Drug Pricing Case: Dr Kulshreshtha Backs Generics, Flags Flaws

New Delhi, October 27: The Supreme Court, hearing a petition on the high prices of medicines, asked on Monday whether pharmaceutical companies are simply running a business or also weighing public interest and utility. The bench noted that making a profit is one matter, but unreasonable profiteering and excessive pricing are not acceptable.

Petitioner Dr Sanjay Kulshreshtha said he had filed actual patient bills as evidence. These showed that certain medicines were being charged 10 to 15 times more than they should be, he said.

Dr Kulshreshtha said the court had been direct in its questioning. It wanted to know whether the petitioners were looking only at business or at public interest and utility as well. He added that the court had already expressed its views on the matter in an earlier comment on the petition. During the hearing, senior advocates, including Kapil Sibal, presented arguments, and the court remarked that most aspects of the petitions filed by Dr Rathore and Dr Kulshreshtha were clear.

As doctors who perform operations, he said, they had highlighted in their patient bills that several drugs were being sold at 10 to 15 times the price. The court accepted these facts during arguments. The petitioners had also submitted a written representation and a rejoinder, and countered the points made by the Ministry of Chemicals and Fertilizers.

He argued that restricting the scrutiny to cancer drugs made little sense. Every medicine should be included, he said, because India's best-selling drugs are used for heart disease, diabetes, acidity, pain relief and infections, and most have no connection to cancer.

He further said that the division between essential and non-essential medicines should not lead to unequal treatment. A medicine prescribed by a doctor carries real value for the patient, and any drug that protects life is important, whether officially labelled essential or not.

The essential medicines concept, he explained, was originally framed by the World Health Organization to address special conditions, emergencies and availability. However, in day-to-day practice, each drug is essential for some patient.

He said the government had stated that it was worried only about costly medicines, but he asked who would determine which drug was expensive and which was not. If a drug is cheap, he said, it benefits patients and should be allowed to stay that way. Each trader and chemist sets profit margins as a percentage, and every seller stocks both affordable and expensive products, so overall earnings are calculated on the entire inventory. Therefore, pricing should be governed by more rational and uniform controls, and the essential versus non-essential categorisation is largely arbitrary, he argued.

He said the court had put forward two important proposals. First, it asked that the MRP system be considered for implementation at the manufacturing level. Second, it suggested a website or mobile app where the margins at manufacturer, distributor, stockist and retailer levels are clearly visible. The platform should also show whether a medicine is essential or non-essential, and whether it is patented or generic. He said the court had heard these submissions and given them consideration.

He hoped the court had seen the issue through the lens of healthcare and public interest, not merely commerce. He also contended that if the health sector offered no prospect of profit, such large numbers of companies and investors would not be entering it.

He pointed to investment from companies in Japan, Korea and other nations in India's healthcare sector, along with hospital acquisitions, as evidence that substantial profit potential is being seen in the field.

On generic medicines, he said the petitioners were not opposed to them. As doctors, they supported generics, but some shortcomings had to be addressed. The first, he said, is that allowing too many companies to manufacture the same generic drug often triggers unethical competition to boost sales, and the product offering greater profit is then pushed more aggressively.