'Opaque pricing cripples Ayushman drug coverage'

The government's national public insurance scheme, Ayushman Bharat, has expanded access to hospital care but falls short when it comes to drug reimbursement, especially for chronic and rare conditions, with patients ending up paying out of their own pockets, said a study commissioned by India's drug pricing regulator.

The multi-jurisdictional study, conducted by Bengaluru-based Bridge Policy Think Tank, highlighted that the country continues to face "lack of transparency" in drug pricing methodologies and "insufficient mechanisms" for rare and speciality diseases.

"While we have achieved affordability in mass-market medicines, the same cannot be said for rare diseases and specialised therapies. India's challenge now lies not in manufacturing capability, but in building a system that allows equitable access to high-cost treatments," said Kritika Krishnamurthy, honorary director, Bridge Policy Think Tank.

The National Pharmaceutical Pricing Authority had tasked Bridge Policy Think Tank, a legal research foundation which undertakes legislative and policy research, with conducting a comparative study of drug pricing policies of multiple regions of the world including the UK, US, Australia, Brazil, Sri Lanka, Bangladesh. European Union, Thailand, China and South Africa. The 350-page report based on the study said that the methodologies used for determining prices in India remain "opaque, leaving stakeholders, especially new entrants, struggling to navigate an inconsistent system".

While market-based pricing was adopted to replace problematic cost-based calculations, both models suffer from ambiguity and lack of predictability, according to the report.

"The result is a pricing regime where manufacturers cannot easily anticipate how their products will be priced," it said.