To say that the last twelve months were eventful for the Indian pharmaceutical sector would be an understatement; it was nothing short of a roller-coaster ride.
The government’s grandiose announcements on universal health care (UHC) and distribution of free generic drugs to people through the hugely inadequate public health system were initially welcomed. When it dilly-dallied, what could have become an election-winning plank, fizzled out and was seen internationally, in poor light. To make matters worse, the government strained diplomatic relations with the United States on its “weak” intellectual property regime (IPR) after compulsory licenses were issued and intermittent threats to cap patented drugs were issued probably as a direct result of heightened patient and NGO activism.
Apart from leaving public health in shambles, the lack of a strong governance structure directly affected the health industry. India’s indecision and weak diplomacy were visible in the lack of strong and pragmatic laws defining the conduct of clinical trials, capping the inflow of foreign direct investment (FDI).
Sadly, the government’s material efforts to balance through deft diplomacy seemingly received inadequate media coverage. Not much was written about or spoken when India held its own on the European Union Free trade agreement, on how it handled the FDA commissioner’s visit to India and the time when the FDA cleared Indian drug imports into the US. Issues that can have devastating impact on India such as the Trans-Pacific Partnership (TPP) agreements are hardly in the public imagination. Broader coverage of these events would have helped to drive up investment sentiment in the sector at a time when the winds of change blew over the Indian subcontinent.
In less than two months, we will see a new government take charge in New Delhi. Assuming that health is taken seriously by any party that comes to power – and keeping in mind that health is a state subject – the implications on the industry are tremendous.
If the government is serious about its role as health provider, it will – like in Rajasthan, Kerala and Tamil Nadu – emerge as the single-largest purchaser and distributor of pharmaceutical products. Doctors will be directed to prescribe generic and their power of influence will diminish greatly. As the focus on anti-corruption crusaders and the taxman moves to hospitals, doctors and the pharmaceutical sector, companies will adopt ‘ethical codes of conduct’ with more enthusiasm.
As this spills over into the private sector, the industry will be expected to adapt. Consolidation of supply channels and hospital groups may cause key account management (KAM) to replace physician calls to a large extent. Formation of physician groups (in hospital chains that discourage private practice) may mean shifting physician priorities and time. This may entail greater adoption and penetration of digital technology. Patients empowered through easier and cheaper access to information on the internet may force health care to become participative as they seek greater say in their treatment processes.
While all this will not happen by the end of 2014, it is likely that green-shoots of change will sprout as a government seeking greater integration for India into the globalized economy adopts open-door policies. To embrace and leverage these changes quickly, it is up to the pharmaceutical industry to ensure that it has trained and equipped talent readily available that can help businesses transition as seamlessly as possible to accommodate for new business models, partnerships, distribution channels and approach to media.
With health care in India on the threshold of such transformation, it is only pertinent that issues are raised, discussed, debated and the opinion of people is sought and heard. This has not been the case in the sector until now. We need stronger voices, opinions and leaders in the sector. Pharma journalists and communication specialists have great power. To borrow from Spiderman, with that comes great responsibility; the responsibility to serve as watch-dog to the health and well being of the largest democracy in the world. That is definitely something to be proud about and flaunted more than is currently done.