Major pharmacists and chemists’ organisations praise the efforts made by the Ministry of Health & Family Welfare (MOHFW) to make medicines cheaper for the people, but argue that the model of AMRIT pharmacies needs key changes in terms of what medicines and implants they are selling at discounted prices, where these pharmacies are being set up and whether mandating generic medicines is in the best interest of patients.
The chemists’ organisations argue that only those medicines that are expensive should be made cheaper instead of generic medicines that are already available in the market at affordable prices. Explaining the reason for discontent among pharmacists, Abhay Kumar, president, Indian Pharmacist Association, told The Sunday Guardian, “We admire the intention of the government to make medicines cheaper. But not all medicines are required to be made cheaper than they already are. There are no such discounts for clothes or any other generic product that are used by the masses. Then why should generic medicines be brought under the knife alone?” The Sunday Guardian had earlier reported on AMRIT (Affordable Medicines and Reliable Implants for Treatment) pharmacies, highlighting how the initiative is benefiting people, but pointing out that the business model of AMRIT pharmacies might have a “negative effect” on the pharmaceutical industry in the long run (Chemists resist PM Modi’s low-cost AMRIT pharmacies, 21 May).
According to HLL Lifecare Limited, the agency under which such pharmacies operate, these pharmacies are able to offer drugs at lower prices in two ways—first, through procurement efficiency, wherein all products are aggregated and purchased in bulk, helping in gaining lower procurement costs. Secondly, AMRIT pharmacies work on a small mark-up on the procurement cost. The channel margins such as retailer margin of 20% and distributor margin of 10% are passed on to consumers as discounts, except on DPCO (drug price control orders) products.
J.S. Shinde, president of Mumbai-based All India Organisation of Chemists and Druggists (AIOCD), said: “There is nothing wrong with the government’s intent to make medicines cheaper. However, the government cannot tell doctors to prioritise generic medicines in their prescriptions. This is in violation of Section 65 11(2) of the Drugs and Cosmetics Rules, 1945.”
Shinde’s reference is the government proposal to mandate doctors to prescribe generic drugs to check the doctor-drug companies’ nexus that makes medicines expensive.
Shinde added, “The government is procuring generic medicines in bulk and trying to mandate doctors to prescribe it, though that is against the law. The discounts on the drugs are being given at the cost of the middlemen and retailers’ margin. This is why we feel that this model will not be able to hold on for long.”
Kumar said, “AMRIT pharmacies are needed, but not everywhere. They should be opened outside big private hospitals where private pharmacies run in collaboration with the hospital. Opening AMRIT pharmacies outside government hospitals would be useful too.”