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Continued from Previous……
In the previous part, we looked at some arguments in favor of brands. Logically, we should see the arguments against brands now.
Here are some reasons why brands should be discouraged.
Brands carry power in all segments, not just pharmaceuticals. Among consumer products and in fashion line, brands hold ultimate power. The customers are actually hostage to the brand. Buy shoes, clothing, accessories of any big brand, and the name of the brand shall be printed all over the article. The customer who wears or carries their articles is a live, walking advertisement of that brand. Pharma is not so bad but certain image has been carried around large brands. Previously, the MNCs claimed their brands to be special, being innovator brands. Now this status is enjoyed by certain branded generics also. The brand owners have done well for themselves by creating a perception of quality and reliability around their brands. Through mass prescriptions over time, these brands have also become ‘brands’ in the mind of patients. Dicloran, Novidat, Risek are some examples where branded-generic drugs have taken over even the innovator brands.
Brand Power also means charging premium price. Although prices are fixed by DRAP, but it has been highly inconsistent and somewhat partial in its pricing policy. The result is that: one, the ‘brands’ are prescribed more, and two, the patients pay more as these are somewhat pricier.
Owing to the perception mentioned above, the physicians have stuck to prescribing the brands. The brand loyalty is reinforced in two ways. One, the brand-owner company keeps doing activities to maintain brand loyalty; and two, the physicians involuntarily believe they are doing the right thing to prescribe brand. If an odd patient asks for a cheaper alternative, either it is refused, or done with a comment about taking it at their own risk.
Brand loyalty works well for the brand-owners but goes against the interest of patients and free market norms. The patients end up paying more and even getting some unnecessary prescriptions.
Brand Building Activities
Brands are built neither easily nor quickly. They take time, effort and investment. In the Pharma landscape, investment on brand building is an accepted norm. There are multiple forms of investment, but it is always there. True, that pharmaceutical prices are regulated by DRAP and the manufacturers are not allowed to increase the prices on their own. Having said that, the Pharma companies are under pressure to get price increase because they need money to spend more heavily on brand building activities. When persistent pleas did not yield desired results, most companies increased the prices arbitrarily and went to court to get stay against DRAP. The court obliged, and the price increased prevailed for almost couple of years. Finally, there was a compromise and price increase was granted in most cases. A price policy was also floated. As a result, the market saw sudden price increase in many products. Some increases were exorbitant but were correct as per policy.
The patient ultimately ends up paying more.
Pakistan is a signatory to WTO and patient protection is obligatory. The ground situation is variable, however. Some Pharma products have become available despite still being in patent, while some other have been refused registration.
Brands in niche markets such as cancer, have products costing hundreds of thousands of rupees. The brands refuse to reduce the price, but they offer some packages where patient pays full price for one pack and gets one, two or three subsequent packs free of cost. In this way, they hold the physicians and the market at the expense of patients.
The registration of generic versions of innovator products has been made complex and cumbersome. This is an indirect barrier to providing relief to patients. The government does not seem to surmount this issue so far. Meanwhile, the patients are paying and suffering.
Brands, whether innovator or generic, do exercise hegemony wherever they can, and this is the downside.
The summary is that the patients are paying more in several cases due to brands.
To be Continued……
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