Sunday, December 19, 2010

NRIs outsource medicines from motherland: Indian medicines are cheaper but effective

By Syed Akbar
As Ratnakar, a finance manager from Florida, packs his luggage after a month's vacation in Hyderabad to fly back, he makes it sure that he has bought enough stocks of medicines for himself and family. He 
got stocks sufficient for a whole year for just Rs 14,000, which otherwise cost him anything upward of Rs 1,00,000 back home in the USA.

Everyday thousands of NRIs and even foreign nationals purchase large stocks of personal  medicines from India to beat the huge price barrier. According to local pharmacists, NRIs, who visit their dear ones in the city,  make it a point to purchase medicines in the bulk before flying home. They save as much as six to 
10 times on daily use medicines, and two to four times on life-saving drugs. NRIs also obtain medicines from 
their relatives visiting them.

Senior pharmacist P Venkatesh, who runs a leading chain of drug stores in the city, says  "many NRIs and people going abroad for a few months purchase complete stock of medicines from here. Tablets and capsules taken daily for diabetes and heart diseases are usually in demand. They also purchase precautionary drugs 
for fever, pain etc."

According to Ratnakar, since most medical insurance do not cover the cost of medication  post- or pre-
hospitalisation, many NRIs have been preferring to outsource medicines from India. "Whenever I come here I carry lots of medicines for me and my family. I even share some with my friends in the USA," he  says.

US Customs estimates that 10 million US citizens bring in medicines from other countries every year. This is besides two million packages of medicines imported from countries like India. That there's a high 
demand for Indian drugs is evident from the fact that the country exports two-thirds of the medicines it 

"Medicines literally cost a fortune in the USA. It is therefore, not a surprise to see most Indians living in the USA buying medicines from India at a fraction of a cost," says breast cancer specialist Dr P Raghuram. For instance, Anastrazole used to treat hormone receptor positive breast cancer in post menopausal 
women, costs Rs 300 per tablet in the USA compared to just Rs 50 in India. The price difference is six times.

Another drug Herceptin, used for breast cancer patients, who are HER 2 positive, costs Rs 2 lakh per injection in the USA, while it is available at half the price in India.

Moreover, the US rule that prescription medicines should be sold only on prescription by  a qualified medical
practitioner also forces NRIs to outsource medicines from India. "Before going to a pharmacist, a patient in the USA needs to approach a doctor, pay him his fee, which is usually quite high. If the doctor's fee is also included the total cost of prescription medicines will go up to 15 times," says a city pharmacist MN Venkat.

Supporting Venkat's argument, Dr S Vijay Mohan, senior consultant physician, Care Hospital, points out "besides the 10-times more cost factor, drugs aren’t available over the counter so easily abroad. Here, one can purchase most of the drugs without prescription but the same isn’t true for the USA or the UK. In the 
US, except tylenol and panadol, which are US versions of crocin, no other medicine can be procured without 

Take the case of  Stieva-A (Renova). It costs about Rs 3,500 for a month's supply in the USA as against Rs 250 in India. The Indian version of cancer medicine Nexavar costs Rs 28,000 a month as against 
its price of Rs 2.80 lakh in the USA. Indian drug Erlocip costs about Rs 1,800 while its US version Tarceva is priced  at Rs 5,500.

While the demand for Indian medicines has been going up, the US does not want to recognise Indian drugs as of high quality. The Centers for Disease Control, a US government body, cautions American  citizens visiting India that they should purchase antimalarial drugs before travel.

"Drugs purchased overseas may not be manufactured according to the United States standards and may not be effective. They also may be dangerous, contain counterfeit medications or contaminants, or be combinations of drugs that are not safe to use," the CDC travel advisory says.

Many doctors point out that medical tourism is booming in India because even the cost of  surgeries is far less here. For instance, heart bypass surgery in the USA will cost around Rs 23 lakh. The same will 
cost between Rs 1 and Rs 2.5 lakh even in high profile corporate hospitals in India.

Comparative cost of medicines

1. Furazolidone-Loperamide (Anti-bacterial, for treatment of diarrhoea and enteritis): Rs 25 per 10 tablets (Rs 300 in the USA)

2. Paracetamol-Aceclofenac (Analgesic, anti-pyretic, for treatment of pains and fever): Rs 15 to 30 per 10 tablets depending on the brand (Rs 250 in the USA)

3. Amlodipine (anti-hypertensive, for treatment of angina): Rs 6.50 to Rs 77 per 10 tablets depending on the brand (Rs 500 in the USA)

4. Ampicillin (anti-biotic, anti-bacterial): Rs 55 to Rs 85 per pack of 10 tablets depending on the brand (Rs 700 in the USA)

5. Omeprazol-Domperidone (gastro-oesophagus reflex disease, peptic ulcers disease): Rs 55  per pack of 10 tablets (Rs 450 in the USA)

6. Pantoprazole (ulcers in oesophagus): Rs 63 (Rs 500 in the USA)

7. Metronidozole-Clotrimazole (anti-biotic, amoebicide, anti-protozoal): Rs 47 (Rs 550 in the USA)

8. Sitagliptin (anti-hyperglycemic, brand name Januvia for type 2 diabetics): Rs 500 (Rs 4700 in the USA)

9. Pimecrolimus (for treatment of eczema and atopic dermatitis; trade name elidel): Rs 600 (Rs 9400 in the USA)

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