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INTRODUCTION
Essential drugs are the foundation for nearly every public health programme aimed at reducing
morbidity and mortality in Bangladesh as well as in the developing world. But about one third of
the worlds population lacks regular access to medicines of a suitable quantity and quality. In
poorer areas of Asia and Africa this figure may be as high as one-half. As a result, millions of
children and adults die or suffer needlessly, although their diseases could have been prevented or
treated with cost-effective and inexpensive essential medicines and the high disease burden in
developing countries such as in Bangladesh is slowing economic growth and worsening poverty
levels.
Irregular access to high-quality essential medicines is an important issue in many countries. The
major cause is either because these are not available or are too expensive, or there are no
adequate facilities or trained professionals to prescribe them; or this may be due to inefficient
pharmaceuticals policy and management systems, poor selection, bad distribution and use,
geographical barriers, lack of resource funding, especially in the public sector, or to a
combination of these.
Although a well-documented Drug Policy and a Drug Administration system including pricing of
drugs are available in Bangladesh, there are pricing differentials of drugs and, availability and
use of essential drugs are very often lacking even at different levels of health care facilities .
There is also limited awareness among related government officials about the impact of relevant
trade agreements (TRIPS: Trade- Related Aspects of Intellectual Property Rights) and
globalization on access to essential drug.
The pharmaceutical sector of Bangladesh is expanding rapidly and some companies have already
certified by different international regulatory authorities like UK-MHRA, Australia-TGA, EU,
etc. for quality management and quality products manufacturing. Moreover, few companies are
on the road to achieve US-FDA approval. According to the information of the Director General
of Drug Administration of Bangladesh (DGDA), there are 263 Allopathic drug manufacturing
companies in Bangladesh; 209 of which are functional, 29 companies are non-functional and 25
companies are suspended in status., Pharma sector has become the 2nd largest potential sector in
Bangladesh to earn foreign currency. At present, about 30 pharmaceutical companies have started
their export activities.
In this report the current scenario of essential drug production of Bangladesh has been presented
along with an analysis of its opportunity and challenges.
Bangladeshs pharmaceutical industry contributes almost 1% of GDP. It is the third largest tax
paying industry in the country. Bangladeshi pharmaceutical firms focus primarily on branded
generic final formulations using imported APIs (Active Pharmaceutical Ingredients). About 80%
of the drugs sold in Bangladesh are generics and 20% are patented drugs. The country
manufactures about 450 generic drugs for 5,300 registered brands which have 8,300 different
forms of dosages and strengths.
Market Players
Domestically, Bangladeshi companies including the locally based MNCs produce 95%-97% of
the drugs and the rest are imported. Although about 250 pharmaceutical companies are registered
in Bangladesh, less than 100 are actively producing drugs.
The domestic market is highly concentrated and competitive. However, the local manufacturers
dominate the industry as they enjoy approximately 87% of market share, while multinationals
hold a 13% share. Another notable feature of this sector is the concentration of sales among a
very small number of top companies. The top 10 players control around two-third of the market
share while the top 15 companies cover 77% of the market. Square Pharmaceuticals is the stand out
market leader with a market share of 19.3% which posted domestic revenue of BDT 11.2 billion in the
last four quarters (Apr 09 - Mar 10). Their nearest competitors are Incepta Pharmaceuticals and Beximco
Pharmaceuticals with market shares of 8.5% and 7.6% respectively. Incepta and Beximco had BDT 4.9
billion and BDT 4.4 billion in domestic sales for the last four quarters. Although a number of MNCs are
operational in Bangladesh market, no MNCs are in the top ten in terms of domestic sales.
Figure : Market share concentration
API Manufacturing
In most cases, APIs have to be imported from abroad.The leading manufacturers are therefore
going into API manufacturing, focusing mainly on Antibiotics, but also other drugs, such as anticancer drugs.
Distribution Channels
Basically, there are three distribution channel systems in Bangladesh: public hospitals, private
hospitals and private pharmacies. Public hospitals source mainly from the state-owned Essential
Drugs Company Limited (EDCL), whereas private hospitals and pharmacies source from the
private sector. However, public hospitals can also source from private pharmaceuticals through
tender bids.
Retail-sales of drugs in Bangladesh are allowed only under direct supervision of a pharmacist
registered with the Pharmacy Council of Bangladesh. The licenses for retail pharmacies and for
wholesalers are also being controlled by the Drug Administration of Bangladesh. There are close
to 76,000 licensed retail pharmacies in the country, and an estimated 125,000 unregistered retail
pharmacies. In addition, drugs like antibiotics can also be found in village shops etc. without
proper supervision. Whereas the law foresees no OTC drugs, requiring all drugs to be dispensed
through a prescription, in fact all medicines are available without any prescription.
Bangladeshs drug distribution marketplace is composed of small independent pharmacies.
Pharmaceutical firms can sell their products to private sector pharmacies, the government and its
Drug Regulation
The Directorate of Drug Administration (DDA), the national drug regulative authority, regulates
drug manufacturing, import and quality control of drugs in Bangladesh. It belongs to the
Ministry of Health and Family Welfare.
The Directorate issues licenses for import of raw materials for different drugs and packed drugs
from a selected list to pharmaceutical companies and importers. It also monitors quality control
parameters of marketed drugs through an agency called the Drug Testing Laboratory.
DDA also administers vaccines and the indigenous systems of medicine called Ayurvedic and
Unani systems. The Homeopathic system of medicine is not, however, under the regulatory
control of the Directorate. Prevailing laws regarding drug regulations are as follows:
National Drug Policy 1940
Drug Act 1940
Drug Control Ordinance 1982
Drug Control Ordinance 2004
National Drug Policy 1982
satisfied that such a medicine is substandard; (vi) the government may, by notification in the
official gazette, fix the maximum price at which any medicine may be sold and at which any
pharmaceutical raw material may be imported or sold; (vii) no person is allowed to manufacture
any drug except under the personal supervision of a pharmacist registered in the Pharmacy
Council of Bangladesh; (viii) no person, being a retailer, is allowed to sell any drug without the
personal supervision of a pharmacist registered in any Register of the Pharmacy Council of
Bangladesh; and (ix) the government may, by notification in the official Gazette, establish Drug
Courts as and when it considers necessary.
that do not have an own production facility in Bangladesh are not allowed to market their
products.
Price Control: 150 drugs were defined as essential drugs. For those, level prices are fixed for
the finished drugs as well as for their corresponding raw materials. No manufacturer can set
maximum retail prices for their goods beyond that limit. However, currently there are 209 drugs
on the essential drugs list. For drugs that do not fall into this Controlled Category, the
manufacturer can set their own price, which must, however, be approved by the Drug Control
Committee.
Major Exporters
The majority of Bangladeshs pharmaceutical exports are from MNCs such as Sandoz. Sandoz,
an MNC operating in Bangladesh, has approximately 25 manufacturing sites globally.
Bangladesh is one of its smaller sites. The Bangladeshi manufacturing site is an EU certified
plant which produces about 500 million tablets a year and generates about USD 35-40 million in
sales. It has been growing rapidly15-18% per yearand is responsible for a significant portion
of Bangladeshs pharmaceutical export growth. It imports APIs, acquires packaging
domestically, and manufactures final formulations in Bangladesh for export of USD 12 million
or for sale to the domestic market ranging from USD 23-28 million.
Most pharmaceutical firms in Bangladesh are family owned. While many have the capacity to
export, some do not have the in-house expertise. As a result, only sixteen firms export products.
There are no majority exporters, e.g., companies that sell more than 50% of their output in
export markets. Beximco, for example, is one of the leading exporters. Its 2009 exports were
about USD 4.0 million or 5.9% of total sales. The export situation is evolving. For example,
Square Pharmaceuticals increased exports by 58% from 2007-08 to 2008-09.
Contract Manufacturing
Contract manufacturing is a good business opportunity for Bangladeshi firms, and if well done, it
can enable technology transfers to domestic firms. Square Pharmaceuticals, one of Bangladeshs
largest pharmaceutical firms, attributes much of its success to what it learned by working with an
MNC.
Bangladeshi pharmaceutical firms can make several types of contract manufacturing
arrangements with MNCs, including:
Contract manufacturing with the product intended for export to a regulated market. The current
National Drug Policy (NDP) permits this. Contract manufacturing for export is a significant
financial opportunity, but challenging. Square Pharmaceuticals is one of the very few
Bangladeshi firms with a qualified facility. It is currently initiating a contract manufacturing
arrangement with a British firm.
Contract manufacturing with the product intended for the domestic market. The Drug Control
Ordinance (DCO) prohibits foreign firms from selling products in Bangladesh unless they have a
manufacturing presence in the country. Thus, Bangladeshi firms can only contract manufacture
for domestic distribution with MNCs that already have a presence in Bangladesh. An example of
For those drugs that are not subject to a fixed price, there is considerable price sensitivity in
Bangladesh, which is explained by the very high variation in quality with significant incidents of
health-damaging spurious drugs and fake drugs that contain no active ingredient.
Thus, it is not uncommon for the high quality branded generics of the leading manufacturers to
have a 100% price premium over their competitors. In some cases the premium is even higher.
Unmet Demand
The demand for essential drugs in Bangladesh is largely covered. In accordance with the above,
in many cases the cheap availability of essential drugs without adequate health care
infrastructure is not without problems.
The global need for essential drugs is huge in theory and the actual demand depends to a large
extent on financing possibilities and mechanisms, which are difficult to foresee in detail, but the
creation and dedication of funds and institutions like e.g. the Global Fund to combat AIDS,
Malaria and Tuberculosis, justify a significant growth expectation for the actual demand. It is
also to be expected that wherever donor funds are directly used to purchase drugs (as e. g. the
Global Fund or the Gates Foundation), the demand will come with such quality requirements that
would put a country like Bangladesh with a good track record and a lot of experience at
advantage over African LDCs that are only just entering the business of pharma manufacturing.
result, there is a large number of very small scale manufacturer present in the industry. These
manufacturers focus mostly on a handful of basic and essential drugs.
Challenges:
Access To Essential Drugs
Although official documents indicate that 80 per cent of the population has access to affordable
essential drugs . there is plenty of evidence of a scarcity of essential drugs in government
healthcare facilities. One study conducted in four district hospitals and one medical college
hospital showed that only eight per cent of patients received the prescribed medicines from these
facilities.In another report, two major hospitals in the capital city of Dhaka were operating
without essential medicines for eight consecutive weeks.
of dexamethasone eyedrops extends from Tk 24 to 90 (US$ 0.34 to1.29) per 5ml, and diclofenac
eye drops are available at a price range from Tk 40 to 200 (US$ 0.57 to 2.86) per unit (6). These
are a few of the existing price discrepancies in the country.
TRIPS
The WTOs Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS)
requires all signatories to legislate twenty-year patent protection for pharmaceutical products into
their domestic law.. While signatory countries must meet its requirements through legislation,
TRIPS provides significant flexibility.
Until 2016, TRIPS provides Bangladesh with domestic, patent-free production rights and limited
exporting advantages. Bangladesh imports approximately 80% of its APIs for domestic
production, 20-25% of which are patented. These API costs will most likely rise as TRIPS phases
in.
Bangladesh enjoys some export advantages from TRIPS. But these advantages are somewhat
offset by the pace and competitiveness of the Indian and Chinese generic markets. In both
markets, companies can produce drugs at highly competitive pricingeven with higher costs
associated with buying patented APIs or paying royalties.
Conclusion
The essential drugs market in Bangladesh is well supplied, and there is no availability problem of
essential drugs. Partly due to the failure of the local authorities to provide credible quality
certifications, and partly due to their aspiration to increasingly target export markets, leading
Bangladeshi manufacturers are already successfully working on obtaining international quality
certification for their products and plants, in some cases bringing in experienced experts from
MNCs or Indian competitors.
The ability of the Bangladeshi drug industry to manufacture drugs for all kinds of needs is
beyond doubt. While some manufacturers are already able to produce world class quality drugs,
others would require considerable assistance to be able to reach that target. However, the
Bangladeshi industry has been largely focused on the domestic market until recently.
In terms of cost, Bangladeshi companies can be expected to compete successfully with African
players, especially if an international quality standard is required. The ability to compete with
Indian and Chinese manufacturers is limited due to the necessity to import machinery and
notably the precursor substances. The ultimate competitiveness of Chinese and Indian
manufacturers depends on the expected rigor of the TRIPS enforcement, the viability of
voluntary or compulsory licensing for Indian and Chinese players, and the amount of license fees
they would have to pay, and the competitiveness of Bangladeshi manufacturers will largely
depend on the pricing of the raw materials. Still, Bangladesh is probably one of the few LDCs
where under the TRIPS agreement new patent protected drugs and APIs can be cost-effectively
produced and at high quality.
Thus, Bangladesh is a natural candidate to supplement or substitute Indian and Chinese providers
to the developing country markets of both finished drugs and APIs, notably in antibiotics, antiulcerants, anti-hypertensives and anti-depressants. However, the domestic market is large enough
to be self-sustaining and lucrative for the domestic players until they become ready to take on the
global pharmaceutical market.
Inadequate supply of essential drugs, substandard quality uncontrolled drug prices and
inappropriate uses of drugs are major problems in Bangladesh. The drugs control authorities
should be better equipped and more vigilant to cope with the situation. Health professionals and
drug manufacturers should be more committed in order to achieve the goals of the NDP.
REFERENCE
Essential drugs in Bangladesh and role of different stake holdersa qualitative study,
International Journal of Science, Environment and Technology, Vol. 1, No 5, 2012, 506
518.
Essential drugs:economics and politics in international health, Micheal R.Reich
Therapeutic drug use in Bangladesh: policy versus practice, Mohammad Saidul Islam,
Indian Journal of Medical Ethics Vol V No 1 January- March 2008
Essential drugs production in Brazil, Russia, India, China and South Africa (BRICS):
opportunities and challenge,Zoheir Ezziane.IJHPM(International Journal of Health Policy
and Management)
Parvez M Chowdhury ,An overview of the pharmaceutical sector in BangladeshAn
Bangladesh July 2010,BRAC EPL STOCK BROKERAGE LTD