The Survey says India must reduce dependence on patented drugs and move towards a generics-driven market.
Prime Minister Narendra Modi had said the government was working towards creating a generics market, from a branded one, to make medicines affordable to all.
The Survey states, “Patent drugs and medicine providers in India have large players, enjoy a monopoly position and so make excess profits at the cost of the consumer. This position needs to be countered in several ways. First, the government and public purchases need to mandatorily shift to generic drugs, to reduce demand for patented drugs and cost to the government.”
This push, if it works out, will dent the pharmaceutical industry. The Indian drug market is a little over Rs 1 lakh crore annually, worth Rs 90,000 crore.
The Survey also states that India has the largest out-of-pocket (OoP) expenditure on health in the five-country BRICS grouping, consistently higher at more than 60 per cent since 2008. “In Brazil, the percentage of OoP expenditure is less than 32 per cent; in South Africa, less than 10 per cent.”
This, it stresses, leads to the impoverishment of poorer sections and widens inequalities. The poor are hit both ways — adverse health impacts their productivity and ability to earn, while paying to get themselves treated adds to financial distress and impoverishes them.
It suggests India has to increase effort to reduce mortality for the under-five years groups and neo-natal mortality.
Before the age of five years, rural males report the highest percentage of ailments at 11.9 per cent. There is a gradual increase in morbidity from the age group of 45 years onwards.
The highest percentage of ailments is reported by urban females in the age group of 60 to 69 years.
Only 29 per cent of rural females aged above 70 years reported ailments, in comparison to 38 per cent of urban males and 37 per cent of urban females.
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