The Drug Regulatory Authority of Pakistan (DRAP) has recently increased the prices of medicines in different categories. This news gives an impression that the DRAP has a sound knowledge of the pricing mechanism and also controls and watches each and every activity of this industry. Similarly, in recent years, there is a quick surge in the number of private Pathological Laboratories and Doctors’ Clinics. This again gives an idea that every person has complete access to the health-care facilities and everyone is getting the optimum benefits from them.
Before drilling further, let’s have a birds-eye view of the existing medicine and health sector and how different players are doing their jobs. In Pakistani market, medicine can be divided into two main categories: 1) Mainstream Medicine or Allopathic Medicine and 2) Alternate Medicine which further divided into Homeopathic Medicine and Herbal or Natural Medicine. According to the DRAP, there are around 611 Pharmaceutical Manufacturers which are manufacturing mainstream medicines. The data for alternate medicine manufacturers have not been compiled yet but has been estimated to be far greater in numbers than its counterpart. Furthermore, according to the sources, there are around 1400 formulations of both innovative and generic allopathic medicines including both locally manufactured and imported medicines. There are total 380 life-saving drugs out of 1400 that fulfills around 80 percent of local market demand and the remaining life-saving drugs have been imported from different countries. These above-mentioned data does not include alternate medicines as DRAP is still working ways to organize this sector.
Since marketing is a very specialized and delicate field, there are many pharmaceutical manufacturers which are restricted to only manufacturing medicine and here come the marketing firms which are specialized in marketing and selling these medicines to the patients. There are at the moment uncountable big and small marketing firms in every part of Pakistan which are working with Doctors to sell their medicinal products. They are using different marketing tools to market and sell their products. Here comes the ailing side of this industry. These marketing tools are actually bribing the respective Doctors to prescribe their products. According to the very conservative estimation, reputed Doctors charge around fifty percent of the retail price of these medicines from the marketing firms. Since there is a stiff competition among the marketing firms over limited reputed doctors and same generic medicines everyone is selling, these marketing firms are filling the stomach of the greedy doctors and set high sale targets for them. These doctors in return are actually prescribing irrelevant and over-priced medicines to the patients to achieve their sale targets.
The dark side of the industry does not end here. These doctors further charge high consultancy amount in their respective private clinics from the patients. Many doctors even recommend their patients in Government hospitals during their regular jobs to visit their private clinic for personal attention and better prescriptions to cure the ailments of the patients. These doctors make sure that every patient must have a high number of clinic visits before the disease is cured. For this purpose, they prescribe irrelevant medicines. These irrelevant medicines are most multi-vitamins, food & dietary supplements. Similarly, doctors also have a very healthy relationship with the pathological laboratories. In order to make this relation profitable, they ask their patients to have a pathological examination from the designated laboratories. These doctors also charge commission from the designated medical stores for recommending their patients to purchase medicines from them.
The best and interesting part of this story is that these doctors have started kicking on the stomachs of the conventional Hakim (Alternate Medicine Practitioners). Our very own doctors who were initially specialized in the field of allopathic medicines have now excelled in alternative medicines. These days they are prescribing alternate medicines to their patients with little or no benefits. It is proven from many researches in the USA that these medicines now called as Nutraceutical Medicines show little or no effect on ailments of the patient. It is mandatory for USA medicinal companies to write on the outer box of these nutraceutical medicines that the food supplements and/or nutraceutical products are not intended to diagnose, treat, cure, or prevent any disease. It is due to the fact that these medicines have a very slow effect on the patients. Under the drug act of 2012 by DRAP, many medicinal companies have started manufacturing these nutraceutical medicines and it is because of this core reason many doctors have started prescribing these medicines to their patients with high monetary returns.
Health industry once considered the industry of educated and law-abiding people have now shattered its impression altogether. In the recent years, DRAP with the help of Health Department has started hunting of the illegal and unauthorized medicinal companies and to the astonishment, most of the pathological laboratories are either unauthorized or do not have trained and certified staffs. Similarly, almost every medical store does not have the license from the relevant authorities. Many distributors don’t even have a valid license and/ or clean hygiene and reasonable temperature in the premises which is required for storing the medicines. Furthermore, it is also observed that our educated and professional doctors do not pay their taxes of running their private clinics as businesses.
It is, therefore, requested to the relevant authorities (in respect of the suo motu action taken by the Supreme Court on Government Hospital) to take a keen and serious action against the main culprits of the above-mentioned system. The Government health care system cannot be spread to reach every citizen of the country; therefore, the private health care system must be organized and developed on strong foundation so that every citizen gets timely, inexpensive and relevant treatment in every corner of the country.