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Feature Access to Drugs

How market based pricing is failing Indian patients

BMJ 2014; 348 doi: (Published 28 January 2014) Cite this as: BMJ 2014;348:g278
  1. Dinsa Sachan, freelance journalist, New Delhi
  1. dinsasachan{at}

New regulations for drug pricing mean that the developing world’s pharmacy cannot provide for a huge number of its own citizens, writes Dinsa Sachan

Rajendra Prasad, aged 56, lies on a stretcher outside the Dr B R Ambedkar Institute Rotary Cancer Hospital at the All India Institute of Medical Sciences (AIIMS) in New Delhi. For two and a half years he has travelled to the capital each month from a village in Aligarh district for treatment of bone cancer, which has cost him more than Rs 500 000 (£4975; €5981; $8127). The disease has cost him his job, and the price of treatment is now covered by his son’s salary of Rs 20 000 a month, with help from his brothers.

A relapse last month let to an unexpected increase in Prasad’s medical bills. “They’ve put me on injections now. They cost Rs 6500 a week,” he told the BMJ. His other drugs cost him Rs 2000 a month.

He has to buy drugs from pharmacies outside the hospital because AIIMS’s subsidised drug store rarely has what he needs. Not only does Prasad wrestle with a debilitating disease, but he also feels guilty. “I can’t marry my second daughter off because the cost of drugs and treatment has ripped off all our money,” he said. Outside the hospital, patients sprawl on the floor or squat around the corner, many with similar stories.

Private pharmacies

India is known as the developing world’s pharmacy because it makes a fifth of the world’s generic drugs and provides most of the developing world with essential high quality, low cost drugs and vaccines.1 Unfortunately, though, the picture is gloomy for the country’s citizens. Some 649 million Indians do not have regular access to essential drugs, the World Health Organization estimates.2 Experts blame the public health system …

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