Most Cancer Medicines Still Unaffordable, Says AIDAN

New Delhi:  Most anti-cancer medicines still remain unaffordable for majority of Indian citizens because there is no curb on profiteering by pharma manufacturers, the All India Drug Action Network (AIDAN), has said, even as it appreciated the government’s decision to cap the prices of 42 anti-cancer drugs.

“The selection of 42 drugs by the MOHFW (Ministry of Health and Family Welfare) was not based on consultations with stakeholders including patient groups. While we welcome the intervention to reduce prices for these 42 drugs, there are many equally high-priced anti-cancer drugs whose prices remain unaffordable and need to be curtailed,” said a statement by AIDAN.

“A strip of 5 mg tablets of Axitinib, used to treat kidney cancer, costs Rs 41,737. A 50 ml bottle of Cetuximab, used to treat head, colon, rectum and neck cancer costs Rs 94,544. A 45 mg vial of Ixabepilone, which is used to treat advanced breast cancer, costs approximately Rs 72,000. A box of containing 150 capsules of Ceritinib, a targeted therapy for non-small cell lung cancer, cost Rs 1,19,700”, it said, adding that high prices of several drugs in the cancer segment may be linked to patent barriers and monopolies.

“In these cases, we do not recommend the exclusive use of trade margin capping to bring down prices but rather the application of various policy tools to increase competition and bring about true affordability “, it said.

Questioning the methodology adopted by the government, AIDNA said the formula was developed by the Standing Committee for Affordable Medicines and Health Products, chaired by the NITI Aayog, which did not have the technical expertise housed by the National Pharmaceutical Pricing Authority (NPPA), neither did they have the data for analysing and designing a methodology to cap margins. “However, the NPPA accepted the methodology without looking into it,” it added.

According to them, the high prices of several drugs in the cancer segment can be linked to patent barriers and monopolies, and AIDAN has recommended that instead of only using trade margin capping to bring down prices, there should be application of various policy tools to increase competition and bring about true affordability.

The statement read, “The formula does not disturb the margins of companies before the medicines reach the stockist. This is a particularly glaring exclusion when it comes to the high margins of companies/entities importing drugs into India. It is encouraging that NPPA has asked companies to submit data on landed costs and we hope post the data collection, the data would be shared in the public domain and margin capping would be brought to subsume importing entities as well.”

AIDAN also said no data has been made available for six of the 42 anti-cancer drugs, making it impossible to assess the impact on their prices. These six drugs are Cladribine, Dasatinib, Olaparib, Olaratumab, Osimertinib, and Ribociclib.

 Also, the formula does not have an adequate impact on the prices of the patented drugs, said AIDAN, adding that “in the case of patented medicines such as sunitinib, nilotinib, crizotinib etc., the exercise has led to negligible price reductions, in contradiction with the stated objective of increasing affordability. In fact, the trade margin rationalisation legitimizes the high prices claimed by manufacturers.

The statement called upon NPPA to not limit itself to trade margin caps but to “move ahead with cost-based price control over all essential and lifesaving medicines and their combinations.”