The Cost of Drugs

Beyond the Supreme Court Order

While the Supreme Court decision in the recent Novartis case has cleared the way for production of generic drugs in India, doctors have to prescribe cheaper alternatives to costly brands if patients with limited means are to benefit. What is being hailed as a victory in the struggle for affordable medicines in the country will actually be one only when there is a pro-patient slant to the prescription process.

Sanjay Nagral
April 27, 2013, EPW

Mr P is an elderly, retired gentleman who suffers from a rare tumour of the stomach called a GIST tumour, which I operated upon last year. Following the surgery, he was advised to take the drug imatinib to reduce the chances of a recurrence of the tumour, a strategy that is very effective. Yes, this is the same drug that the Supreme Court gave a judgment on in the now well-known Novartis case. Imatinib, better known by its brand name Glivec, is usually used for chronic myeloid leukaemia, a form of blood cancer, but it is also very effective for GIST tumours.

Mr P came to see me last week for a follow-up visit. I asked him, “Which brand of imatinib are you taking?” “Glivec” was his prompt reply. “But isn’t it costly? Why have you not chosen the generic brand that is much cheaper?” I asked. Mr P paused, smiled wryly and said, “I was advised by a senior cancer specialist that the cheaper brands are no good. I have exhausted all my post-retirement savings, but what can I do? How can I compromise on quality?” After some discussion and goading, I managed to convince him that he should switch to the cheaper brand. I suspect he may have, but am not sure.

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