Keeping medicine prices as low as possible cannot be the sole goal of drug policy, experts say. Instead, they argue, a policy framework is needed that ensures patients can access necessary medicines within their means while allowing manufacturers to sustainably continue producing and supplying quality medicine. To that end, experts have called for a scientifically grounded essential medicines list, transparent and predictable price-setting, regular price reviews, uninterrupted supply, and financial protection for patients.
According to these experts, medicine prices must remain within patients’ reach, but manufacturing companies must also be given room to survive. If prices are kept artificially low, they say, production could decline and create shortages in the market. If prices are too high, on the other hand, patients’ treatment costs will rise. A balanced medicine policy is therefore needed that weighs the interests of both sides.
These points emerged at a policy dialogue titled “Medicine Within Patients’ Reach, Sustainability for Manufacturers: In Search of a Balanced Medicine Policy,” held Tuesday at the CIRDAP auditorium in the capital. The dialogue, organized by the Public Integrity Network for Evidence and Transparency (PINET), brought together public health specialists, health economists, researchers, members of parliament, representatives of professional organizations, media figures, pharmaceutical industry representatives, lawyers and civil society representatives.
The keynote paper was presented by Professor Syed Abdul Hamid of Dhaka University’s Institute of Health Economics. He said the formula used to set prices for 117 medicines since 1994 was designed around the realities of 1982. Even as production, energy, transport and research costs have risen, the formula’s markup has not changed. In 2016, the essential medicines list was expanded from 117 to 285 items, but the newly added medicines were not brought under the earlier pricing mechanism. The list stood at 285 in 2016 and 295 in 2026, but not all medicines on it were previously subject to price controls. He said phased price adjustments and annual alignment with inflation are essential.
Professor Syed Abdul Hamid said keeping medicine affordable for patients and ensuring the sustainability of the pharmaceutical industry are not conflicting goals — rather, they are two essential objectives of the same public health policy.
He said the goal of drug policy should not be to set the lowest possible price. The goal should instead be a sustainable price that patients can afford and that allows manufacturers to sustainably produce quality medicine.
Noting that Bangladesh’s pharmaceutical industry’s biggest challenge is its dependence on foreign active pharmaceutical ingredients (APIs), Professor Syed Abdul Hamid said production costs rise whenever there are problems importing raw materials from India and China, or instability in international markets. Energy, transport, shipping and import costs are rising as well, he said, and these realities must be factored into pricing policy.
Noting that more than 70% of people’s health spending in Bangladesh comes directly out of pocket, he said nearly 60% of that spending goes toward medicine. But he said reducing medicine costs cannot be achieved through price cuts alone — selling medicine without a doctor’s prescription, self-medication and irrational drug use must also be stopped. He also emphasized ensuring medicine availability at government hospitals. In his view, financial protection for patients is not the responsibility of pharmaceutical companies alone — the government, too, must build a healthcare protection system for the poor, alongside ensuring the quality, safety and rational use of medicine.
Noting that drug policy’s goal should not be price reduction alone, he said three things must be ensured together: medicine within patients’ reach, uninterrupted supply, and sustainability for manufacturing companies.
At the event, National Professor A.K. Azad Khan said blaming pharmaceutical companies alone for medicine prices and shortages will not solve the problem. There is no room for a blame game here, he said — companies have to operate in various ways simply to survive in a competitive market. Noting that it is the government’s responsibility to ensure medicine availability and affordable prices, he said the Directorate General of Drug Administration must also become more professional and robust. He said effective measures are needed to control medicine quality and prices, and that marketing practices that offer doctors unethical incentives must be stopped. Ensuring the public has access to essential medicines is the government’s responsibility, he said, and while the industry should be encouraged, violations of rules must be strictly enforced.
Bangladesh Jamaat-e-Islami MP Mohammad Mosleh Uddin Farid said that to ensure healthcare for all, essential medicines must be made accessible to the public. He said there are concerns that medicine costs in the country could rise after 2030 because of intellectual property rules, so preparation needs to begin now. Calling for coordinated work between the government, the pharmaceutical industry and other stakeholders on the essential medicines list and supply, the lawmaker said the funds allocated to the health sector must be fully utilized, investment in research and development must increase, and regular dialogue and engagement from policymakers is needed on this issue.
Public health expert Mushtaq Hossain said the government should not rush in setting medicine prices, and that the 2026 pricing policy should also take the essential medicines list into account. He noted that many medicines and antibiotics on the older list have since been discontinued, so the policy needs to be reviewed in light of current realities. He said medicine prices should be set so that production costs are covered and companies can earn a reasonable profit, while also taking people’s purchasing power into account.
Noting that low-income people should receive medicine for free and the middle class at subsidized rates, Mushtaq Hossain said government institutions responsible for supplying essential medicines need to be strengthened further.
Mamunur Rahman Malik, World Health Organization representative and head of mission, said the essential medicines list needs to be updated regularly as new scientific and medical information emerges. He said availability, affordability, safety and quality of medicine must all be ensured, while also emphasizing pharmacovigilance, rational drug use, stock management and strengthening demand forecasting.
Supreme Court lawyer Shishir Monir said that on matters of national importance such as the essential medicines list and price-setting, objectionable provisions should be amended rather than abruptly scrapping decisions altogether. He said legal processes and court rulings should also be properly taken into account in this regard.
Syed S Kaiser Kabir, vice president of the Bangladesh Association of Pharmaceutical Industries and executive director of Renata PLC, said that modestly reducing medicine prices will not deliver major savings for the poor. He said providing free medicine to the poor for long-term illnesses and cancer treatment would be more effective. Forcibly lowering prices risks halting production, he said, adding that Bangladesh’s medicine prices are comparatively low by international standards. He said the market should instead ensure competition while increasing government support for the poor.
Md Mizanur Rahman, executive director of Square Pharmaceuticals, said that if domestic production is disrupted in the process of lowering medicine prices, it will create a major crisis. He said roughly 98% of the country’s medicine demand is met locally. Around 35 billion taka worth of medicine is consumed monthly, he said, yet per capita spending remains below 200 taka. He said the real-world impact of any price-reduction decision needs to be assessed before it is made.
Dhaka University Emeritus Professor Chowdhury Mahmud Hasan said that, rather than controlling medicine prices, it is essential to ensure competition and quality in the market. He said the country’s pharmaceutical industry advanced precisely because of the benefits of deregulating medicine prices in 1994. Rather than pressuring for irrational price cuts, he said, support should be given to the poor, while unethical marketing by companies, unethical incentives for doctors, and irrational medicine management must be stopped. He also called for boosting domestic API production to reduce import dependence.
Professor Mahmud Hossain said an effective medicine policy is needed to control price, quality and rational use of medicine in order to ensure medicine is within people’s reach, while also stopping unethical marketing.
Other speakers at the dialogue included National Health Alliance convener Professor Shadrul Alam; Abu Mohammad Zakir Hossain, a former member of the Health Sector Reform Commission; Zahirul Islam, secretary general of the Doctors Association of Bangladesh (DAB); Professor Dr Mahmud Hossain, secretary general of the National Doctors Forum (NDF); and Professor Dr Mostafizur Rahman, president of the BCS Health Forum, along with various other leaders of the BCS Health Forum.
বাংলায় মূল প্রতিবেদন পড়ুন · Read the original Bengali report