BioSpectrum (Asia) - - Bio Edit - Milind Kokje Chief Ed­i­tor milind.kokje@mmac­

Cost ap­pears to be the ma­jor con­cern across the world, in­clud­ing Asia, when it comes to drugs. The US Pres­i­dent Don­ald Trump re­cently ex­pressed con­cern over the prices of pre­scrip­tion drugs go­ing “out of con­trol”. His state­ment in the cabi­net meet­ing re­sulted in stocks of pharma com­pa­nies drop­ping slightly.

The con­cerns are sim­i­lar and equally deep and se­ri­ous in the Asian re­gion too. A re­cent Busi­ness Mon­i­tor In­ter­na­tional’s re­port ‘Pharma and Health­care In­sight, Asia – In­dus­try Trend Anal­y­sis’ also touches the sub­ject of drug prices and their af­ford­abil­ity in the Asian re­gion. “Gov­ern­ments across the Asia Pa­cific (APAC) re­gion will face chal­lenges in en­sur­ing the pop­u­la­tion’s ac­cess to medicines in a cost ef­fec­tive man­ner,” the re­port says.

The de­mand and con­sump­tion of drugs is rapidly ris­ing in the APAC re­gion. Ag­ing pop­u­la­tion and grow­ing bur­den of chronic dis­eases are fu­el­ing the growth in de­mand. Phar­ma­ceu­ti­cal mar­ket of APAC was about $ 304 bil­lion the pre­vi­ous year. It is ex­pected to grow to $ 375 bil­lion by 2021 with 6% CAGR. While var­i­ous re­search re­ports pub­lished in the near past are fore­cast­ing rapid growth in the pharma mar­ket in APAC re­gion, they also have ex­pressed grow­ing con­cerns of the re­spec­tive gov­ern­ments over the ris­ing health­care cost caused in one way by high drug prices and the mea­sures an­nounced or taken by them to meet the challenge to make treat­ments af­ford­able to the peo­ple.

How­ever, ac­cord­ing to one study in US, pre­scrip­tion medicines in­clud­ing re­tail phar­macy sales are only 14% of the over­all health­care spend­ing and hospi­tals com­prise the largest share of about 30%. Physi­cians and clin­i­cal ser­vices are about 20%. How­ever, no mat­ter how low may be the per­cent­age of pre­scrip­tion medicines and phar­macy sales in over­all health­care ex­pen­di­ture, when it ac­tu­ally comes to paying the price of drugs by in­di­vid­ual pa­tients that low per­cent­age does not mat­ter and what counts is the ac­tual price of the drug and if it is high it be­comes un­af­ford­able to many.

In or­der to over­come this prob­lem in­creas­ingly ag­gres­sive pric­ing con­trols have been im­ple­mented by the au­thor­i­ties. They in­clude value based pric­ing, an­nual price re­vi­sion and cap­ping of medicine prices. This has been pointed out by the in­dus­try trend re­port quot­ing ex­am­ples from Ja­pan where al­most half price re­duc­tion is in­tro­duced in case of a drug. Ja­pan has also pro­posed cre­at­ing a more struc­tured cost-ef­fec­tive­ness as­sess­ment scheme. In China, price re­duc­tion of some drugs is re­im­bursed to the drug com­pany from na­tional health in­sur­ance.

An­other re­port by E & Y has men­tioned that In­done­sia is al­low­ing im­port of low­er­priced copies of patented prod­ucts, while Malaysia is adopt­ing mea­sures to con­trol the rise in health­care costs. A con­sumers’ as­so­ci­a­tion in Malaysia has urged the gov­ern­ment to in­tro­duce na­tional drug pric­ing con­trol sys­tem. Along with the price con­trol by au­thor­i­ties, one more solution be­ing con­sid­ered by them to re­duce the prices is pro­mot­ing generic drugs and biosim­i­lars. In its re­port, Frost & Sul­li­van ex­pects the pric­ing en­vi­ron­ment in APAC to be­come more dy­namic, which would drive gener­ics and biosim­i­lar mar­ket as sub­sti­tu­tion to ex­pen­sive prod­ucts.

BMI’s in­dus­try trend re­port has men­tioned that Malaysia is try­ing to in­crease the use of gener­ics and biosim­i­lars. Aus­tralia has stated to pro­mote lower value generic medicines to re­duce pharma ex­pen­di­ture. Ja­pan un­veiled its plan of boost­ing use of generic drugs from 56% to 80% by 2020. The Philip­pines FDA has sup­ported the for­ma­tion of a com­mit­tee on generic drugs de­vel­op­ment to en­cour­age in­vest­ment in generic drug pro­duc­tion with higher qual­ity and more af­ford­abil­ity.

Thus, af­ford­abil­ity of the drugs is go­ing to be the main fo­cus of the gov­ern­ments to pro­vide re­lief to the ci­ti­zens. For that, the mea­sures adopted by the gov­ern­ments will be force­ful pric­ing pres­sure and fo­cus on generic sub­sti­tu­tion in ad­di­tion to boost­ing do­mes­tic drug pro­duc­tion, the re­port has pre­dicted. This, of course, will pose a challenge to the pharma com­pa­nies, par­tic­u­larly the multi­na­tion­als.

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