Imagine having to spend a lifetime’s savings in just four months on one single cancer medication. That is what happened to 63-year-old Narayan Bantu when he was put on a course of Bayer drug Nexawar which fights liver and kidney cancer. Bantu had to take four tablets a day and though he got it at a discount he ended up spending about 10,000 rupees, or US $200 a day.
“I watched all that I had saved up through the years disappear”, says Bantu. “My insurance does not cover these medicines. There came a point when I felt I could no longer continue with the treatment. Fortunately my doctor put me on another medication.”
Cancer patients like Bantu now have a reason to hope. For the first time, the Indian government has allowed Hyderabad-based pharma, Natco to sell its generic version of Nexawar at a fraction of what the latter drug costs in India. The order came because it was felt that Nexawar which is a lifesaving drug was exorbitantly priced and its benefits were was available to less than 1% of the public. But it does not permit Natco to export the drug.
“Like Nexawar there are over 20 cancer drugs whose costs run into lakhs,” according to Vinaya Chacko, Head of Patient Care at the Cancer Patients Aid Association, an NGO working for the welfare of cancer patients in India. A dose of Herceptin hailed as a breakthrough drug for breast cancer patients costs between RS 7-23 lakhs (US$ 20000- 50,000) depending on the treatment stage.
“Naturally the poor cannot afford them. Hardest hit are the middle-class. Insurance does not cover the costs of cancer drugs. At least the poor have access to NGOs,” says Chacko.
The order will hopefully open the field for other Indian pharmas to make cheaper versions of cancer drugs. ‘Patients are groaning under costs,” says Dr Jagannath, Chairman, Surgical Oncology at Mumbai’s Lilavati Hospital and Research Centre. ‘We as surgeons are finding it difficult to justify the costs for the benefits.” Multinational pharmas he says cannot price drugs in developing countries at the same cost as they do in the West.
At the same time Dr Jagnnath points out,” Indian companies must invest in research and development. They cannot be mere copycats of the West. Costs can also be brought down if manufacturing units are set up in developing countries.”
A group of cancer surgeons, including Dr Jagannath are carrying out trials of lower cost drugs in India. It’s a critical need. Consider the figures. There are over 3 million cancer patients in India with 800,000 new infections of various cancers and over 500,000 deaths every year.