The Hindu : Front Page : The price people won’t pay

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Tuesday, Jun 03, 2008
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The price people won’t pay

M. Dinesh Varma

How the increase in the cost of medicine forces patients to go off treatment

Photo: Karishma Anand

Six tablets and two tonics once a day for over six years. This everyday dose that sustains 93-year-old heart patient Meenakshi’s life has been a severe drain on her family’s monthly budget.

Medical expenses add up to around Rs. 800 a month. “Add to that the transportation costs and the ECG or X-ray that the doctor sometimes recommends and the monthly visit to the physician costs much more,” says Ramesh, her son, an employee o f Sathyam Computers.

With drug prices up by 300 per cent over the last five years, the family was forced to adjust its lifestyle to save money. The patient also alerted caregivers before medicines went out of stock. However, in an estimated 10 to 20 per cent of cases, drug prices force patients off the treatment course, doctors say. “Patient non-compliance is the direct and most serious outcome of drug prices,” says V. S. Natarajan, geriatrician.

At his geriatric clinic, at least 10 per cent of the roughly 200 patients every week drop out midway because of their inability to afford the full course of medicines. The levels of non-compliance are increasing in the lower-to-middle income class of patients who get started on treatment for a chronic disease, but are unable to sustain the therapy for the full course. Relief or remission immediately prompts these patients to stop the therapy as they see medicate beyond that stage as wasteful. “Many patients suffer a relapse and have to be put on treatment that could turn even more expensive.”

State Indian Medical Association president L. V. K. Moorthy says that while people had no option but to borrow money for medical emergencies, the price rise had forced patients to seek cheaper substitutes.

Chemists say that contrary to claims that a unified tax regime would lower prices of medicines, the costs of almost all commonly used branded drugs have gone up in the post-Value Added Tax period. Tamil Nadu Chemists and Druggists Association spokesman Sakthivel, however, claims the price increase was restricted to a few drugs.

The price of a blood pressure control tablet like Amlong went up from Rs. 35 a ten-tablet strip to Rs. 40 a strip while Cardace 5 mg which cost Rs. 86 is now priced at Rs. 109.50. The prices of most Paracetamol tablet brands and the commonly prescribed anti-biotic Amoxicillin (250 mg) have doubled from Rs. 5 and Rs. 25 per strip respectively. Market forces have not spared even tonics and cough syrups — the price of a bottle of Piriton syrup has gone up from about Rs. 38 to Rs. 45 while Ascoril which used to cost only Rs. 32 for a bottle now costs Rs. 42.50.

Antacids like Gelusil which was priced at Rs. 32.50 per 170 ml bottle now costs about Rs. 50. Diabetic patients too have been hit hard by price rise with mainstays like Insulin injections costing Rs. 158 a vial as opposed to Rs. 145 a vial some time ago and prices of vitamin B12 tablets going up from Rs. 6 a tablet to Rs. 8 a tablet.

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