The challenge of access to cardiovascular drugs in India

The increasing social and economic burden of non-communicable ailments such as heart disease, diabetes, cancers, Alzheimer’s disease, lung disease, and mental illnesses has become one of the world’s greatest health challenges.

Many of these diseases are preventable through lifestyle changes. In many cases, they are also very manageable with inexpensive, effective medicines, hundreds of which are readily available in generic copies. Despite the availability of these medicines, however, they are grossly underutilised.

A recent study of a sample of patients from around the world revealed that in low-income countries, less than 20 per cent of patients with cardiovascular disease were using secondary prevention drugs. These drugs are proven effective cardiovascular medicines that treat existing conditions to reduce the risk of heart attack, stroke and other serious complications. What is surprising is that an overwhelming proportion of the sampling for low–income countries consisted of patients from India, the world’s biggest supplier of low-cost generic medicines. Less than 5 per cent of patients in low-income countries were using either diuretics or statins available as generics.

The study underscores the reality that in many low and middle-income countries, inadequate distribution and the lack of access to care are as much, or even a greater, barrier to health than the cost of care.

 

Barriers to medical resources, including adequate healthcare facilities, trained healthcare professionals and diagnostics, are significant and entrenched. They also take many forms including geographical socio-economic and gender barriers. Geographic barriers result from limited means of transportation and infrastructure; socio-economic barriers include the cost of healthcare, but also encompass social factors such as the lack of culturally appropriate services, language/ethnic barriers, and prejudices on the part of providers; and in too many countries, gender discrimination results in women having less access to healthcare and therefore more vulnerable to various diseases and associated mortality.

The need for medical research and innovation is essential to the well-being of every nation. The ability of a country to sustain its economic growth, increase the standard of living of its citizens, and improve human health directly depends upon successful development and access to new products, processes and services.

Considering the present healthcare scenario in India and the nation’s large disease burden, it is crucial to overcome these barriers to improve health, ease patient suffering, and reduce the economic and social burden of disease. India is a global leader in the production of new medicines and health technologies that can significantly improve health outcomes. But it faces many challenges in ensuring that patients get access to the medicines they need. This recently published global study on the use of preventive cardiovascular drugs underscores that the availability of low cost generic medicines does not ensure patient access if health systems lack the capacity to make them available to patients in need.

The author is Vice-President of International Affairs and Advocacy at the Pharmaceutical Research and Manufacturers of America (PhRMA). Views are personal