NPPA AUTONOMY DILUTED – SICKENING!

Mrs.Patel, every time she flies back to USA, carries a year-long supply of Saridon, Crocin and multi-vitaminates. Ditto for scores of Indians who live abroad; along with papad and aachar, they also carry supplies of medicines for regular cough-cold-fever ailments.

Indians living abroad, often rue about one thing – the high cost of medicines vis-à-vis the low costs in India. They all envy that we in India have something like a National Pharmaceutical Pricing Authority’s (NPPA), which regulates and controls price of essential or life-saving drugs. But for the NPPA, India would have been a free-for-all kind of country where getting basic medicines too would have been a killer. And even in India, like USA, getting cheap medical aid would have been a huge election issue.

All this might undergo a change soon. This week, on Monday, the Govt made moves to take away the autonomy of one NPPA too.  It has formed a committee - Standing Committee on Affordable Medicines and Health Products (SCAMHP). Now this new body, housed under NITI Aayog will recommend to NPPA, regarding prices of drugs and health products. One more autonomous body whose power is to soon be diluted.

How this works currently - National List of Essential Medicines (NLEM), drawn by the Health Ministry and the Department of Pharmaceuticals (DoP), prepares the list of drugs eligible for price regulation. This is based on a list of essential medicines released by the World Health Organisation, which says what medicines should be affordable and available to the people of each country. This is then forwarded to the NPPA, which then fixes the prices. Currently, prices of at least 870 drugs have been fixed according to NLEM.

This need for the Govt to wrest control from the NPPA has come after former NPPA Chairman, Bhupendra Singh created a furor by bringing down prices of stents by 85% at Rs.7260. Before this, the pharma companies made merry by charging Rs.45,000 for bare metal stents and drug-eluting stents for Rs1.21 lakh.

NPPA also decided against multinational stent makers’ request for a new category for advanced stents. The latest order will remain valid till 31 March 2019.

Post this, there has been tremendous lobbying for pharma companies to get their drugs out of the NPPA purview though they were making profit margins over 250-450%.  Call it pressure from these pharma companies or the need to have control over every autonomous body in the country, the power of NPPA is seriously under threat.

Apart from losing the power to price the drugs, the new order also brings to a naught the existing process under which, drugs that have been declared as “essential” will automatically come under price control. Henceforth, it is the NITI Aayog committee will decide which drugs should be under price control; it short, it will decide what drugs are ‘essential’.

Thus the new committee will clip virtually every wing of the NPPA – it seeks to delink essential drugs from price control, NPPA will not have the sole authority to decide on the price – the NITI Aayog committee will.

More importantly, NPPA under Para 19 of Drug Price Control Order (DPCO) had the liberty to regulate prices of those drugs which were crucial but not in the list, known as ‘non-scheduled’ drugs. These are the same powers NPPA used in 2017 to cap prices of cardiac drugs, stents and knee implants. The NITI Aayog committee now wants to encompass those powers too.

Obviously, those in the industry say that this is a good move but for most people like you and me, this does not bode well. There is no doubt that this will weaken the power of NPPA as an enforcement body. It was well respected and hailed as the institution which had the ability to enforce price controls and curtailed rampant overcharging.

Taking away the autonomy of every single body; we are becoming a sick nation!!