How Will Cheaper Cancer Drugs Help?

For those affected by this debilitating disease, a price control on cancer drugs can bring at least short-term relief

Published: Jun 10, 2011

In his Pulitzer Prize winning book, The Emperor of All Maladies, oncologist-author Siddhartha Mukherjee calls cancer the “defining plague of our generation”. A rather morbid description of a disease that until recently trailed infectious diseases, particularly in India, in garnering public policy attention, but is now inching up on the government’s agenda.

 

 

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The government revised its list of essential medicines after eight years, and the new list includes drugs for treating cancer. Once the New List of Essential Medicines (NLEM) is notified, the Ministry of Chemicals and Fertilisers will push for imposing price control on all the drugs on the list. This could have been triggered by the Supreme Court’s directive to the government to do so. Right now, the government controls the price of only 74 of the 354 drugs on the list.

So, what does the presence of cancer drugs on the list of essential medicines mean for patients? They will get affordable treatment in the short term; however, the quality of a patient’s life in the long term remains questionable.

“On an average, 15 to 30 percent cost reduction can be expected. In a treatment whose cost ranges from Rs. 5 lakh to Rs. 15 lakh, even this price reduction can bring significant relief,” says Himanshu Goel, assistant vice president of Guardian Lifecare, a wellness and pharmacy retail chain. However, he advises patients to negotiate with pharmacies and stockists, as this can bring down prices by 15-20 percent from the maximum retail price (MRP).

Globally, cancer is a scourge and drug sales for this malady are growing twice as fast as other pharmaceuticals. India is no exception. Of the 1,153 drugs that saw price increases in the quarter ending November 2010, anti-cancer drugs were the only category (other than contraceptives) where price increase exceeded 15 percent, according to PharmaTrac, a report from the All India Organization of Chemists and Druggists.

For a disease that affects 2.5 million people in India, with about 800,000 new cases reported every year, cancer drugs are beyond the reach of the average patient, says a study of the Department of Industrial Policy and Promotion.

Former medical oncology chief at Tata Memorial Centre in Mumbai and current head of Indian Co-operative Oncology Network Purvish M. Parikh says price control reduces the base price of the drugs by 10 to 90 percent. “But,” he says, “the list is slightly skewed; I don’t get the logic behind it.” Drugs for some of the common cancers in India — such as testicular and breast cancers — that are curable, are not in this list, he says.

An essential list has to be a bare-bone roster of drugs whose all-time availability and affordability is the government’s responsibility, says Y.K. Gupta, head of the Department of Pharmacology at AIIMS, New Delhi, who chaired the committee that prepared the NLEM. “By and large, the majority of cancers can be handled by these drugs,” he says.

However, Gupta cautions that the government should consider the profitability of drug companies while enforcing price control. In the past, manufacturers have stopped producing drugs that have low profit margins.

Additionally, just as cancer is not a single disease but many diseases, so is its treatment. It requires a combination of drugs that can often change, a fact that is exploited by drug manufacturers — they circumvent price controls through “non-standard combinations”. In dealing with this “pervasive adversary”, the government has to walk a tightrope. “It must ensure access and affordability in a manner that the industry finds sustainable,” says Gupta.

(This story appears in the 17 June, 2011 issue of Forbes India. You can buy our tablet version from Magzter.com. To visit our Archives, click here.)

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  • Senthil Chengappa

    It's a pity that cancer cases are rising and even this little bit that the govt announced to do is not done yet. And drugs alone will not make a dent. Look at the hospitalization cost specially when half the family has to live with the patient either inside or outside the hospital. Everybody should visit a large cancer hospital and see the slum like scene outside the gates, be it a govt place like Tata memorial or a private hospital like Apollo in Hyderabad. Nobody talks about opening more affordable hospitals. Media should also highlight the incidence or care of various types of cancer. Urban India witnesses a big song and dance about breast cancer every year in october but what about stomach, kidney and head and neck cancers which I suspect is among the highest anywhere? Apparently one cancer case is detected in India every 5 seconds!

    on Mar 31, 2012
  • Gv Reddy

    I think cancer drugs in the list are old drugs, many of which are already reasonably priced. Can govt do something about the effective new drugs, which don't compromise the quality of life and prolong a patients life by a good number of years? A dose of breast cancer drug herceptin costs over a lakh and one needs 18 such doses. Sure this drug is not effective in all cases, one needs genetic testing to take this but still, imagine a middle class family shelling out Rs 20 lakhs for one round of treatment. Cancer by itself kills people, its cost of treatment kills the family as well.

    on Jun 11, 2011
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