In its Twelfth Five Year Plan, the Government of India diverted a significant amount of attention to its healthcare strategy, and the goal to establish a Universal Health Coverage. The 12th plan period strategy highlights the increasing need for skilled professionals to provide high quality care, as well as the importance of integrating paramedical and community level health workers into the system. It also discusses the urgency for promotion of generic medicines, and to make these drugs accessible to all citizens. A monumental paradigm shift in the Indian healthcare scenario is on the horizon. The pharmacist must therefore prepare to see yet another revolution in his role, from the classic ‘lick, stick and pour’ dispensary role towards a more integrated member of the healthcare team.
A study published in the British Medical Journal in October 2015 reported that India has merely 1 doctor per 1,700 patients – much lower than the WHO recommended ratio of 1:1000. Doctors are overburdened and often work with extremely limited resources. This has a direct impact on the quality of healthcare and support provided to a patient, to ensure maximum efficacy. There is a pressing need for a greater number of healthcare providers, and the solution to this problem may have to be addressed by non-conventional means.
In May 2006, the UK began recognizing ‘Pharmacist Independent Prescribers’. An earlier legislation in 2003 enabled pharmacists to become supplementary prescribers. The United Kingdom has successfully implemented a system enabling expansion of the pharmacist’s role, resulting in improved health outcomes for patients. With direct involvement in a patient’s disease state, medication and diagnosis, the pharmacists in UK have been able to share the workload of physicians. A significant increase in the market share of OTC products has also aided this system.
As of June 2003, the Pharmacy Council of India reported 5.5 lakh registered pharmacists. This army of highly qualified, skilled and knowledgeable professionals might be integral to solving India’s healthcare crisis. Integrating Pharmacist Independent Prescribers into the Healthcare system would take a fair share of patients off the doctor, enabling them to cater to chronic cases and overall, benefit more people.
Disease is the biggest money maker in our economy. With soaring drug prices, and negligible public health infrastructure, medical expenses are driving people to poverty. More than once, India has been dubbed the pharmacy of the world. In 2001, Cipla saved the world from the ever growing AIDS crisis, by brining prices down to 99% of that of the innovator’s products. Much of what Indian pharmaceutical companies have been able to achieve locally, as well as globally, is due to support from the government and the Indian Patent Laws.
While as a country, we have been at the forefront in the global movement for establishment of generic medicines, it is imperative we turn our attention towards home. Pharmacists in the industrial and regulatory sectors must ensure that life-saving drugs are not a privilege enjoyed only by wealthy citizens of the western world.
A promising enterprise by the Government of India on this front is Jan Aushadhi. Jan Aushadhi aims to bring low cost, high quality generic medicines to the general population. Pharmacists are at the fore front of this movement – right from the manufacturing of these generic drugs, to bringing them to communities who need them the most.
Powerful initiatives to improve access are being undertaken by individual pharmaceutical companies. Merck & Co. launched Su – Swastha programme in 2013 in Bihar and Uttar Pradesh. They aimed to increase access to quality healthcare products at an affordable price in rural India and to address the lack of healthcare infrastructure in rural areas. It involves community level healthcare meetings and educational health programmes run by local pharmacists, as well as products based on their needs in the areas with adaptive prices.
Pharmaceutical companies today are engaging their top scientists in research for New Chemical Entities. Despite all the effort, the new drug pipeline has been quite dry. We need to change the way we approach research and look at the drugs we already have, and how we can maximize their utility and efficacy. We need to look at ways to develop affordable and robust therapy, to enable better health outcomes.
In the long run, the collective aim of the Indian Government is to provide access to quality healthcare to all its citizens, which is a necessity for a better future. Today, the Indian pharmacist is indispensable to make this a reality.