Cheap generics no panacea for India’s poorest

But medical experts say cheaper drugs are just one tiny part of India’s health deficit.

“The compulsory license system might not really work because poor people cannot even afford the discounted price,” said G. Balachandhran, former head of the National Pharmaceutical Pricing Authority (NPPA), India’s drug price watchdog regulator.

“Instead of dealing on a case-to-case basis, India needs to have a policy that will bring more and more people under medical cover ... We need to increase the health insurance penetration, so that even poor people can afford treatment,” he added.

Only 15 percent of India’s 1.2 billion population is covered by health insurance, according to business lobby group the Federation of Indian Chambers Commerce & Industry, meaning even at a lower price, Nexavar will be out of reach for many.

Still, the head of Pfizer, the world’s largest drugmaker, told Reuters on March 12 that there were around 100 million people in India with “wealth equivalent to or greater than the average European or American, who don’t pay for innovation”.

Pravin Anand, managing partner at Indian law firm Anand and Anand believes that compulsory licenses should primarily be granted in the case of pandemics, suggesting that affordability is a tricky gauge of necessity.

“Affordability is not an absolute concept; therefore something that is affordable for one individual might not be so for others,” said Anand.

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On the congested street in downtown Mumbai, scores of cancer sufferers sit, lie and sleep on the hard concrete pavement outside the Tata Memorial Hospital, clutching X-rays and medical documents and wait to be prescribed drugs they cannot afford.

“Look what has happened to my boy,” said 65-year-old Debiprasad Sharma, wiping his tears as he pointed to the large tumor on the side of his six-year-old grandson Prithvi’s neck.

“We don’t have insurance ... and we have spent more than 6,000 rupees already, double our monthly income,” said Sharma, who had travelled from northern India to the Mumbai pavement.

“Hundreds of people come here every day. Whatever money we can collect is spent on their treatment. There is no help from the government,” says H.K. Savla, managing trustee of Jeevan Jyot Cancer Relief & Care Trust.

His charity, run from a cramped office around the corner from the hospital, collects and sells used newspapers and glass bottles to pay for drugs, medical supplies and food for the cancer sufferers who arrive from across the country with little or no money for treatment.

Savla, who has been working for cancer sufferers for 27 years, says he needs 1.5-2 million rupees ($30,000-$40,000) a month to provide basic services to the people who come to him for help. His budget stretches to just $3,000 a month.