Is Bangladesh to India what India is to China?

In a twisted way, that’s a question worth asking. At least when it comes to cancer drugs.

India has, for a long time now, been one of the top suppliers of generic drugs in the world. The Indian pharma industry is possibly the largest provider of generic drugs, meeting about 40% of generic drug demand in the US. The drugs are mostly of decent quality and relatively low price, which is a win-win for any buyer out there.

But when it comes to cancer, India is failing its own population, let alone the world.

In July 2018, China agreed to reduce the import tariffs for Indian medicines, specifically cancer drugs. This came days after a hugely-popular dark comedy Chinese movie called Dying to Survive told the story of a man diagnosed with leukaemia who imports cheap cancer drugs from India to China.

While Indian cancer drugs are a cheaper alternative for the Chinese, as irony may have it, not all Indians can afford them. In fact, according to a first-of-its-kind WHO report from December 2018, the price of many oncology drugs in India are as high as in developed countries, taking Indians purchasing power into account.

So what are Indians doing about this? Turning to Bangladesh.

That’s right. The likes of S Distributors, a small-time importer and drug distributor in South Delhi, form the middle ground between Indian cancer patients and cheap cancer drug alternatives from Bangladesh. And it’s a bit hard to not draw parallels between their business and the plot of Dying to Survive.

What doesn’t help Indian patients’ case in all of this is that there is practically no price control on patented cancer drugs that promise higher chances for survival than older drugs. These drugs have been and will continue to be outside the ambit of the price control policy, even though India has amended the Drug Pricing Control Order DPCO in January 2019—the legislation used for capping prices of drugs. The direction the price control policy has taken is evidence that lowering the price of cancer drugs is not a priority.

Cancer drugs can cost as high as Rs 2,11,538 ($2979) (for two months treatment of leukaemia with Dasatinib – with a daily 70 mg tablet). The drug is patented by New York-based Bristol-Myers Squibb and is used for treating leukaemia. About 40% of the oncology drugs market in India is made of patented drugs, says a senior executive with the American pharma major Eli Lily. Patented drugs are new and carry more benefits than risks.

AUTHOR

Ruhi Kandhari

Ruhi writes on the impact of healthcare policies, trends in the healthcare sector and developments on the implementation of Electronic Health Records in India. She has an M. Sc. in Development Studies from the London School of Economics.

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