That right there should be the guiding principle for policy makers !
One early April morning, my dad who resides in Kerala woke me up, quite distressed about not being able to source his anti-diabetic drug (Metformin combination) in Kodungaloor, Trichur & Cochin. He requested me to purchase it in Mumbai & courier it across. His blood sugar which was steady for long had started fluctuating again since his diabetologist started him on two new drugs/ brands instead of the combination brand he had been taking for 3 odd years. The fluctuating levels made him feel faint several times in a day even when he was eating well & taking the new drugs prescribed a fortnight ago.
That got me thinking. While the pharma industry was reeling under the Govt diktat of ban on 343 drug combinations, getting ready for a protracted legal battle after getting stays on the ban, both the Ministry of Health (MoH) & pharma really never thought about what the patients & doctors would have to go through. Without so much as a warning to both of them, drugs were banned leaving patients in the lurch and doctors having to bring blood glucose again under control which we all know really takes time. Endocrinologists have gone on record detailing the challenges being faced by them with this sudden-ness of ban. What if the MoH had cautioned doctors beforehand , atleast six months in advance, the doctors would have got time to inform the patients and start the titration process with them. That would have been so comfortable for the patients, don’t you think ?
Both pharma industry and the govt (MoH) have an acute challenge with being patient centric in their thinking & actions. The MoH did ban the drugs keeping patients safety at the core, but forgot about the same while planning their implementation. Patients will suffer interim challenges, in this case a possible hypoglycemic episode, so does the end justifies the means ? This looks so formulaic in light of the recent decisions of surgical nature, implementation hitches et al. But even the govt must know such surgical strikes cannot be carried out when its patient’s health is at stake.
Those in the know can argue most of the drug combinations that were banned belong to the respiratory, pain and antibiotic categories. But if any of the drugs were being used for a chronic condition such as persistent cough linked to asthma, or even acute conditions like migraine headaches, we know the relief is strictly associated with brand prescribed by the doctor & taken for a long time.
This also brings me to the last point - Did the brand heads/ marketing heads & BU heads pause and think how they would communicate about the possible ban & resultant unavailability to the patients via the doctor? Did they brain storm regarding how to address patients concerns in the interim period ? The answer is probably a big fat No. There would have been discussions galore & hours of man-hours spent on how to get a stay on the ban, Plan B to manage top line & bottom line if the inevitable happens, even what story to tell the doctors; but no thought spared for the patients who are left high & dry!
So the broad action point here for the industry in my opinion is : Let us move patient centricity out of the board room talk into the strategic framework for the company, not just the brands. This will ensure more pushback from the industry on patients behalf when strikes of this sort is orchestrated by the MoH. Action point for govt : Let’s educate the policy makers so they understand & include the patient impact when they frame policies. Above all lets educate the people so they are empowered to understand the situation & act in tandem with doctors instructions.
We owe this to our country ! And we as patients deserve this !
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