Too much of a 'good' thing

The alternative drugs industry is booming in India, keeping with the global trend as the pharmaceutical products such as drugs, vaccines, syrups and injectables are increasingly under global scanner for their side effects — ranging from bad to severe. Physicians rarely explain the side effects of prescribed medicines to patients. So-called prescription drugs are easily available over the counter at most medicine shops. Unfortunately, the government and industry bodies are yet to take full note of the growth of the country's alternative drugs market, comprising Ayurvedic medicines and therapies, homoeopathic drugs, Unani products among several others. Thanks to the listless approach by the government and regulators, the industry is showing an undesired and haphazard growth. A large number of dishonest operators, manufacturers and traders are making it big right under the nose of the authorities. Gullible drug consumers influenced by advertisements are being taken for a ride. Significantly, little do such operators show care or respect for public health and the government's tax laws. This is also considerably impacting the business of genuine manufacturers of alternative medicines.

Two years ago, a study by the Confederation of Indian Industry revealed that the gross market size of the country's Ayurveda sector was around $4.4 billion or roughly Rs 32,000 crore. Some 10 years ago, the Associated Chambers of Commerce and Industry did a study of the domestic homoeopathic drugs business and estimated the market size at around Rs 12.5 billion, less than 10 per cent of the global market of homoeopathic medicines in 2010. The study said the country's homoeopathic drugs industry was growing at the rate of 25-30 per cent as against the pharmaceutical industry's annual growth of 13-15 per cent. There is no reliable picture of the market for Unani medicines. Many in the industry feel that the current size of the alternative medicines market would be as large as Rs 90,000 crore.

Although the current government has shown deep interest in promoting alternative medicines by bringing them under the AYUSH streams (Ayurveda, Unani, Yoga, Naturopathy, Siddha, and Homeopathy), a lot more need to be done to use their full potential, improve reliability, help make them pocket-friendly and influence people to try these ancient form of medicines. Increasing budget allocations to the AYUSH ministry to develop education and research in these areas of medicines and opening institutions are not helping the cause for want of qualified teaching doctors. Almost the entire alternative drugs industry is growing on advertisements through media, hoardings, posters and roadshows, mostly around rural market sites. Though no one knows the source of the latest official estimates, the present market size of AYUSH products was stated to be around $10 billion in 2017. The government expects the market to grow by 50 per cent by 2020-end.

An interesting part of the growth of the alternative drugs market is that the focus seems to be more on cosmetics than drugs. This is more so in the case of Ayurvedic and Unani products. Homoeopathic and biochemical product manufacturers are more focused. Their business has been brisk. For instance, Haridwar-based SBL Private Limited is India's biggest homoeopathic drugs manufacturing firm. Its operating revenue range is said to be close to Rs 500 crore. The company's products and services include a host of homoeopathic drugs, mother tinctures, dilutions, bio-chemic, speciality tablets, liquids, ointments, herbal products and cosmetics. Kerala-based HOMCO, the country's only state-sector homoeopathic drugs maker, boasted a turnover of nearly Rs 40 crore and profit of over Rs 6 crore in 2018. It is now setting up India's single largest homoeopathic medicine factory in Kerala, involving local farmers for cultivation of homoeopathic medicinal plants. HOMCO's turnover is expected to go up to Rs 125 crore. Other well-known homoeopathic drugs manufacturers include Willmar Schwabe India, Reckeweg, Bahola Lab, Bakson, Medisynth, Ramkrishna, Fr. Muller Homeopathic Pharma, Hannemann Publishing (Hapco) and Mahesh Bhattacharya. The expensive German brands are lately gaining a share of the homoeopathic drugs market. While most German brands are actually made in India, the market also directly imports drugs from Dr Willmar Schwabe of Germany.

Unani medicines are probably the most unique. The practice originated in ancient Greece and is now followed primarily in India. It offers herbal remedies, dietary practices and alternative therapies. According to Unani medicine practitioners, achieving a balance of the bodily fluids known as "the four humors" (blood, phlegm, yellow bile, and black bile) is essential to health. A key principle of Unani medicine is that disease results from an imbalance in air, earth, water and fire, four elements thought to comprise all that exists in nature, including the human body. Unani medicine is also partly based on the principle that environmental conditions, including the quality of water and air, can significantly impact health. Among the well-known producers of Unani medicines are Tayyebi Dawakhana Unani (Indore), Avni Herbals, Amar Pharma and Shahi Labs.

Lately, Ayurvedic products have been so popular that even the US multinational, Colgate-Palmolive, the world's largest toothpaste and dental cleaning agents marketer, had to launch a special Ayurvedic Colgate toothpaste brand — Vedshakti — to protect its market share in India. Ayurvedic products have become the latest craze among Indian consumers, locally and globally. India's export of Ayurvedic and herbal products in 2018-19 was close to $450 million. Manufacturers are mushrooming. The government and regulators seem to have totally failed to regulate the market, product quality and prices. This is affecting established Ayurvedic companies such as Dabur, Baidyanath, Himalaya Wellness, Hamdard, Ganga Pharma, Patanjali, Arya Vaidyasala (Kotakkal), Zandu, Hoolone Remedies and Emami. The AYUSH ministry, which proliferated since the BJP-led government came to power in 2014, seemed to have failed in its objective as the Ayurvedic market is getting flooded with untested and ineffective products. The quality of research is poor. Drugs are launched without any rigorous pharmacological studies and meaningful clinical trial. The country's rural population appears to be the biggest victim.

Views expressed are strictly personal