[Commons-Law] Drug companies chasing profits, cheating patients

[Prashant Iyengar]

Date:14/05/2008 URL:
http://www.thehindu.com/2008/05/14/stories/2008051451520400.htm Back

New Delhi

Drug companies chasing profits, cheating patients

Bindu Shajan Perappadan

'High-price Doxofylline being promoted as an alternative to low-price
theophylline'

Doxofylline bulk drug is not a patented medicine and can be purchased
in tons in China

NEW DELHI: Exploiting the ignorance of the common man, over half a
dozen drug companies in the country have suddenly discovered the
hidden virtues of an age-old, low-lying medicine called "doxofylline",
claim experts.

Before the aggressive promotion to sell the drug started last year,
doctors were not even aware that such a molecule existed.

Explaining what he claims is the real reason for doxofylline's entry
into the country, the Editor of the medical journal, Monthly Index of
Medical Specialities, Dr. C. M. Gulati, says: "The answer lies in the
way drug prices are determined and controlled in the country.
Doxofylline is being offered as a more profitable alternative to
theophylline, prescribed to prevent and treat wheezing, shortness of
breath, and difficulty breathing caused by asthma, chronic bronchitis,
emphysema, and other lung diseases. It relaxes and opens air passages
in the lungs, making it easier to breathe."

"Theophylline and etofylline – molecules approved for sale in over 200
countries after having undergone rigorous post-marketing trials -- are
scheduled drugs and subject to price control by the Government. By
successive orders in 2006, all loopholes to sell theophylline products
at high profit margins have been closed by the National Pharmaceutical
Pricing Authority (NPPA), the body that monitors medicine prices in
India. Therefore, nearly all companies selling theophylline
formulations have been scouting for similar molecules outside the
price control system irrespective of whether they are similar, better
or even worse than their current brands" adds Dr. Gulati.

"The core issue is profits, not patients," asserts Dr. Gulati. "The
strategy is to stop selling less profitable, price-controlled products
and replace them with hugely profitable alternatives of the same
class. Doxofylline fits into this tactic. A molecule which is not even
considered fit for mention in standard textbooks is being paraded as
if it is major advancement in the treatment of asthma," he notes.

Doxofylline bulk drug is not a patented medicine and can be purchased
in tons in China at a very low cost without any licence. Yet to give
it an international foreign flavour, some drug companies in India have
proudly announced that their brands are being produced "under licence"
from overseas entities.

Dr. Gulati has warned that patients in India are being made to pay
excessively high price for a very ordinary medicine.

"While the cost of a ten-tablet strip of theophylline-400 mg is
Rs.6.40, the cost of a ten-tablet strip of doxofylline is Rs.80."

After the discovery of aminophylline, a double salt of theophylline
and ethylenediamine, in 1910, attempts were made either to isolate
similar xanthine alkaloids from plants or to synthesize them in labs.
Result: dozens of derivatives of theophylline were discovered such as
etofylline, theobromine, oxtriphylline, dyphylline, enprofylline,
etamiphylline, proxyphylline and pyridofylline.

Doxofylline is just another derivative of theophylline in this chain
and resembles the parent compound in its mode of action, efficacy and
safety profile.

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