Zydus boss: Access debate needs to look beyond pricing
This article was originally published in Scrip
Zydus Cadila's straight-talking chairman and managing director, Pankaj R Patel, quite stole the show at the healthcare access summit organized by the Organization of Pharmaceutical Producers of India (OPPI), which represents multinational firms.
Mr Patel, a guest speaker at the event, emphasized that pricing gets disproportionate attention in the access debate even when generic drug prices in India are the lowest across several therapy areas. But what perhaps caught the attention of the largely Big Pharma audience at the event was the Zydus boss's candid and sharp comments on how the environment for doing research in India was not conducive to R&D and that healthcare appeared to be no one's baby in the country.
Speaking at OPPI's Third Healthcare Access Summit in Mumbai, Mr Patel said if India wants to find appropriate healthcare solutions for itself, it would need "Indian therapy regimes" and also decipher the Indian way of treating disease relevant to the Indian population which is both effective and less expensive. However, that in turn would need a conducive R&D environment and one that clearly does not appear to exist in India currently.
"Improving India's environment to support innovation is critical to improve access. Without research, nothing can move and we have created an environment in the country where we cannot do research. My own experience of doing research is clearly telling me that I have to go out of India to do research," he lamented.
Mr Patel was careful "not to blame anybody" but said: "We've created a system that is talking different tunes everywhere… we are missing the symphony."
Zydus Cadila's boss noted innovation worldwide was moving towards locations such as China and South Korea since these nations can foster such innovation. While there are 76 R&D hubs in North America and 12 in China, India had just three, he said.
Mr Patel's comments come in the backdrop of a string of new orders regarding clinical trials, including restricting the number of studies that an investigator can be involved in and an apparent tightening of the clause that permits a waiver of trials in the Indian population for new drugs already approved elsewhere (scripintelligence.com, 9 July 2014). These orders come amid an ongoing case brought about by the NGO Swasthya Adhikar Manch concerning alleged illegal trials being conducted in the country amid lax regulatory procedures, checks and balances.
Mr Patel also noted how healthcare appeared to be "nobody's baby" in India, neither the health ministry nor the finance or industry ministries. "And that's why we don’t have a comprehensive policy that can ensure everything that is required to bring in modern science, modern medicine to our country," he said.
He also took a dig at how the absence of government agencies at the event was perhaps an indication of the importance given to access in India.
pricing issues
Mr Patel also explained that reducing prices of medicine alone may not improve access to medicines.
"Even for patented products, prices in India are generally lowest across many emerging markets. Despite lower prices, access remains a challenge due to lack of healthcare infrastructure in India," the executive observed.
Drug price increases in the last seven years in India have never been "drastic", nor is it expected to be above inflation going forward, he added.
Among other facts, he also noted how Indian drug firms supply an estimated 40% of over-the-counter and generic prescription drugs consumed in the US. "In 2012, Indian companies helped the US health system to improve access by saving $100bn," he added.
Mr Patel referred to public private partnerships as an area for consideration to improve access and policy interventions to develop healthcare infrastructure, procurement and distribution, financing and education and awareness
Other speakers also emphasized how the access challenge needs multi-stakeholder collaboration.
"One stakeholder cannot cover these [challenges] and you need strong collaborative stakeholder partnerships," said Ranjit Shahani, vice chairman and managing director of Novartis India.
Mr Shahani referred to how access remained a "chimera", how poverty and health had many dimensions and the "vicious circle" of poverty and poor health. "Are the poor the wards of the state or of the pharma industry? The answer is neither. We need multiple stakeholders to come together to meet this challenge," he emphasized.
Dr Shailesh Ayyangar, president of OPPI and managing director, India, and vice president, South Asia, Sanofi, in his address, said that the pharmaceutical industry was more than willing to partner with the Indian government to achieve its vision of healthcare access for all. He said that a focus on human resource augmentation, last-mile availability of medicines and stronger healthcare distribution will catalyze access to healthcare.