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EDITORIAL: Finally, the caretaker government has taken the tough but necessary decision of approving an increase in prices of 146 essential lifesaving medicines, but not before stoking a fair deal of completely unwarranted controversy.

It must be noted that the federal health ministry, specifically the caretaker minister, was singularly to blame for the crisis that rampaged through the pharmaceutical industry for months without any check. He let the matter of approving changes to prices of no less than 262 medicines, including lifesaving ones, linger for months, despite repeated pleas from the Pakistan Pharmaceutical Manufacturers Association (PPMA), DRAP (Drug Regulatory Authority of Pakistan), and all provincial health ministers. And this policy paralysis persisted even as important medicines that first disappeared from the market were replaced by spurious and counterfeit drugs that fetched three-to-five (sometimes even 10) times the actual prices, boating the black market, and hurting patients, the pharma sector and the exchequer alike.

There was no progress since at least November, even though yet another bitter exchange with PPMA has produced yet another statement from the minister — that the matter was being given the urgency it deserved and a final decision would come very soon.

Yet this problem goes back to the PDM (Pakistan Democratic Movement) coalition government that preceded the present caretaker setup. And clearly the sitting minister, just like his predecessor, did not want to be the person to greenlight a price hike, that too in lifesaving drugs, when people were already crushed by the worst inflation in living memory.

It is unfortunate that authorities didn’t budge till things got completely out of control, and people were forced to pay a lot more for possibly fake drugs, and every link in the economic chain from producers to consumers all the way to the government was being harmed.

Producers have long faced increasing input costs because of rupee weakness and international commodity market volatility, yet were not allowed to adjust prices. And the government stood idly by as multinational companies burned by needless losses simply packed up and left, further damaging the local consumer market.

It’s shocking that nobody at the top seemed to realise that the only choice was between expensive but readily available drugs and not-too-expensive medicines that were not to be found or, as is increasingly the case, much more expensive and counterfeit drugs.

Reforms that have been urged since forever by all stakeholders, including this space, have never even been considered. There is an urgent need to overhaul DRAP and split it into two entities, one that regulates the drug market and another that fixes prices. Caretaker PM Kakar has, at long last, asked for recommendations to improve the regulator’s performance. But whether it goes any further, and it is indeed divided into two bodies, remains to be seen.

There’s also a lot to learn from neighbouring countries that faced the same problems yet overcame them a long time ago. India, for example, has a National Pharmaceutical Pricing Authority (NPPA) that limits price control to a scheduled list of 302 essential drugs while Bangladesh extends controls to a list of 117 essential drugs.

In Pakistan, on the other hand, the black market is left to dictate prices just because the government does not wish to appear unkind to people who are fighting for their lives and seeing their life savings enable mafia operators and market manipulators to laugh all the way to the bank.

Unless the decision to revise prices of select drugs is followed by thorough reforms, this problem will come back to haunt producers and consumers before long.

Copyright Business Recorder, 2024

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