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Editorial

Regulating Healthcare

August has been a busy month as far as regulation goes.

After coronary stents, the National Pharmaceutical Pricing Authority has issued an order that there will be price control on knee implants in the range of Rs. 54,720 – Rs.113,950, exclusive of GST in an immediate intervention to check unethical profiteering and exploitative pricing at the cost of the patients in an unregulated market. This will very likely result in some brands withdrawing their products from the market, and the discerning Indian, including patients from overseas looking for alternatives. The point here is how is this an advance in healthcare? What about the principles of market mechanism, and prices being decided by the forces of demand and supply? Does the answer not lie in opening the market to more competition, ensuring monopolies do not exist and letting competition take care of prices?

The draft of the pharmaceutical policy, recently released by the government, which aims to revamp the sector’s practices and ensure drug security for India may end up favoring large pharmaceutical companies, which adhere to relatively high standards of manufacturing and marketing practices, and being negative for smaller firms. It will also likely increase barriers to entry and strengthen the position of existing established companies, thereby killing competition. The proposal to discontinue loan licensing or third-party manufacturing would also be negative as almost 40–50 percent of local drugs are sourced through loan licensing or contract manufacturing from small-scale units.

The industry welcomes the government’s directive that it is mandatory to display MRPs on all imported and indigenous medical devices ultimately meant to be billed to consumers. The directives will help curb marketing malpractices, over-invoicing and plug the loophole that had been used in the past to evade taxes, hype up the MRP while eroding the competitiveness of domestically manufactured medical devices.

The guidelines under National Health Mission for provision of healthcare services under public private partnership mode have been circulated to the states/UTs. This will help strengthen their respective health systems.

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