Brands are the promises they make. People love brands since they are sure they will get what is promised. Legally speaking, brands represent IP, patents, copyright, trademarks and design or a combination of these.
Branded products are expensive. They sometimes are more expensive than they should be. No doubt, brand distinguishes a company’s product. It differentiates a product from other products.
It should be noted that a product cannot be an absolute monopoly. It can be substituted to various degrees.
To the extent a brand differentiates a product, the producer can charge a mark-up for the added value. The added value can be real or perceived.
A brand, as we noted, is a promise — and it is basically a promise of quality. This builds brand loyalty.
In pharma marketing, there are clinical trials. There are side effects of drugs. There are patents to create temporary monopolies. There is the so-called ethical promotion through doctors.
Here in the name of promotion, the doctors could be bribed to prescribe the medicines.
In other words, in pharma marketing, there is asymmetric information — there is, therefore, no informed choice.
This escalates the healthcare costs for the patients. Mostly, these costs are out-of-pocket.
There are three types of medicines broadly – on patent medicine which are brands, off-patent medicines which are generic but produced by a reputed company, off-patent generics that are unbranded. In treatment, there is substitution between these three. There are differences in price between these three.
Wholesale pharma markets such as Bhagirath Palace, Delhi and Princees Street, Mumbai reveal non-adherence to existing regulations, and lack of quality controls.
In India, pharma manufacture consists of 3000 drug companies and 10,500 manufacturing units. Out of these 10500 units, about 8500 are MSMEs. GMP or good-manufacturing-practices are there since the late 1980, and still only 2000 units are GMP-compliant. There is tardy implementation of Drugs and Cosmetics Act.
Mashelkar Committee (2003) quoted 0.5 to 35 per cent as the extent to which drugs are spurious. Regulatory authorities report sub-standard drugs to the extent of 8.19 to 10.64 per cent. There are spurious drugs to the extent of 0.24 to 0.47 per cent. Spurious means fake or counterfeit and sub-standard.
Spurious and sub-standard drugs do not facilitate treatment.
GMP, it seems, are directed towards exports, but they should also be directed towards domestic consumption too. Those MSME units which are not GMP-compliant must be closed down.
Jan Aushadhi stores sell unbranded generics. There was a recommendation that doctors should prescribe unbranded generics. It is since then withdrawn.
Just like doctors, pharma companies do influence chemists and retailers. A generic prescription gives the pharmacist a choice to sell brand, a branded generic and an unbranded generic.