E-DRUG: Sri Lanka Regulatory Authority assures price control (8)
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I am a 4th year Medical Student from the Faculty of Medicine, University of
Colombo, Sri Lanka and I would like add some comments to this thread, in a
medical student's point of view. This is my personal opinion with regard to the thread.
As Prof. Krisantha has highlighted perfectly, NMRA has done a great job on
this matter. As a Sri Lankan, I am proud about NMRA's brave action against
the violation of the agreement by the pharmaceutical companies. Once
agreed, the pharmaceutical companies cannot increase the prices as they
wish.
Perhaps you all may have heard (SHOULD HAVE heard) of the name Prof. Senaka
Bibile, a great Sri Lankan, a great doctor, a great pharmacologist, a great
leader and a great futurist. What Prof. Krisantha has described as "State
Pharmaceutical Corporation" or SPC, it was Prof. Senaka Bibile who
implemented it back in 1971! Later it developed into SPMC (State
Pharmaceutical Manufacturing Corporation) and influenced to establish NMRA
(National Medicines Regulatory Authority) in Sri Lanka in the recent past.
We as medical students, usually check the prices of the drugs that are
mentioned in the lectures/wards to get an idea of the cost. What we always
find is SPC price is lower than everything else, with optimum quality
assured! SPC, as the state buying agency of the pharmaceutical products,
does a tremendous job in that case.
As future doctors to-be, what we are taught is to become competent,
compassionate and caring doctors. And I personally, believe that from all
my heart. We are supposed to be treating the patients; not treating the
diseases per se! Therefore price cost becomes an important determinant to
such a doctor when prescribing medicines.
Sri Lankan state sector health service is FREE. However, private sector also plays a role in providing health care in Sri lanka. Therefore, affordable, reasonable maximum retail price should be for each and every drug. What is meant by "affordable" means that it should be affordable for the poorest of the community. Otherwise there is no point.
As medical students, we are trained to use generic names. We are trained
not to promote trade names. Sri Lankan MBBS degree programme never promotes
trade names (which are expensive).
Also to minimize the medication/prescription errors, as a tradition, we write the drug names in block capitals, so that the dispenser finds it easier to issue the correct drug.
However, Pharmaceutical industry finds their way to the doctors via "drug
representatives", by providing them luxurious offers for promoting their
product/trade name. For example, Sitagliptin is one of the newer anti
diabetic medications used in Sri Lanka, but if you go to seven doctors
looking for the drug, they will prescribe 7 different brands of the same
medication. Some of the brands are very expensive but most patients who
believe that "higher the cost, better the quality", easily fall for the
trap. So technically speaking, both doctors and patients should be rescued
from the inhumane, profit based activities of the pharmaceutical companies.
As far as I know, pharmaceutical industry is only second to few major
industries in the world, one of them being Armament Industry. There are 7.5
billion people in this world, but not all of them go to war! But they all
get sick at some point! In other words, Pharmaceutical Companies are one of
the "profit lords" in the business world.
In my personal point of view, how Pharmaceutical industry differs from
other industries is that, Pharmaceutical industry deals with patients.
Patient is a person who is ill and helpless. Therefore, this
industry/business directly hangs in the balance between "humanity" and
"profit". That is how the real problem arises.
As mentioned before, Prof. Senaka Bibile led a fight against this "Big
Pharma", literally with a 'one man army'. He faced an untimely death back
in 1977, 29th of September, due to a cardiac arrest as mentioned in the
Death Certificate. My point is, good people have died for the concept of "quality assured, low & affordable priced medicines, so that humanity will outweigh the profit".
I have seen and read how some countries have been trapped entirely by the
ghost of pharmaceutical companies. Dear all, please read the last few
months of Prof. Senaka Bibile's life, when he travelled through the
Caribbean Islands to form Drug Policies in those countries and saw how
Pharmaceutical Companies technically "ruled" those countries back in 1977!
Prof. Pascal has mentioned that if one company is banned in a country, it
eventually provides an opportunity to another company to invade the gap. It is true. However, if they also increase price unreasonably, NMRA will cancel
their registration as well. They will have to cancel all the companies if
they all violate the ceiling price of particular drugs. (I believe that
will not happen, because they all come crawling back again to restore their
"market place"). However, if it comes to that ultimately, I strongly
believe that 100% drug manufacturing in Sri Lanka, should be done by SPMC.
It may not be practical for a developing country like Sri Lanka. But no
country, should lose their dignity or humanity, over the Big Pharma.
Reference
The political economy of controlling transnationals: The pharmaceutical
industry in Sri Lanka (1972-1976). Sanjaya Lall, Institute of Economics
and Statistics, Oxford University, UK, Senaka Bibile, University of Sri
Lanka, Peradeniya, Sri Lanka https://doi.org/10.1016/0305-750X(77)90085-7
Chamath Lavinda,
Medical Student
Sri Lanka
Chamath Lavinda <chamathlavinda@gmail.com