THE government’s decision on a revised national essential medicines list and comprehensive drug pricing guidelines is a timely, commendable intervention. The list, approved by the authorities on January 8, has expanded the earlier list, with the addition of 135 essential drugs, taking the total to 295. The commitment to a phased, set pricing system also acknowledges a long-standing reality: unchecked medicine prices have become a major barrier to healthcare access, especially for the poor and low-income people. When nearly two-thirds of health expenditure comes directly from people’s pockets, mostly spent on medicines, the move is a significant and long-overdue pro-people intervention. By recognising that essential medicines can address around 80 per cent of diseases, the government has rightly placed affordability at the centre of public health policy. Over the decades, a gradual deregulation allowed price control to shrink to 117 medicines while the number of unregulated products ballooned, creating wide disparities and fuelling treatment costs. Earlier estimates show that the country manufactures more than 5,300 registered brands of 450 generic drugs. If implemented as intended, the move has, therefore, the potential to deliver substantial health benefits.
The scale and complexity of the reform, however, demand careful, transparent and consistent implementation. The introduction of pricing formulas based on ingredient costs — alongside internal and international reference pricing for non-essential drugs — suggests a more rational framework than the arbitrary system that had evolved over three decades. The provision of a four-year adjustment period for pharmaceutical companies is also prudent, giving the industry sufficient time to align with price ceilings without sudden shocks to production or supply. At the same time, regulatory vigilance will be crucial. A market that has long enjoyed considerable freedom will inevitably test the limits of compliance, whether through subtle price manipulation, brand proliferation or quality compromises. The plan to eventually establish an independent national drug pricing authority is, therefore, essential as credibility and enforcement cannot rest indefinitely with temporary, ad hoc committees. Equally important is coordination with drug quality regulators to ensure that pharmaceutical companies do not compromise standards in the name of cost effectiveness. Without robust and round-the-clock oversight, the promise of affordability could be undermined by substandard medicines. The success of the decision will ultimately be measured not by policy declarations but by outcomes at pharmacies and hospital wards.
Price control on essential medicines is believed to directly improve access to treatment for nearly 80 per cent of the population. The authorities must, therefore, address the challenges comprehensively to ensure an effective implementation. The government should also move swiftly to establish a drug pricing authority to translate the policy intent into tangible public health gains.
