My liver transplant was performed in November 2020, and I have been on a specific regimen of medication ever since. My body recognizes the new organ as a foreign object, so my immune system could potentially attack it at any time. To prevent this, my doctors have prescribed immunosuppressive medications. I take two different immunosuppressant drugs and a steroid that acts as an anti-rejection medication. These drugs are Tacrolimus, Mycophenolate, and Prednisolone. The most common brand of Mycophenolate worldwide is Cellcept, produced by Roche.
Initially, my doctors prescribed Cellcept, but I experienced side effects including upset stomach and headaches. Consequently, they discontinued it. Since my transplant, I’ve primarily relied on Tacrolimus and Prednisolone. However, during the past four years, I’ve had occasional infections requiring Mycophenolate. While the standard brand is Cellcept, I’ve been taking Mycofit S, produced by the Indian company Intas Pharmaceuticals. Cellcept is available in 500mg and 250mg strengths, whereas Mycofit S comes in 360mg capsules.
Cellcept typically costs around ₹650-700 per strip of 10 tablets, with a print rate of ₹750. Some people report getting even better deals, purchasing it for as low as ₹550. Mycofit-S 360, on the other hand, has a print rate of ₹1,330 per strip of 10 tablets. Given this significant price difference, I’d aim for a substantial discount on Mycofit-S. A 30% discount would bring the price down to around ₹930, which is still higher than Cellcept but more reasonable. However, I’d personally negotiate for a discount closer to 40% to make it more comparable to Cellcept’s price range.
Due to their specialized nature, immunosuppressant medications can be difficult to find. Despite Varanasi having a large medicine market near BHU, I struggled to locate Mycophenolate last year. Eventually, I found a shop that carried Mycofit-S 360 and purchased it for ₹900 after a 30% discount. I was surprised by the price. Considering my previous experience with Cellcept, I anticipated a similar or lower cost for Mycofit-S 360. However, it was nearly twice as expensive.
Given the high print rate of ₹1,330, I initially accepted the ₹900 price without question. However, I had a gut feeling something was amiss. I contacted a friend who had also undergone a transplant and was taking Mycofit-S, but in the 500mg strength. To my surprise, he paid only ₹300 per strip, despite a similar print rate of around ₹1,400. This significant discrepancy between the print rate and the actual selling price was shocking.
My friend explained that these pharmacies often charge regular customers between ₹900 and ₹1000 for Mycofit-S 360. However, they offer significant discounts to repeat customers or those with personal connections. He introduced me to his pharmacy, where I’ve been purchasing Mycofit-S 360 for ₹275 per strip ever since. Incredibly, this pharmacy is located just 50 meters away from the one that initially overcharged me.
Print rate of Mycofit S 360
I purchased Mycofit-S from the new pharmacy for a month until my doctors determined it was no longer necessary. Unfortunately, my liver function tests have been unsatisfactory for the past month, and despite adjusting the medication dosage, my doctors have restarted Mycofit-S 360. I typically buy medications from the ILBS hospital pharmacy in New Delhi. However, to my surprise, they quoted me ₹850 per strip for Mycofit-S 360. ILBS is a semi-private hospital operated by the Delhi state government, where I expected to receive subsidized medicines.
Initially, I considered buying other medications at ILBS and purchasing Mycofit-S 360 in Varanasi upon my return. However, I was concerned about the availability of the drug in Varanasi and my deteriorating health, so I opted to buy it at the ILBS pharmacy for ₹850 per strip. Upon returning to Varanasi, I visited a local pharmacy and was shocked to find the same medication for ₹275 per strip. Questioning the drastic price difference, the shopkeeper claimed it was a coordinated exploitation by pharmaceutical companies, retailers, and the government.
He explained that pharmaceutical companies have free rein to set exorbitant prices, and there’s little to no oversight. They collaborate with retailers to create a deceptive marketing strategy. While companies sell medications at relatively low prices, retailers drastically inflate costs. These retailers can offer substantial discounts while still making enormous profits, keeping customers satisfied. Unsuspecting consumers believe they’re getting a great deal with a 30% discount, unaware that they’ve actually paid four times the reasonable price.
Mycofit S 360
India boasts a massive pharmaceutical industry with a stellar global reputation. However, this sector is also plagued by significant control issues. Contributing over 20% of the world’s pharmaceutical supply and meeting approximately 60% of global vaccine demand, India’s pharma industry is a cornerstone of healthcare. It supplies 40% of generic drugs to the US and a quarter of all medicines in the UK. Given its immense scale, it’s shocking to witness such a lack of oversight. This clearly indicates a substantial failure in government regulation.
It’s impossible to claim the government is oblivious to these unethical practices. They’re fully aware but seemingly indifferent to addressing the issue. Prime Minister Modi launched the Jan Aushadhi Kendra initiative to provide affordable, quality medicines. While offering generic alternatives at reduced costs, these centers unfortunately don’t stock all medications, including immunosuppressants. Had they done so, it would have been a game-changer for patients like me.
Life becomes prohibitively expensive after an organ transplant due to exorbitant medication costs and frequent hospital visits. Patients endure significant financial hardship, a reality that pharmaceutical companies seem to disregard. While pharmacies often overcharge, it’s essential to acknowledge the role of companies in setting inflated prices and the government’s failure to regulate the industry. Every patient I speak with expresses deep concern about the astronomical cost of their medications.
Immunosuppressive medications are a lifelong commitment, and I’ve observed that patients consistently seek ways to reduce costs. They explore different brands and alternatives to manage medication expenses, especially for Mycophenolate, the most expensive drug in the regimen. Exploiting the financial vulnerability of already suffering patients is unconscionable and must be stopped. However, considering the industry’s current practices, immediate hope for change seems elusive.