Move to allow NITI Aayog to steer drug-price control raises hackles

In what seems like diluting the National Pharmaceutical Pricing Authority’s (NPPA) powers, the government has now authorised think-tank NITI Aayog to recommend drugs that could be put under price control.

Earlier, the National List of Essential Medicines (NLEM), drawn by the Health Ministry and the Department of Pharmaceuticals (DoP), would merely notify the list, for prices to be fixed. That has changed now. A Standing Committee on Affordable Medicines and Health Products (SCAMHP), another body, has been constituted with VK Paul, Member (Health), NITI Aayog, as the Chairman, to act like a recommending body to NPPA regarding prices of drugs and health products.

The move has attracted ire from all quarters. “No one had the power to fiddle with the list of essential drugs that were to be under price control. Now everyone can potentially fiddle with the list,” said a senior government official.

NLEM, formulated by the Health Ministry, is based on a list of essential medicines released by the World Health Organisation which says what medicines should be affordable and available to the people of each country. “By making a standing committee to scrutinise NLEM, the DoP has diluted the mandate of affordability,” the official further said.

Currently, prices of at least 870 drugs have been fixed according to NLEM 2015 by former NPPA Chairman, Bhupendra Singh, who was abruptly transferred last year, after relentless action by the regulator on overpricing of drugs by private hospitals.

Apart from regulating NLEM, NPPA under Para 19 of Drug Price Control Order (DPCO) had the liberty to regulate prices of those drugs which were crucial but not in the list. “All drugs will now undergo the scrutiny of the committee housed in NITI Aayog, of which NPPA is not a member,” the official said.

A representative of NPPA is not a part of the committee, which is composed of Member (Health) NITI Aayog, Chief Economic Advisor – Ministry of Finance, Secretary – Department of Health Research, Vice-Chairperson – NLEM, Joint Secretary – Department of Industrial Policy and Promotion (DIPP), Director General of Health Services. “This when the NPPA has the expertise and the database to implement price control,” said the official.

Delinking NLEM
Experts believe that the Standing Committee will work towards delinking the NLEM with price control. “The idea is to abandon the NLEM, and let the standing committee decide which drugs will come under price control. This is because the pharmaceutical industry dislikes price control,” said S Srinivasan, co-convenor of All India Drug Action Network (AIDAN).

The circular released by DoP states that the standing committee may take up a matter of drug price control suo-moto or on request of DoP, NPPA or Ministry of Health and Family Welfare and make recommendations. Sources said such a proposal was a part of the Draft Pharmaceutical Policy framed two years ago, which never saw light of the day. “The proposal was opposed tooth and nail by certain quarters of the NPPA for two years, and the transfer of the former NPPA Chairman paved way for it’s passage,” the official said.

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