Kathmandu. The Committee submitted its report to Minister for Health and Population Pradeep Poudel on Tuesday. The committee formed under the coordination of economist Dr Posh Raj Pandey to suggest price adjustment of medicines had submitted its report to the government after a long study.
However, pharmaceutical entrepreneurs have objected to the report submitted by the committee to the government saying that it is not service-oriented. They have argued that the impact of the report will create a painful environment in the days to come where people cannot get safe, effective and quality medicines when they are needed.
In this context, edited excerpts from a conversation i had with Narayan Prasad Dhakal, member-secretary of the committee and director general of the Department of Drug Administration, on the topics mentioned in the report, adjustment of prices of medicines, future strategy, etc.:
The high-level committee formed by the government to solve the problem of drug price adjustment has already submitted its report, you also worked in that committee, what policies, methods and scientific basis have been included for the long-term solution, how will its practical implementation be ensured?
In order to ensure the quality and price availability of medicines, the Government of Nepal had earlier fixed the maximum retail price of some products, while the price of some medicines could not be adjusted. There was a problem of adjusting the fixed prices and adjusting the prices of medicines that were not prescribed but had MRP.
In the context of how to solve this problem and how to ensure how to provide universal medicines to the people, after the arrival of the Honorable Minister, the prices of some medicines that have increased the prices, which have to pay high prices, should be reduced.
His direction and goal was to maintain good governance in medicine. Instead of how to solve this problem, we have to look at what is the law. No body can adjust the price by taking a decision against the law except in the situation provided in the law.
There is a provision in the Drug Act to fix the price and so far we have fixed the price of 117. Theoretically, we have different theories on how to review these medicines, but the fix is that the government should adjust the price of three by sticking to the principle and the process being followed by the department, which demands the price, we should also adjust the price of other medicines that have not been prescribed according to the time.
Minister Xu has formed a high-level committee after the question of what should be done now and how to adopt the policy regarding the price has been raised after there is no clarity in the law and procedure to do this. I worked as a member-secretary.
Nepal Pharmaceutical Manufacturers Association is a member, Nepal Pharmaceutical Entrepreneurs Association, Association of Drug Importers, manufacturers and business associations working in various other health sectors, wholesale traders associations, journalists, Nepal Medical Association, various councils, Nepal Pharmaceutical Association, Nursing Association, Public Health Association, who we have come to know, we called all of them and took suggestions. That’s how we gave the report.
he said that discussions were held with the stakeholders including drug manufacturers association, businessmen, medical associations, journalists, councils while preparing the report, but their suggestions have not been included.
Their suggestions have been given space. Now if there are psychological suggestions, they are not there. We have tried to incorporate suggestions that are appropriate on a scientific basis and based on international practices/ practices. We have also put together international practices and incorporated their suggestions on what is appropriate.
They may not have had the same language and the same suggestion as they wanted, but it was done with their suggestions.
If the report was made after taking their suggestions, how did those in the committee decide to join the movement?
Maybe they didn’t come there as they said. We don’t even know how. We have not yet made the report public. Since it has already been submitted as the property of the Ministry of Health, it cannot be said what is in the report. I don’t know that the Ministry of Health has officially made it public. They may know why they said it.
Isn’t it an obligation to include ?
Answer: This is an excuse. There is an excuse to not get stuck in reality. As far as I think, they won’t do that. In yesterday’s press conference, hon’ble Mr. Ju has clearly said that I have understood the report, I also have to study it.
He has said that he is ready to make some improvements by taking suggestions from others according to the time. He didn’t even need that excuse. If they feel so, they have not stopped going to the concerned authorities and speaking. We have worked in an open and transparent manner. The President of Nepal Pharmaceutical Manufacturers Association is present as a member of any discussion we have put forward.
We haven’t hidden anything. The thinking of the Government of Nepal to work will be included in them. No one will be left out. There is one saying that imports should be banned, we cannot rise up, if the prices are to be regulated here and there, then the government should create a working environment for us, while the other side says how to ban imports, how do we eat by doing business.
We don’t understand how it affected them. They had to know from where and how they came to know why they went to the movement and what was in the report. Even after the report is made public, they have been kept in a position to give suggestions.
What are the reasons why pharmaceutical entrepreneurs should be alarmed in this way, some drugs are in a position to disappear from the market and some have high prices, in such a situation, what are the scientific criteria adopted by the department regarding price increase or decrease, what efforts are being made to develop a clear method of pricing?
Answer: The main thing to be suspected is that this price is linked to this price, the advantages or disadvantages of whatever business the traders produce, the amount of business they do when they sell it. It may be natural for him to be apprehensive where values arise.
Their advantages or disadvantages are decided by the price. Or, they may have thought that the government should fix the price. The government has to look at not only businessmen but also ordinary citizens. Ordinary citizens also had to get medicines in an accessible manner.
Even today, about 54 percent of the health expenditure including medicines is being spent from our own pockets. As a result, the poor cannot. They have to be deprived of treatment. The government had to think about those citizens as they feared that all the property would be lost even if they were treated. Therefore, it is natural for them to be concerned about prices and the government’s concern should also be focused on the people.
He said TAG_OPEN_strong_60 that the government’s focus on the price of medicines is to ensure people’s access and accessibility, in reality, the people have to pay a large part of the expenditure on medicines from their own pockets, in such a context, what is the visionary plan of the Department to make medicines easily available to the poor and underprivileged, as well as how to increase mutual understanding in long-term policy making by reducing the apprehensions, mistrust or dissatisfaction of the private sector on sensitive issues like pricing?
If we have to say how to fix the price of medicines, if you have to say that the price of medicines has to be kept so much, then what is the basis for it and what is the scientific basis for it? The basis had to be cleared. The Department of Pharmaceuticals is especially sitting to ensure quality medicines. Do the work given by the law.
It goes so far as to say that the Department of Drug Administration may fix the maximum retail price of any medicine if it deems necessary and such fixed price should be published in the Gazette with the permission of the Government of Nepal. This means that prices are a part of the Drugs Act in relation to implementation.
Sub-section 2 of Section 5 of the Drugs Act says ‘all’ work required to implement this Act, there is a word ‘all’. Understand it by lighting it up. This means that the department has a responsibility. However, we have to clear the principle of how prices fluctuate rather than how to fulfill this responsibility and make it transparent. We don’t have that in the system we have right now.
If that didn’t happen, we had to do it. There is also a situation to increase the price of some medicines as they are being removed from the market due to non-adjustment of prices. We had to have a clear procedure on how to increase the price of such medicines, that is why this issue has arisen.
When there was a need, this committee was formed. That committee has studied itself, included everyone’s views as much as possible, studied national and international practices and submitted a report with the consent of all. They also agree on the submission of the report, they have come together in the process, their points have been included as much as possible, and after the report is made public, they can still suggest if it is better to do so on anything.
Hon’ble Minister has already said that the government is open. It’s not a committee’s job. They should move towards increasing understanding and contributing to the formulation of appropriate policies. There is no need to provoke it, it does not have to be done.
प्रतिक्रिया दिनुहोस्