The sale of low-cost medicines repacked and labelled as expensive life-saving drugs poses a grave risk to public health and points to systemic failure. Such a racket would not have been possible without the active collusion of unscrupulous players across the supply chain, from raw material suppliers to retail units.
The Drug Enforcement Wing of the Karnataka Food Safety and Drug Administration (FDA) uncovered the network during an inspection near Bengaluru. The state FDA has cancelled 16 licences and suspended eight others belonging to wholesalers and retailers. Beyond blocking batch numbers on the FDA portal to prevent circulation, the top priority must be tracing and seizing counterfeit drugs already on pharmacy shelves or with patients. According to officials, a reputed pharma company is not cooperating with the investigation, withholding crucial information sought by the authorities, raising suspicions of non-compliance, if not outright complicity.
The government’s advisory urging consumers to buy medicines only from licensed pharmacies against valid tax invoices has come too late. Authorities should ensure that only genuine medicines are stocked on pharmacy shelves, while periodic inspections to check labels, barcodes, and QR codes on packaging would have acted as a deterrent.
Secondly, the offering of huge discounts by pharmacies should have set off alarm bells and prompted regulatory intervention much earlier. For some time now, pharma retailers have been demanding regulation of e-pharmacies since they were unable to compete with them on pricing. Thus, it should not take a scandal for authorities to monitor online platforms that lure gullible patients with steep price cuts while operating largely below the regulatory radar. It remains unclear if the FDA is equipped, both in terms of technical capabilities and legal provisions, to scrutinise their records or monitor their business.
The critical question is whether and how authorities verify that online platforms dispense genuine prescription drugs against valid prescriptions, especially given the ease of generating fake prescriptions using AI tools. This is an area of concern, and the government needs to initiate necessary steps, including expediting action on the draft e-pharmacy rules to regulate the online drugs trade.
The larger issue lies in the unusually high profit margins within the pharmaceutical industry, which can go up to 70% to 80%. Healthcare activists have been advocating against unfair pricing practices, which are arguably one of the main drivers for unsafe, unethical and questionable business practices such as exerting undue influence on physicians to prescribe expensive branded medicines when affordable generic alternatives are available.
The government has so far appeared to have been quite resistant to acting on rationalisation of trade margins, lending credence to allegations by activists that it is unduly biased in favour of the industry in the name of promoting ease of business and making India the so-called “pharmacy of the world”, rather than prioritising and adequately safeguarding the interests of the patients. Consumer education and patient empowerment should be done on a regular basis. Besides expanding barcode mandates, strengthening regulatory staffing and intensifying crackdowns on illicit manufacturing units, the government must update regulations and deploy digital surveillance tools to monitor e-pharmacies effectively.