eventually procured and found their way to my friend’s patient in China, one wonders how long such life saving drugs will be even relatively accessible to the common man. For it is in respect of this drug Glivec, that Novartis has filed a suit alleging violation of the patent laws and the TRIPS agreement in the Chennai High Court. As a life saving drug, it is important that the product be available at prices that one can consider affordable.

The campaign against cheaper access to drugs, initially highlighted by the high cost of anti retro virals has now spread to look at other drugs with global religious leaders having joined worldwide demands that the company withdraw the case in India. These include Nobel Prize winner, Desmond Tutu, Bishop Yvon Ambroise of the Commission for Justice and Peace of the Catholic Bishop’s Conference of India, Prawate Khidharn, General Secretary of the Christian Conference of Asia, Bishop Mark Hanson, presiding bishop of the Evangelical Lutheran Church in America. Charitable associations see Novartis’ challenge as one against the right of worldwide poor patients for affordable drugs.

Drug companies have long argued that huge funding is required to research and carry out clinical trials for new drugs and they need to recover the costs by pricing them high in the initial years when they hold exclusive patents. If that alone were the case , the reasoning might still hold good for the phenomena of ever greening of molecules that large companies indulge in and which will prevent the manufacture of generic versions ever. Ever greening allows companies to make slight changes in off patent molecules and patent those again arguing it has improved efficiency and is in that sense a never ending cycle.

Even as drug companies see their only loyalty to the share holder and there is and will be a perennial clash between private profit and public interest , the only way out seems to be to break the gird lock of private funding in the research of new drugs and encourage, publicise and encourage initiatives like the Neglected Diseases Foundation whose vision it is to improve the quality of life & the health of people suffering from neglected diseases by developing new drugs or new formulations of existing drugs for patients suffering from these diseases. The foundation has broken new ground by launching ASAQ, a none patented, once a day, fixed dose anti malarial, the first new anti malarial drug in decades. Even as drug companies for the most part treat the sick as vulnerable milking cows, initiatives like the Neglected Diseases Foundation deserve all the publicity; encouragement and funding that they need to expand their portfolio.