Policy Recommendations

C-3 : Access to Healthcare and Competition
  • Competition enforcement and policy efforts to promote and protect competition will be vital to manage the impacts of the COVID-19 crisis and create the best environment for economic recovery.
  • In the pharmaceutical trade, the practice of evergreening is problematic and harming access and affordability of medicines. Also, in Pakistan, specifying where passengers should get COVID-19 tests needs to be stopped as it is impacting competition.
  • Competition policy has, overtime, been a key intervention tool in addressing market inefficiencies and rising prices in the healthcare markets. It is high time to start the conversation about intellectual property rights within competition authorities.
  • The COVID-19 pandemic has shown that if cost of the required pharmaceuticals is not competitive and affordable, there can be global heath catastrophe. Recent steps taken by Indian and South Africa in the WTO calling for the suspension of protection of IP-related to COVID-19 health products (though unsuccessful) signals the need to look broadly into measures necessary for equitable access to healthcare and acceptable pricing practices.
  • To keep the market competitive, competition law enforcement alone may not be sufficient. First thing that is needed is an enabling policy environment that promotes competition in the market, including removal of entry barriers and market distortions, and inducing ease of doing and running businesses. to enhance access to healthcare, understanding that access to healthcare is largely dependent on its ‘availability’ and ‘affordability’. It is all the more important and relevant in the wake of COVID-19 pandemic.
  • Price regulations of drugs where generic competition is available, will kill market contestability. Price regulation needs to be used as last resort in case of market failure.
  • Doctors prescribing in brand name pose hurdles to competition. Though they may be doing so due to ‘trust’ on quality, a nexus with pharma companies cannot be ruled out. In order to engender confidence in doctors, it would be wise to invest in drug quality regulation, so that there is no trust deficit.
  • A standard treatment guide would contribute to transparency by removing information asymmetries, and could reduce cost of healthcare. Hence, better access to affordable healthcare.
  • Discourage the practice of fixing trade margins by distributors associations.
  • Leniency schemes should be advocated to bust the cartels present in the pharmaceutical supply chain.
  • Strengthen competition advocacy to address information asymmetry.
  • UNCTAD recommends five key actions: 1. Ensure a level playing field between competitors
    2. Temporarily allow cooperation arrangements to ensure the supply of affordable products.
    3. Closely monitor markets to ensure availability of essential products.
    4. Vigorously enforce competition law against businesses that take advantage of the crisis
    and 5. Adapt competition procedures and deadlines to the circumstances created by the pandemic.
  • There is a need for greater stakeholder involvement in the World Intellectual Property Organization to ensure participation in decisions regarding healthcare services.
  • The Government of Pakistan needs to integrate consumer protection policy and competition policy to ensure justice in accessing healthcare and competition. It also needs to focus on enforcing consumer protection policy and probation laws in order to ensure consumer gains.
  • The policy makers, sector regulators and competition law regulators need to prioritize affordable healthcare to ensure providing fundamental right of life to citizens.
  • Stakeholders need to focus on enabling policies for increased government expenditures in healthcare sector to ensure health services.
  • The government needs to focus on competition issues in pharmaceuticals and healthcare markets in order to address them properly.
  • There is need for competition authorities and competition policy to have active engagement with healthcare service regulators and pharmaceuticals in order to ensure affordable and accessible healthcare services.
  • There is a need to enable the rights of consumers and manufacturers to ensure justice.