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This is the season of tenders. Tendering is a process through which government and private institutions purchase items of their requirement. There is plenty to talk about this process, but we shall not talk about these tenders.
Tender is also soft touch, behavior, talk which is used when handling with care is desired; Tender Loving Care – TLC is in common use. We are not going to discuss that either.
Tender in medical terms is any spot which hurts upon touching. When we get a sprain for example, we have a tender ankle which becomes more painful when touched. We shall talk about tender spots of Pharma Industry. These are the areas where the industry is vulnerable to damage, and is already hurting.
As a preamble, we would say the following.
- Pakistan Pharma industry is worth about 600 billion rupees
- There are over 700 manufacturers
- Market keeps growing every year as the population increases and the access to healthcare improves
- Over 95% or about 570 billion rupees business is limited to 100 companies. Rest of the over 600 companies fight for a peony 30 billion business
- Pharma Industry is centrally regulated at every step and at all times by Drug Regulatory Authority Pakistan – DRAP. Provincial regulatory mechanisms are also in place.
- Drug prices are controlled by DRAP and Federal government
There are several tender spots where Pharma Industry hurts, and has been hurting for years, with no remedy in sight.
Price Politicization – Though Pharma Industry is a small industry, but it gets politicized quickly and repeatedly, mostly for no fault of its own. Some life saving drugs are in perpetual short supply because of unviable prices, which are lower than the cost of drugs and also very small in cost to patients. The prices are not revised appropriately so that abundant supply would be ensured. However, the matter remains a favorite rhetoric topic in all circles and is a worthy matter for politicization.
Drug Prices in general are also always subject to political debate. The summary keeps going back and forth but is neither rejected nor approved; inaction is considered the best action. The summary for increase in prices of Petrol/Diesel etc. is submitted every fortnight and is approved 99% of times. Electricity charges increase summary is also approved without political issues. We have come to a level where utilities in an average household cost upward of 30,000 rupees a month (30% or more of household income). But this increase does not get politically noticed. Every month prices of consumer items go up by 5-10% or more, but there is no reaction. Every now and then Sunday Bazaars are announced where poorest quality goods are sold at 10-20% less than market prices, which is actually premium price for those items.
The usual argument is that medicines are lifesaving and must be controlled. This argument is untenable. Food is certainly more life saving on everyday basis.
Quality Politicization – After the unfortunate incidence of PIA plane crashing on the Malir residential area, the concerned minister effectively killed the airline by publicly announcing pilots’ fake degrees. As a result, the airline flights got restricted and most destinations were closed. Even if it was a fact, it should have been subject of internal investigation, not public announcement. In similar fashion, every now and then, there are public shows that Pakistan market is rife with fake medicines. Firstly, it is not a reality; secondly, suspected cases should be investigated and prosecuted; thirdly, the huge regulatory structure should be able to preempt production of fake medicines; fourthly, it should not be subjected to media exhibition as it serves nothing. We have heard and seen some allegedly big hauls of fake medicines being produced in some factory, but we have never found out what happened finally. The prosecution rate is dismal, and penalties are rare. This means that either the cases shown were fake and politically motivated, or the prosecution mechanism is completely inefficient.
The primary issue is that such political stunts are constantly hurting the image of Pharma Industry of Pakistan. Having dealt with exports and international marketing for several years, I can say firsthand that the quality of Pakistani Pharma products is generally considered good and better than Indian companies. Unfortunately, we are showing a reverse image of our industry and are insisting on cutting the branch on which we are sitting.
It is not so that politicization of Pharma industry accrues more benefits to the accusers; It is because the Pharma Industry is weak and does not defend itself effectively. Why does no one talk about quality of textile, or surgical goods, or sports goods, or consumer goods. Those industries are big in size at home and also among few earners of foreign exchange. Try taking them on, and you will have to run for your life.
To be continued……