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R. Desikan

The latest issue of Consumer Research had some interesting information on the cost of pharmaceutical research by Dr. Henry Miller of the Hoover Institution, Stanford, CA. He writes: `Bringing in a single new drug to the market in the United States now co sts a manufacturer on average more than 500 million, by far the highest price tag in the world.' A Duke University study reveals a sobering corollary -- fewer than three out of every 10 drug products generate revenues covering their development costs. Tu fts University researchers discovered that the time taken from synthesis of a new drug to marketing approval increased from an average of 14.1 years to 15.2 years, between 1980 and 1989. These trends should cause alarm. Fewer drugs will be developed and those that do emerge from the pipeline will have inflated prices. And there is no FDA reform either on the horizon.

When I was in the UK recently, the newspapers carried a press statement by one of the ministers who complained that the national health scheme has gone up so much that patients may have to be sent to India for serious surgeries such as heart bypass, valve replacement, and other expensive surgeries. Of course, many of our hospitals (especially in Chennai and Mumbai) are world-class as regards advanced surgical procedures.

Does this mean that India can well become the Mecca for high-cost surgical treatment? I have two suggestions.

1. Indian medical institutions, universities and research institutes must enter into collaborative arrangements for undertaking medical research, both lab as well as field tests. This offers tremendous scope for the pharma indust ry. With current exchange rates being what they are, our research costs will be a fraction of what prevails abroad.

2. We need to ensure that international standards of research and field testing are available in this country. This is not to say that we did not have such facilities earlier. I can say that at least for one disease, leprosy, as it is commonly kn own, the field trials conducted in India were most useful for the rest of the world. This was feasible perhaps, because we had dedicated medical and research professionals (both Indian and Western).

It is possible that in many other fields, India can help. In fact, such arrangements will also help India achieve world standards in medical and pharmaceutical research. But it is important that such research be conducted under the aus pices of universities in India in close collaboration with the Central Drug Institute, Indian Council of Medical Research, etc.

Sometime ago, a young researcher said, based on his own experiences, that many research organisations in India do not come up with any original research. While this is not totally true, it is not all that misleading either.

If we were to take advantage of such opportunities immediately, it could lead to scientific confirmation of many traditional Indian medicines. We can also put a stop to Indian medicinal herbs being patented in the West and it will give a tremendous boost to indigenous systems of medicine.

But all of the above requires a team of planners who have a proven record of performance against heavy odds and unpalatable criticism.

One of the best institutions created by the Tamil Nadu Government is the Tamil Nadu Medical Supplies Corporation, which had functioned very effectively. They were able to buy quality medicines at very reasonable prices, allowing a decent m argin of profit. The organisation was supplying quality medicines to all hospitals in the State run by the Government.

India can well become a Mecca for medical care and basic medical research, including field research. Will all concerned act to achieve this? This also ensures quality medicines for Indian patients at reasonable prices.

The author is former chairman, Federation of Consumer Organisations, Tamil Nadu. He can be contacted at rdesikan@vsnl.net.in

Pic.: Can Indian hospitals become a destination for high-cost medical care?