After successfully launching the ‘Make in India’ campaign, PM Narendra Modi launched the ‘Digital India’ project’ in early July. While the government is trying to connect remote areas/ villages via high-speed Internet services, most of these locations often do not have functioning primary healthcare centres or chemist shops where patients can buy routine or life saving drugs. Experts from the pharma fraternity give their views on how Indian Pharma Inc can translate the Digital India initiative into better patient access By Usha Sharma
Implement Digital India project without hesitation
Digital India project is a remarkable concept and is achievable considering India’s strength in the software industry. This will definitely become a success. Almost all large software companies in India have already come forward to invest heavily in the Digital India project. Normally any industry would like its factory either close to availability of raw material or skilled manpower or the market. For pharma industry skilled manpower is crucial. It is for this reason the pharma industry has come up in and around big cities. However, we cannot really say that the pharma industry is restricted to large towns. In fact there are large pharma industries in Dewas, Madhya Pradesh, Baddi in Himachal Pradesh and now in Sikkim and many other backward areas. However, these developments in smaller towns as above are mainly due to incentives given such as excise free zones. It is not always required to give such incentives. If infrastructure and connectivity are available, companies particularly in the pharma sector would develop industries in rural areas.
Pharma companies would definitely be interested in the Digital India project as it would help them expand product availability and reach to the remotest villages, as over 60 per cent of our population is in rural areas. The concept of tele-medicine is an area where hospitals and pharma companies can work together for the benefit of patients in rural areas. Currently, most rural India patients are serviced by barefoot doctors. This would dramatically change with the implementation of the Digital India project.
If the government aims to make a success of the newly launched programme then it needs to implement the Digital India project without hesitation. The medical fraternity and the pharma industry together will automatically step in to provide patient care and availability of medicines across India.
Currently, the pharma industry is heavily burdened with heavy cost of medical representatives, non availability of professional medical representatives on the one side and price control order by the Government of India is virtually stifling the industry growth.
The Digital India project coupled with the ease of networking would enable the pharma industry to reach out to doctors with innovative cost effective marketing and would probably even connect doctors through Skype and other web related technical inputs of their products. The companies may even organise and support the hospitals for telemedicine. To conclude, the Digital India project will open up several avenues.
– TS Jaishankar, Managing Director, Quest Life Sciences
Success depends on creating infra, literacy
Digital India project is an excellent initiative which possibly is the need of the hour when we are seeing significant technology advancement. There is a need to connect rural and semi urban areas. Success of this project is very vital to serve the purpose. But success of the project would depend on creating infrastructure and literacy.
I don’t think pharma companies have neglected rural areas and small towns. But possibly the penetration of pharmacies is less. What can be done is to initiate steps to increase number of pharmacies as well as implement the Jan Aushadhi programme very rigorously. Patients will be benefited with the easy access to doctors, government healthcare institution and restrict their excessive movements between hospitals/clinics as data would be available. This would also simplify record keeping.
Steps for improving access to medicines
- Developing necessary and adequate technical infrastructure
- Creating awareness by various programmes
- Training to operate and use technology optimally
- Ease of regulations to suit online models
- To have one tele – healthcare centre in each village
The Digital India project would have a huge impact on healthcare domain first with telemedicine bringing patients and doctor more closer. Digital India project has a bright future in healthcare space. However, certain concerns regarding data privacy, online selling of medicines need to be taken care of.
– Dr Milind Antani, Partner Pharma and Healthcare Practice, Nishith Desai Associates
Digital India can transform the way we do business
The vision for Digital India as proclaimed by the Government of India (GoI) is to transform India into a digitally empowered society and knowledge economy. Since pharma industry is a science and knowledge based industry, the GoI vision fits quite well with industry’s own vision. Following are some of the areas where Digital India can transform the way we do business.
Access to medicines: Inspite of India having achieved the distinction of being a reliable source of quality medicines at affordable prices, access to essential medicines is less than 40 per cent of the population. The reason for low access is poor health infrastructure. In the interiors where 70 per cent of the population lives, there is lack of diagnostic facilities, doctors , pharmacies as well as hospitals. With the result, pharma industry has also not penetrated well in to the interiors. This can be corrected by providing Wi-fi connections in villages where patients can access medicines through’ e-pharmacy by getting e-prescription from district hospitals on their mobile phones.
Sales force effectiveness: This is increasingly becoming a challenge for the pharma industry. The traditional method of detailing has lost its significance as the medical profession has little time and patience to listen to the spiel of medical reps. The doctor coverage of over Rs 6 lakhs healthcare professionals (HCPs) and also hospitals and retail chemists is also increasingly becoming area of low ROI. Many companies like Cipla, Ranbaxy, Biocon etc. have adopted digital platform of Cirrius Pharma CRM model on Microsoft Azure which integrates the company with patients, HCPs and supply chain through this platform increasing the sales productivity and patient access substantially.
The mobile health market: It is estimated that the mobile healthcare market is set to cross $27 billion by 2017. Apple iTunes today have more than 20,000 health-related mobile apps. Remote patient monitoring devices are one of the fastest growing markets. Many patients suffering from chronic diseases like diabetes, hypertension, CVD, arthritis etc. have to take medicines life long. They find it difficult to make frequent trips to the local pharmacies to replenish their medicines stock. Online pharmacies with doctors giving e -prescriptions can help these patients get home deliveries. The model is particularly suitable for OTC medicines as most minor ailments like headache, cough & cold, diarrhoea, skin infections etc. are self limiting and can be addressed without intervention of HCPs, ordering OTCs online is quite feasible. Responsible self medication is an important aspect of healthcare in many developed countries.
While many of the above suggestions for digital future are doable, their success will depend on some basic requirements. Digital future is possible only on top of good physical infrastructure. This means that old issues like good roads, good connectivity, literacy, electricity etc. would still be required to makeDigital India a success.
The regulatory issues also need to be addressed for platforms such as e-pharmacy, e-prescription etc. Attention to environmental issues are also important. For instance, it is reported that unscrupulous competition among cell phone operators in Chennai who have installed too many towers in proximity of each other has resulted in radiation emanating from such towers making small birds like sparrows and also squirrels virtually extinct. Finally, the contentious issue of net neutrality needs to be resolved to make Digital India a success.
– Dr Ajit Dangi, President and CEO, Danssen Consulting
Multiple stakeholders need to be onboard
Technology is a great enabler and we have experienced its positive intervention across sectors. This is no different for healthcare delivery; telemedicine, electronic health records, online consultations are all transforming the ways patients are treated. E-healthcare forms part of the Digital India initiative, but able execution in the healthcare sector will require an enabling infrastructure to maximise the benefits. Multiple stakeholders will need to be onboard and connected, to ensure the success of Digital India in relation to healthcare. Over all this is a welcome step that can contribute to delivering better healthcare in our country.
– Ranjana Smetacek, Director General, Organisation of Pharmaceutical Producers of India (OPPI)
‘Shooting the messenger’ does not kill the ‘message’ or the problem
Legal drafting or redrafting of technical statutes is not just a matter of law but a blend of arts, science & law. The (Indian) Drugs & Cosmetics Act is a 1940 Act left-over from the British times with “patch-work” and touch up amendments from time to time. A new Act, 2020 or before, may be welcome, if drafted to meet the emerging needs and challenges. The word “exports” has been virtually missing for two reasons. The ‘wise’ argues that Drugs & Cosmetics Act is for India not for overseas and hence no “exports” in the statute. The other being lack of adequate exposure to Indian pharma regulators to international markets and developments, so much so, the need for giving (Indian) Drugs & Cosmetics Act, an International favour, when everyone including the Government of India, is loud and clear in their demand for international approval for Indian pharmacopoeia.
All these days India has attracted global attention on “affordability and accessibility” issues vis-à-vis TRIPs, Doha Round and Intellectual Property based regime. However, too little too late (never late) has been done or attempted adequately to address rural penetration and to improve affordable access to life saving masses in interiors and far flung villages. It is often seen that rural patients come to nearest cities like Patna, Allahabad etc. and camp with spot cooking and families in overnight queues to get medical consultation with reputed specialists referred by rural doctors.
While India is “empowering and financing” more and more middlemen in its new skill development initiative and are relying on data being dished out by them, very little skills are in fact being developed in locations and pockets where they are badly needed. The skill development benefits must reach the common man which is often not the case. Similarly, Digital India will be a success provided the benefits filter down to reach the public mostly located in rural pockets.
Recently one of the popular “e-retailors” has been targeted and sued by the Government for offering medicines through the web to the needy. ‘Shooting the messenger’ does not kill the ‘message’ or the problem. India is declared as the Digital India today. Much is being achieved and more is being promised. From “land records” to all data on tax and direct taxes, banking, insurance, identity modes are all getting digitalised. Much have been achieved and is being achieved, which we are proud of.
Can the nation be labelled (proudly) as Digital India, without using the “digital” means to address the health needs of the poor and downtrodden, a population in majority in India? India should not miss the Digital India bus to address the “affordability-accessibility” issues without letting in the “patient passengers” on board. Instead of prosecuting those who make medicines available to the needy through the web, India should amend its Drugs & Cosmetics Act, 1940 (?) or have a new Drugs & Cosmetics Act, 2016 or thereabout by facilitating and empowering web-based solutions to address “medicines for the masses on demand”. Web, being global, needless to say that, intellectual property violations and “patent and trademark” infringements must be strictly prevented or avoided on the web. The ‘web operator’ should be allowed to tie up with a registered medicine wholesaler or retailer (or even the manufacturers themselves) who should take all legal and regulatory responsibility for meeting the obligations under (to be amended) Drugs & Cosmetics Act. All medical prescriptions issued by qualified medical practitioners, must be digitally uploaded or made available to dispense scheduled and restricted medicines. OTC and non-scheduled (non-IP violative) medicines, ayush and nutraceuticals must be freely available on the web/ net to the needy. Those who abuse the system or provide spurious or non-quality medicines including mis-branded (not originating from the IP address holder or genuine manufacturer) must be strictly monitored and punished.
Above all, the ancient or antique Drugs & Cosmetics Act should be made “web-enabled” and “internationally usable” by incorporating appropriate amendments with all ‘safeguards’ to make the dream of affordable access to rural masses and to make “Health for all by 2020” not just a slogan but a realisable goal. As suggested by me earlier, the large network of Indian post offices all over India can be made a partner in a Digital India enabled “e-medicine” portal which may as well, be promoted by the Government with high degree of transparency, without enriching the middlemen to eat away the ‘cream’ and leave the poor still “patiently suffering”. If there is an e-will, without an evil, we can fight the menace of non-accessibility of medicines to the poor in far-flung India, the e-way.
Digital India can be a success for pharma industry to penetrate all over India including neglected rural India, small towns and remote areas, provided legal and regulatory support is provided with supporting network of hardware and personnel. Indian pharma companies can avail the Digital India platform to establish contact with the patient population, get diagnosis done online, extend expert medical help including from specialist consultants, online. Mobile application-based innovations are getting commercialised currently for diagnosis, examination online and advanced consultations, monitoring and treatment. Digital India can be a success in the medical and pharma domain if the regulatory framework in India is also updated to support ‘web-enabled’ services including diagnosis, prescription, distribution and eventual door delivery of goods and services to patients.
– Dr Gopakumar G. Nair, Chief Executive Officer, Gopakumar Nair Associates