Access to Affordable Medicines in India
Accessibility to medicines is the fundamental right of every person. Medicines are integral parts of the health care and the modern health care is unthinkable without the availability of necessary medicines. Inequitable access to medicines is a major weakness in the Indian health care system. The challenge to affordable drugs becomes a prime concern while discussing about the chronic illness such as Diabetes and Hypertension.
Since patient suffering from Diabetes and Hypertension are bound to take the medicines life-long, the cost of relevant medicines can drive people living with diabetes into a downward spiral of debt and poverty. Further, the need for other mandatory expenditure like food, housing, and other family members living on the salary changes the affordability estimate. Affordability can be severely affected by multiple illnesses in the family or if the earning member is one to fall ill.
It was previously considered that Diabetes and Hypertension are “diseases of the rich” and is likely to be less prevalent in developing countries like India. But contrastingly it is found that people living in poorer countries on or below the poverty line tend to be diagnosed later and have less access to treatment and thus suffers more acute complications than the rich.
The majority of poor and even middle-class people in India do not have health insurance and are forced to pay for medicines as they need them. It is an irony that, though India is classified as “the diabetes capital of the world”, only a limited number of insurers specifically address the insurance needs of diabetics and hypertensive individuals. Most Indians pay for medicines – a key factor that contributes to the impoverishing effect of out-of-pocket (OOP) payments for healthcare.
In India, confusion and misinformation about generic medicines is abounding. Although the generic medicines are bio-equivalents of their innovator counterparts but, these are widely believed as inferior in their therapeutic efficacy and quality to branded products. The confusion is spread across all the stakeholders including the general public, prescribers, policymakers and pharmaceutical trading agencies. Marketing practices adopted by manufacturers of imported branded medicines also propagate the belief that generics are of inferior quality.
Sustainable Development Goals acknowledges the need to improve the availability of affordable medicines for the world’s poor in its Goal 3.8 which aims to “Achieve universal health coverage including financial risk protection and access to safe, effective, quality and affordable essential medicines for all.” A significant proportion of chronic disease morbidity and mortality can be prevented if medications are made accessible and affordable.
The foremost solution to the above mentioned problems is the sensitization of both, the medical practitioners and the patients about the generic medicines. The doctors need to be encouraged to prescribe generic medicines and the patient needs to be made aware about the generic medicines so that they can ask for them.
Also, creating only awareness is not going to reduce the burden of Diabetes & Hypertension. We need to encourage the community to involve into health promotion activities such as exercise, diet modification and strong social/peer support to halt the progression of disease and prevention of complications!