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“Come into my parlour..” India’s strange #medtech pricing decisions

18 Oct

webCorrect me if I am wrong but I do believe that the Union Ministry of Health and Family Welfare just acknowledged that when prices of a product are fixed, manufacturers are discouraged from entering the market. And that competition brings down prices. Yes, you read that right, competition, and not price control. Continue reading

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Guest column : The UN High-Level Panel on #accesstomedicines is a wolf in sheep’s clothing

3 Oct

Dr Kristina LybeckerIn 2015, the United Nations Secretary-General Ban Ki-moon convened a High-Level Panel on Access to Medicines. Its charge was to recommend solutions to the fallaciously described “policy incoherence between the justifiable rights of inventors, international human rights law, trade rules and public health in the context of health technologies.” Unfortunately, their starting point was misguided, and – not surprisingly – the resulting report is dangerous nonsense.  Continue reading

Why do chemists hate e-pharmacies so much?

23 Jun

Last June, I wrote about the burgeoning online pharmacy business on this blog.

Taking off on a column that I had authored for the Indian Express, I pointed out that while India’s regulation of brick-and-mortar pharmacies (or chemist shops) has been slack, online pharmacies would be held to higher standards. That in the absence of a clear-cut legal pathway for online pharmacies to follow, friction with regulators could not be ruled out. And that these uncertainties would adversely impact e-pharmacies’ ability to raise funds from investors.

At a recent event organised by the Indian Internet Pharmacy Association (IIPA), it became clear that all this and more had come to fruition.

What intrigued me is that the e-pharmacy’s enemy number one appears to be India’s foremost chemist association AIOCD. IIPA members allege that they have had to endure regulatory harassment triggered by complaints from AIOCD members. These complaints have led to police investigations, regulatory raids, and the cancellation of licences of chemist shops supplying Internet pharmacies culminating in the IIPA openly accusing AIOCD members of instigating the administration to launch unnecessary probes against them. And of pressuring those chemists who do supply e-pharmacies to back off. Continue reading

#Clinicaltrials : Are India’s Ethics Committees weak links in the chain?

7 Jun

Clinical trials, that hot-button subject hogging headlines up until a year ago, appears to have quietly slipped into the realm of business-as-usual. However, there are still some knotty issues to be resolved. Chief among them is the oversight of Ethics Committees (ECs) as was evident at a recent event I attended.

ECs – which are a mix of experts and lay persons – are the gatekeepers of ethics within their institutions. Just as a strong EC can blow the whistle on unethical behaviour, a weak or careless one might inadvertently abet it. Continue reading

Guest column : How to leverage a global policy revival in traditional medicine

19 May

Ashwin NaikOn Friday, May 13, India committed close to a million dollars to help create a benchmark document for training and practice of Ayurveda, Yoga, Unani, Siddha and Homeopathic medicine. It is indeed a significant commitment and the reinforcement of ongoing efforts by the World Health Organisation (WHO) to promote traditional health systems strengthening around the world.

What started with the Delhi declaration in 2012-13, with a consortium of South-East Asian countries is now slowly growing into an international collaboration. The Indian government used a country-by-country approach to sign bilateral agreements, starting with information centres in Mexico, Nepal, Malaysia, Russia among others. Continue reading

Hospital infection big problem in India: NABH #indiahealth #nosocomialinfections

26 Oct

Last week, the Indian Express published my column on the urgent need for hospitals – big and small – to follow infection control norms. Click here to read.

While researching the column, I spoke to officials at the National Board for Accreditation of Hospitals and Healthcare Providers (NABH) to understand how the issue might be addressed. While hospital-acquired/associated infections (HAIs) have been a concern for some years now, the spectre of drug resistance makes addressing their occurrence that much more of an imperative. For that, hospitals need to take infection control seriously.

NABH, as its name suggests, sets up and operates accreditation programmes around quality-of-care at Indian hospitals. One of the things that piqued my interest was Safe-I, a handholding programme for hospitals, that is focused on infection control. Since 2012, NABH runs this in partnership with the healthcare company Becton Dickinson. Safe-I hopes to eventually become a robust source of HAI data through a network of participating hospitals. Excerpts from an e-mail interaction with NABH CEO Dr K K Kalra. Continue reading

Tinderbox : How a meningitis vaccine tender singed GSK, Sanofi in India #UHC

23 Jun

The Competition Commission of India (CCI) recently slapped a Rs 63.5 crore fine collectively on GlaxoSmithKline Pharmaceuticals (GSK) and Sanofi Pasteur for attempting to collude to share a Union Ministry of Health tender for a meningitis vaccine and inflate prices. Indian health authorities have been immunising Indians performing Hajj, or the annual pilgrimage to Mecca, against meningitis since 2002. The case, which dates back to 2011, appears to be a great lesson in how not to tender.

What should’ve been a straightforward process for a single product with the same three suppliers year after year, took on the appearance of a farce with the tender being floated thrice over, more than one lawsuit, a disgruntled local producer and two vilified multinationals protesting their innocence. And to top it all, the guilt or lack of it of the Union Ministry of Health appears still open to question. Continue reading

Guest column : Doctor ‘scarcity’ a crisis of numbers or leadership? #UHC

27 Apr

Dr Raman KumarA recent article in the Indian Express reported statistics from India’s National Health Mission to highlight what it called “a debilitating shortage” of health specialists in the country. In doing so, it only reaffirmed what several experts, committees, and policy wonks have said all along: India needs more doctors.

For the longest time, India’s healthcare problem has been defined as one of numbers. Doctor demand outstrips supply, we are told. The accent has been on creating supply (predominantly in the private sector) to address this perceived shortage. I use the word “perceived” because the problem does not lie in numbers alone. What India faces is a full-blown leadership crisis caused by the systematic undermining of primary care physicians and the disproportionate clout wielded by super specialists in medical regulation against the backdrop of a lacklustre public health system. Continue reading

Unassuming billionaire : I profile Dilip Shanghvi for Outlook magazine

16 Mar

Dilip ShanghviThe media, it appears, cannot have enough of Dilip Shanghvi, the 60-year old founder and controlling stakeholder of Sun Pharmaceutical Industries. That’s not surprising if you consider that on March 4 he overtook Mukesh Ambani, the second-generation oil-to-telecoms tycoon and arguably India’s most influential businessman, to become the richest Indian.

Of course, just because Shanghvi went from number two to number one among wealthy Indians that day does not suddenly make him a new-improved version of himself nor does it throw up hitherto unknown facets of his personality (unless you go dig really deep and if you want to do that why wait for him to grow a shade wealthier, right?)

What it does, however, is generate curiosity. So when Outlook magazine reached out, my job was cut out for me. Here’s the link.  Alternatively, you can click here and here for the PDF documents of the story as it appeared in the magazine, since the web edition seems to be missing some stuff.

The headline is not mine – as far as I am concerned, this ‘Sun’ arrived a while ago.

As an aside, this is the second time I’ve been warned by a commissioning editor to keep it simple. Do not badger the unsuspecting reader with big drug names, I was told categorically. (Seriously, I must be a pretentious bore). So I haven’t. That does not mean Shanghvi’s Sun Pharma does not make them. Try saying levetiracetam five times over without tripping over your tongue. Why? Because that barely pronounceable drug is one the reasons he upstaged Ambani.

Pic source : Sun Pharma

This post was altered to include more links to the article

Thermometers, BP monitors and other vital stuff that India DOES NOT regulate #MedTech #safety

16 Feb

Dr Ravindra GhooiThe Indian medical devices sector has lately been in the news for the government’s decision to liberate foreign direct investment controls on it. There is also some movement on the regulatory front with a decision to set up government-recognised medical device testing laboratories in the country. Apothecurry’s guest columnist Dr Ravindra Ghooi revisits the one issue that needs immediate attention but for some reason continues unaddressed. The sector’s appallingly unregulated state. Read on.

Whether it is pacemakers, bone implants or cardiac stents, patient lives hinge on the safety and effective functioning of devices. It is assumed that like other governments, India has strict laws concerning the manufacture, quality and testing of these. It may therefore come as a shock to those unfamiliar with the Indian regulatory landscape that the government seemingly does not consider many of these devices important enough to regulate. Continue reading

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