Down to Earth – 1th to 15th April Summary - New Age Executives (Part - 2) (Download PDF)


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Head out - National Pharmaceutical Pricing Authority (NPPA), government’s drug pricing watchdog, triggered by a complaint filed by few patients who were charged extraordinary but did not find solution to their problem.

The report, released by NPPA says

  • Private hospitals are “looting” patients to maximise profits.

  • Syringe and needle distributors enjoy exorbitant profit margins

That day, NPPA chief Bhupendra Singh was transferred to the National Authority for Chemical Weapons Convention.

Treating For Money

NPA submitted two reports, after studying mainly 4 cases. The main points of the report are

  • Doctors intentionally prescribe non-scheduled drugs (not listed in the National List of Essential Medicine or NLEM) to maximise profits.

  • 25.67 % of the bill was for nonscheduled drugs and 4.1 % was for cheaper scheduled drugs.

  • The share of cost incurred on consumables, such as gloves, was more than double the cost of scheduled drugs

  • Most hospitals have opened pharmacies to pressure manufacturers to print inflated maximum retail prices (MRP)

  • Distributors on an average earn 516 % profits in syringes and needles.

NPPA had slashed the prices of coronary stents by up to 85 % in February 2017 and knee implants by up to 78 % in August 2017. It also recovered a huge amount as penalities from overcharging companies for overcharging drugs.

NPPA had also persuaded the All India Syringe and Needle Manufacturing Association to announce voluntary price caps which is being resisted by the Medical Technology Association of India.

Wrong Treatment

  • In 2015, NPPA released a list of 871 scheduled drugs under NLEM. Industry began releasing “new expensive alternatives” by “altering dose combinations”.
  • In 2013, NLEM list had 18 per cent of all the medicines in the market, today it has dropped to 10%.
  • Ministry of Chemicals and Fertilizers unsuccessfully tried to dismantle NPPA which was stopped after health activists alleged that the government was siding with the private healthcare lobby.
  • The government has removed two heads of the National Pharmaceutical Pricing Authority in the past four years. The move, health experts say, has only weakened the country’s lone drug pricing watchdog
  • Health activists are now demanding that the government should make the agency autonomous and fix a minimum tenure for its head


  • On March 9, 2018, the Supreme Court (SC) declared the right to die with dignity as a fundamental right and passed an order allowing End of Life Care (EOLC), passive euthanasia in common parlance, in the country
  • In passive euthanasia, the patient dies because the mechanism (life-support machines) that keeps the patient alive is removed. In active euthanasia, medical professionals, or a relevant authority, act upon a patient’s desire (such as giving an injection or medication) to die.
  • The bench of 5 judges, including Chief Justice of India Dipak Misra and Justice D Y Chandrachud issued guidelines in recognition of the “living will” made by terminally ill patient.
  • The living will should be signed in the presence of two attesting witnesses and counter-signed by the concerned Judicial Magistrate of First Class (JMFC).
  • In a case where the patient is bed ridden and there is no one to take care of, if the patient requests for active euthanasia, which is illegal in India, though legal in some countries.

Harrowing legal Paths

  • If the executor of the will becomes terminally ill and is undergoing prolonged medical treatment with no hope of recovery, the doctor shall constitute a board consisting of experts of general medicine, cardiology, neurology, nephrology, psychiatry or oncology with experience in critical care on the request of family members.
  • After the certification of the board, the district collector concerned will constitute a board of medical experts. After the consent of the second board, the last call will have to be taken by JFMC.
  • If the permission to withdraw medical treatment is refused by the hospital’s medical board, the family members of the patient can approach the high court concerned.
  • The court will form a board of medical experts who shall submit their report. The court, in turn, would take a final call.
  • In cases where there is no advance directive, the process shall remain the same and the doctor treating the patient would be responsible to inform the hospital about constituting a medical board.
  • The will can also be changed any number of times or it can be revoked by the executioner.
  • The complex legal formalities have to be simplified if terminally ill patients are to be provided the right to die with dignity and their caregivers the right to let their loved ones go with dignity.

Fresh Comes Calling

  • A few e-shops are changing the way wet markets operate by offering fresh, chemical-free fish, poultry and meat at the doorstep.
  • Customers increasingly prefer buying fish, steak or fillet online.
  • The e-shop provides detailed description of the product and is delivered in a eat and sealed pouch. The e-shop also assures customers that the product is fresh and of good quality, but the charges are more compared to the conventional shops.
  • e-shops which were launched as small start-ups, have expanded and grown exponentially in just a couple of years. For example: FreshToHome and Licious launched in 2015, the brands have their presence in Hyderabad, Gurugram, Delhi and Bengaluru.
  • The annual turnover of the companies have increased many folds. 90 % of the business comes from repeat customers.
  • Similarly ‘TenderCuts’ in Chennai launched in 2016, which has 7 outlets covering 60 locations.

Beating The Game Of Time

  • Traditionally the time the catch comes to the shore and is delivered to markets, the fish is about three weeks old.
  • The e-shops partners with small scale fisheries and meat producing farmers, Post procurement, the products are airlifted and stored in cold storages at 0 - 40C till the time of delivery.
  • To ensure that the products do not get spoiled during transit, Licious uses IOT (internet of things) device to keep a tab on the temperature of the delivery box, while TenderCuts uses gel packs.

Stringent Quality Check

  • e-shop companies perform atleast 30 quality checks in the farm at the time of collection. The products are tested again in the meat processing factory to ensure that they are free of toxins. The products are then cleaned properly in reverse osmosis water and vacuum packed.
  • Companies have cancelled their contacts with few local fishermen, after the product was tainted with toxins.
  • The e-stock companies educate the live stock rearers on breeds, feed and land types fro grazing animals. And have brought butchers and fisher-folk into mainstream by providing them with stable income, bank accounts and insurance facilities.
  • e-shop companies also obtain quality check reports from Food Safety Authority of India (FSSAI) and biotic = free certification from Eurofins, a world-wide lab testing services.

It’s Farmers Inc

  • Decades of agrarian distress and failure of cooperatives have made marginal farmers take charge and form companies.
  • Bahulaone Agro Producer Company Ltd in Bahul town of Maharashtra, around 10, 000 farmers are shareholders of the company that sold fruit and vegetables at a 20 % profit in 2017 - 18 and had a turnover of about Rs. 1 crore
  • THE Union finance minister announced a five-year tax holiday for farmer producer companies (FPCs) in Budget 2018 - 19
  • 5, 000-odd FPCs have mushroomed across the country in the past two decades, according to the Union Ministry of Corporate Affairs. Also known as FPOs.
  • FPCs aggregate crops from member farmers and sell. Since they deal in bulk, FPCs are better placed to negotiate the selling price, and make more profits. The profits go directly to farmers because they own and run the companies
  • Swaroop Shetkari Producer Company Ltd (sspcl), an FPC based in Sultanpur block of Aurangabad district, Maharashtra is a part of Maha Farmers Producer Company Ltd (MAHA-FPC), a group of 150 FPCs of Maharashtra.
  • Recognising the reach of MAHA-FPC, the state government authorised it to buy pulses from farmers at MSP on its behalf in February 2017, breaking the decades-old monopoly of traders in 14 districts, particularly in the Marathwada region.
  • Mandla Tribal Farmer Producer Company Ltd (MTFPCL) that has helped farmers in 29 villages in Madhya Pradesh’s Mandla district, one of the poorest in the country.
  • Action for Social Advancement (ASA), a non-profit based in Bhopal, helped Mandla farmers form the FPC in 2012, which is helping farmers to start farming again, which they left because of insufficent income.
  • In Gujarat, 135 fisherfolk formed a first-of-its-kind FPC in 2013 and were able to more than double their income in the very first year.

The Origins

  • FPCs were conceptualised in 2001 by the late Verghese Kurien, a former IAS officer who took voluntary retirement in 2011 and launched Sabziwala, a fruit and vegetable retail chain that buys directly from farmers.
  • Kurien created the milk cooperative Amul, but later realised cooperatives were vulnerable to political influence.
  • In 2002, the NDA government enacted the Producer Companies Act. Though the Act came in 2002, the real push from the government came a decade later, in the 12 Five Year Plan for 2012 - 17.
  • The rise of FPCs is evident in SFAC data. In 2011 - 12, SFAC promoted seven FPCs, while the figure for 2017 - 18 was 807.
  • International Fund for Agricultural Development, a UN agency, has funded 240 farmer related projects across the world, especially in Africa.
  • The cooperative model does not seem effective in the agriculture sector, FPCs have shown promise.

- Published/Last Modified on: May 12, 2018


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