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India exports affordable generic drugs to the region, in contrast to the costly, patented products
supplied by MNCs. This has led Latin American governments and people to have a positive view
of India as an important contributor to their objective to reduce the cost of healthcare. In fact,
Brazil and Chile encouraged the entry of Indian pharma companies into their countries to put
pressure on MNCs and local drug-makers to increase the availability of generics and reduce the
cost of medicines.
India is also a major supplier of bulk drugs (pharmaceutical raw materials known as API) to
Latin American manufacturers of pharma products. The export of bulk drugs are worth over
$300 million. This helps Latin American manufacturers reduce their cost of production, thanks to
the low-cost inputs from India. Indian pharmaceuticals are not considered a threat to the Latin
American industry, which has been hurt badly by the large-scale entry of Chinese manufactured
products in many sectors.
Some Indian pharma companies have even set up manufacturing plants in Brazil, Mexico and
Argentina. Besides supplying to the local markets, these units also export to the US and other
countries outside the region. The Glenmark plant in Buenos Aires has become the company’s
global hub for the manufacture and export of oncological products to over 20 countries,
including the US.
The success and positive perception of Indian pharmaceuticals have helped in enhancing the
image of other Indian companies, as well as India as a whole, in Latin America. Latin American
trust in Indian medicines has helped in increasing their confidence in the quality of other Indian
products as well.
But India’s pharma lead over China is not just limited to Latin America. In fact, India’s global
export of pharmaceuticals is double that of China. In 2016, India’s pharma exports were worth
$13 billion, as against Chinese exports worth $7 billion. India is the tenth largest pharma
exporter in the world, while China ranks at 16.
Other importers
India is the fourth largest supplier of pharma to the US, with exports worth $5.1 billion, while
Chinese exports to US were just $1.1 billion in 2016. Indian companies account for 30% of the
US’s generic drug imports. It is also creditable that India has the largest number (over 200) of
US FDA-approved pharma units outside the US. Some Indian firms such as Sun
Pharmaceuticals, Lupin, Reddy Labs and Cipla have also established manufacturing units in the
US.
India leads China in exports to the EU as well. In 2016, India’s exports were worth $1.56 billion
as against China’s $1.36 billion. Even in Africa, where the Chinese have spoiled the market with
massive credit and some non-transparent practices, India’s pharma exports were worth $2.8
billion as against China’s $618 million in 2016.
The UK is the second largest market for Indian pharma exports, which stood at $464 million in
2016. India also exported to other developed markets in 2016, including Australia ($220
million), Germany ($161 million), France ($145 million), Netherlands ($143 million), Canada
($143 million) and Belgium ($125 million).
India exports half of its total production of pharmaceuticals. Exports to the US and other
rigorously-regulated western markets account for over 50% of India’s global exports. This has
given a stamp of quality to Indian pharmaceuticals, adding to the confidence in Indian medicines
in Latin American and the rest of the developing world.
India is the largest exporter of generics (by volume) in the world, accounting for 20% of global
export volume. The low cost of production and the large and strong base of scientific and
technical human resources have given Indian exporters of generic medicines a competitive
advantage. The world has recognised India’s role as the main contributor to the lowering of
healthcare costs in developed countries like the US and the UK. Western NGOs was well as
foundations such as the Bill and Melinda Gates Foundation, Doctors Without Borders and the
Clinton Foundation buy Indian generics for use in their healthcare work in Africa.
There are, of course, many challenges that Indian pharma exports face. Some Indian companies,
including Ranbaxy, have been caught and fined or their products banned by the US FDA and its
EU counterpart for violations of quality standards and authenticity of data. There is a shortage of
qualified pharmaceutical scientists for research and development work. While the exports are
dominated by a few large players, there are many small and medium companies that need
technological and infrastructural support. There is a need to strengthen the Indian regulatory
system and train people for the industry in collaboration with educational institutions. Indian
companies have profited from mass producing those products whose patents have expired. But
they need to move beyond this business model and become innovative, with more investment in
research. The government of India should also keep up its solid stand against pressures from the
US to change Indian patent laws.
Pharmaceuticals are not a focus area for China; it is its 39th largest export item. But China has
started catching up fast. For India, pharma is of greater importance, as its fifth-largest export
item. Given this significance and the competitive advantage that India has, it is time for the
government to specially focus on pharma exports, just as it has successfully done for IT. The
government and the Indian pharmaceutical industry should work out a comprehensive strategic
policy to increase exports in the future. According to a June 2016 study by Assocham, India’s
pharma exports could reach $20 billion by 2020.
While the large exports of IT products and services, and diamonds are facing a downturn due to
unfavourable global trends, the exports of generic medicines offers a brighter future in both the
short and long term. The developed and developing world are concerned about the high costs of
patented medicines and what this means for healthcare. Countries are keen to use more generics
to cut down the cost of healthcare. This is an unmissable opportunity for India.
The success of pharma exports should be an inspiration for Indian exporters of other
manufactured products who complain about and suffer from Chinese competition.
Generic medicines in India have received a new impetus with Prime Minister Modi
himself advocating the usage of these medicines. Doctors will now be required to
prescribe generic formulations of medicines, as opposed to specific brands. The
Prime Minister has announced that prescription of medicines by their generic names
will be mandatory.
What’s good about this move?This is expected to bring down drug prices and
expand access to affordable health solutions. As per the latest National Sample
Survey Office survey on healthcare, in 2014, medicines emerged as a principal
component of total health expenses—72% in rural areas and 68% in urban areas.
For a country with one of the highest per capita out-of-pocket expenditures on
health, even a modest drop in drug prices will free hundreds of households from the
widespread phenomenon of a medical poverty trap.
In addition to the social benefits, the generics-only policy also makes economic
sense. By promoting generic drug consumption, the government safeguards the
health of its generic drug manufacturing industry—one of the largest suppliers of
low-cost medicines in the world.
With increasing pressure from the “Big Pharma” companies in developed countries,
Indian generic manufacturers must now operate under a markedly restrictive
intellectual property rights (IPR) regime. The new policy can ensure that—at least in
the Indian market—generic manufacturers retain an advantage. Big Pharma’s
access to Indian consumers will have to be routed through generic companies using
channels such as voluntary licensing.
Low-cost medicines, apart from their attribute as a commercial commodity, have far-
reaching implications on public health and international human rights. India has
unambiguously subscribed to the pro-public health argument, and has articulated its
position several times at home and in international forums.
Expected Questions
Syllabus
Additional information
A Bureau of Pharma PSUs of India (BPPI) has been established on the 1st of
December 2008 comprising all the Pharma CPSUs under the Department of
Pharmaceuticals.
The Bureau will bring about effective collaboration and cooperation in furthering
the working and resources of these organizations.
1. Co-ordinate marketing of the generic drugs through the Jan Aushadhi stores.
2. Co-ordinate supply of medicines in the State from their own plants, other
Pharma PSUs of Central & State Governments and Private Sector.
Experiments in states
The Tamil Nadu and Rajasthan governments procure generic name medicines
at extremely competitive prices year after year, and crores of drugs are in use
in their public health systems, thanks to the quality assurance systems in place.
The success of the drug procurement system in these two states should
counter the defeatist narrative that insists that generic medicines can never be
good.
This is not to underestimate the challenges in ensuring quality generic
medicines countrywide, but the critics from the medical profession are doing
the poor patient enormous disservice by swallowing the disinformation from the
pharmaceutical industry about the general lack of bioavailability of generics as
compared to brands.
When a pharma company invest & develop any new drug & earn patent rights for it,
then is called branded drug(BD). The duplicates of branded drugs are known as
generic drugs. They have following differences:
Production: Only Company with patent rights are allowed to manufacture Branded
Drug. Once patent lapses, other companies are allowed to produce generic drugs.
Cost: Unlike generic drugs, branded drugs incur high cost due to high investment
research & development.
Ingredients: The active ingredient (the one which cure the disease) of both drugs
are same but the differs in colour, shape or taste
Affordable, effective & easy drug access important for "universal healthcare”. So,
India has decided to bring a law for doctors to prescribe generic medicines which
have certain issues:
A generic drug is approved only after it has met rigorous standards established
by the FDA with respect to identity, strength, quality, purity, and potency.
All generic manufacturing, packaging, and testing sites must pass the same
quality standards as those of brand name drugs.
The generic drug manufacturer must prove its drug is the same as
(bioequivalent) to the brand name drug.
For example, after the patient takes the generic drug, the amount of drug in the
bloodstream is measured. If the levels of the drug in the bloodstream are the
same as the levels found when the brand name drug is used, the generic drug
will work the same.
In the West, brand names are given to researched and patented first-in-market
innovator drugs.
After the expiry of patent period, other companies launch generics of the
innovator drug with just the pharmaceutical salt name at a hugely discounted
price. So, the only difference between a brand name drug and its generic
version is the price.
The issue in India is not about expensive brand name drugs versus cheaper
generics, as in the West, but one of quality drugs versus suspect quality drugs.
Branded generics are also generics with a brand name, plus the quality
assurance from well-known companies like Cipla, Sun or Dr Reddy’s. Doctors
have come to trust these companies and their brands over time.
Indian pharma’s field force numbering nearly one million medical
representatives have done a good job of building this trust in their companies
and brands.
It is simply not possible for doctors to transfer this trust to generics,
manufactured by unknown companies.
The entire issue of cheaper generics is based on the premise of measurable
and enforceable assurance about quality through bioequivalence tests and
other globally mandated parameters. In the absence of that, the generics-only
diktat is a non-starter.
In the absence of an international standard drug regulatory mechanism like the
USFDA, Indian doctors have to rely on the reputation of companies like Cipla,
Sun and hundreds of others who have demonstrated their commitment to
quality over time and become trusted names in the eyes of doctors and
patients.
Also, Indian branded generic companies have been innovative in terms of drug
delivery systems to improve absorption, reduce side-effects, thereby increasing
the efficacy of the drug.
These novel drug delivery system (NDDS) drugs are available in all category
of drugs from ordinary mouth dissolving pain-killers for quick results to complex
diabetes drugs that are released into the blood in a steady stream to ensure
better blood-sugar control with lesser chances of hyperglycemia – one of the
dangerous complications of taking diabetes medicines.
The Public Health Foundation of India (PHFI) was asked to study the
Scheme and suggest remedial measures. PHFI in their report pointed
out the following factors which were mainly responsible for the
scheme not being successful:
(i) Over dependence on support from State Government.
(ii) Poor Supply Chain management.
(iii) Non-prescription of Generic Medicines by the doctors.
(iv) State Governments launching free supply of drugs.
(v) Lack of awareness among the public
The first relates to the efficacy of Indian-made drugs. Oftentimes, such drugs
have been found to contain less than the required amount of active
pharmaceutical ingredient (API), rendering them ineffective.
Closely linked to the issue of efficacy is the lack of data integrity. The poorly
managed documentation practices of Indian generic firms featured as the
primary criticism flagged by foreign regulatory authorities. The lack of reliable
and complete data on the test results of specific drug batches, along with
inconsistencies in the records presented, meant that inspection and verification
of drug quality was extremely difficult.
Another aspect relates to the hygiene standards of the manufacturing plants.
Individuals suffering from illness are especially susceptible to infections, and
inspections of generic drug plants reveal pest infestations and dilapidated
infrastructure
Way forward