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Rare Diseases in India:Time for Cure-Driven Policy Initiatives and Action


Affiliations
1 Department of Biology, Ashoka University, Sonepat 131 029, India
2 Department of Biology, Indian Institute of Science Education and Research, Pune 411 008, India
 

India is estimated to have a large number of patients suffering from rare diseases (RDs). More than 95% of such diseases are incurable. In many cases, the available treatments are expensive and often have to be provided lifelong to the patients. As a result, the direct and indirect costs of these diseases are significantly high, adding to the country’s socio-economic burden. It is time for India to implement healthcare policies that are focused on encouraging domestic production of drugs against RDs and finding innovative cures for them. This article delineates the existing social, economic and policy scenario governing RDs in India.It also examines someof the global policy approaches in this field. Taking a cue from such international practices, this article advocates the need for a comprehensive regulatoryframework for RDs in India with the ultimate goal of ensuring ‘cure for all patients’.

Keywords

Diagnosis and Treatment, Health Policy Initiatives, Orphan Drugs, Rare Diseases.
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  • Khosla, N. and Valdez, R., A compilation of national plans, policies and government actions for rare diseases in23 countries. Intract. Rare Dis. Res., 2018, 7(4), 213–222.
  • Katoch, V. M., Majumder, P. P. and Bhattacharya, A., Rare diseases need our attention. Curr. Sci., 2016, 111(1), 7–8.
  • MOHFW, New drugs and clinical trial rules. Ministry of Health and Family Welfare, Government of India (GoI), 2019, pp. 149–264; https://cdsco.gov.in/opencms/opencms/system/modules/CDSCO.WEB/elements/download_file_division.jsp?num_id=NDU0Mg.
  • MoHFW, National policy for rare diseases, Ministry of Health and Family Welfare, GoI (draft policy document), 2020, pp. 3–20.
  • MoHFW, National policy for treatment of rare diseases. Ministry of Health and Family Welfare, GoI, 2017, pp. 3–36.
  • Sukumaran, A., Am I going to live? Genetic diseases leave 70 million Indians at God’s mercy. Outlook Magazine, June 2019, 1–6.
  • Nair, K., Raj, T. P., S., Tiwari, V. K. and Piang, L. K., Cost of treatment for cancer: experience of patients in public hospitals in India. Asia Pac. J. Cancer Prevent., 2013, 14, 5049–5054.
  • Yates, N., I have spinal muscular atrophy. Critics of the $2 million new gene therapy are missing the point. 2019; https://www.statnews.com/2019/05/31/spinal-muscular-atrophy-zolgensma-price-critics/
  • Canadian Agency for Drugs and Technologies in Health, Pharmacoeconomic Review Report on Migalastat (Galafold). Common Drug Review Report, 2018, pp. 1–30; https://www.cadth.ca/sites/default/files/cdr/pharmacoeconomic/SR0522_Galafold_PE_Report.pdf
  • Katoch, V. M., Kabra, M. and Bhattacharya, A., Policy towards finding cure and management of rare diseases. Jawaharlal Nehru University and World without GNE Myopathy (India), Recommendations, 2017, pp. 3–19.
  • Wakap, S. et al., Estimating cumulative point prevalence of rare diseases: analysis of the Orphanet database. Eur. J. Hum. Genet., 2019, 28, 165–173.
  • Bhattacharya, S., Kotach, V. M., Majumder, P. P. and Bhattacharya, A., Rare diseases in India: current knowledge and new possibilities. Proc. Indian Natl. Sci. Acad., 2016, 82(4), 1183– 1187.
  • Rajasimha, H. K., Uniting and connecting >70 M patients with rare diseases in India with globalinitiatives. Organization for Rare Diseases India and International Rare Diseases Research Consor-tium. 2017; https://ordindia.org/wp-content/uploads/2017/03/ ORDI-IRDiRC-Conf-Paris-Feb2017.pdf
  • Theodorou, D. J., Theodorou, S. J. and Kakitsubata, Y., Skeletal muscle diseases: patterns of MRI appearances. Br. J. Radiol.,2012, 85(1020), 1298–1308.
  • DBT, Unique methods of management and treatment of inherited disorders, Department of Biotechnology, Ministry of Science and Technology, GoI, 2019.
  • Kar, A., Phadnis, S., Dharmarajan, S. and Nakade, J., Epidemiology and social costs of hemophilia in India. Indian J. Med. Res., 2014, 140(1), 19–31.
  • Kar, A., Mirkazemi, R., Singh, P., Potnis-Lele, M., Lohade, S., Lalwani, A. and Saha, A. S., Disability in Indian patients with hemophilia. J. Haemophilia, 2007, 13(4), 398–404.
  • MHRD, Educational statistics at a glance. Ministry of Human Resource Development, GoI, 2018; https://mhrd.gov.in/sites/ upload_files/mhrd/files/statistics-new/ESAG-2018.pdf
  • Dharmarajan, S., Gund, P., Phadnis, S., Lohade, S., Lalwani, A. and Kar, A., Treatment decisions and usage of clotting factor concentrate by a cohort of Indian hemophilia patients. J. Haemophilia, 2012, 18(1), 27–29.
  • Angelis, A., Tordrup, D. and Kanavos, P., Socio-economic burden of rare diseases: a systematic review of cost of illness evidence. J. Health Policy, 2015, 119(7), 964–979.
  • Dharssi, S., Wong-Rieger, D., Harold, M. and Terry, S., Review of 11 national policies for rare diseases in the context of key patient needs. Orphanet J. Rare Dis., 2017, 12(63), 1–13.
  • Song, P., Gao, J., Inagaki, Y., Kokudo, N. and Tang, W., Rare diseases, orphan drugs, and their regulation in Asia: current and future perspectives. Intract. Rare Dis. Res., 2012, 1(1), 3–9.
  • MoHFW, Review of national policy for treatment of rare diseases 2017. Ministry of Health and Family Welfare, GoI, 2018, pp. 1–3; https://mohfw.gov.in/sites/default/files/National-policy-for-Treatment-of-Rare-Diseases.pdf
  • TJ 2nd, M. and Wastila L. S., Patient-centered drug approval: the role of patient advocacy in the drug approval process. J. Manage. Care Spec. Pharm., 2017, 23(10), 1078–1082.
  • International Rare Diseases Research Consortium, Rare disease policy in 11 countries: an analysis, 2017; http://www.irdirc.org/rare-disease-policy-in-11-countries-an-analysis/
  • Bhattacharya, A. and Bhattacharya, S., Patient driven initiatives for prioritizing drug discovery for rare diseases. Indian J. Med.Res., 2019, 149, 326–328.
  • Choudhury, M. C. and Saberwal, G., The role of patient organizations in the rare disease ecosystem in India: an interview based study. Orphanet J. Rare Dis., 2019, 14(117), 1–14.
  • MoHFW, Guidelines regarding implementation of Umbrella Scheme of Rashtriya Arogya Nidhi. Ministry of Health and Family Welfare, GoI, 2019; https://mohfw.gov.in/sites/default/files/RAN_Guidelines_2018-20.pdf
  • International Federation of Pharmaceutical Manufacturers and Association, Rare diseases: shaping a future with no-one left behind. Report, 2017, pp. 1–24.
  • Bhattacharya, S., An ordinary lifewith rare disease: battle for drug discovery. 2018; https://fit.thequint.com/her-health/gne-myopathy-battle-with-rare-disease
  • Shire, Rare disease impact report: insights from patients and the medical community. 2013, pp. 1–30; https://globalgenes.org/wp-content/uploads/2013/04/ShireReport-1.pdf
  • Arora, S. and Arora, S., Rare diseases and orphan drugs: challenges, regulatory movements and market strategy. Information Booklet, Knowledge Isotopes (India), 2014, pp. 1–22; https://knowledgeisotopes.com/wp-content/uploads/2019/03/Rare-DiseasesandOrphanDrugsChallengesRegulatoryMovementsand-MarketStrategySpecialFocusIndia.pdf
  • Genethon – Cure through Innovation. Advancing gene therapy treatments for rare diseases. Web Portal, 1990; https://www.genethon.fr/en/
  • Shafie, A. A., Chaiyakunapruk, N., Supian, A., Lim, J., Zafra, M. and Hassali, M. A. A., Status of rare disease management in Southeast Asia. Orphanet J. Rare Dis., 2016, 11(107), 1–11.
  • Indian Council of Medical Research, GoI, Indian rare diseases registry. Web Portal, 2017; http://bmi.icmr.org.in/irdr/index.php.
  • IISc, GenomeIndia launched to unlock India’s DNA. Indian Institute of Science, Bengaluru, 2017; https://www.iisc.ac.in/ events/genomeindia-initiative-launched-to-unlock-indias-dna/
  • Ministry of Science and Technology, GoI, CSIR conducts whole genome sequencing of over 1000 Indians for biomedical applications, 2019; https://pib.gov.in/newsite/PrintRelease.aspx?relid= 194023
  • Cannizzo, S., Lorenzoni, V., Palla, I., Pirri, S., Trieste, L., Triulsi, I. and Turchetti, G., Rare diseases under different levels of economic analysis: current activities, challenges and perspectives. RMD Open J., 2018, 4(Suppl. 1).
  • Pearson, I., Rothwell, B., Olaye, Andrew and Knights, C., Economic modelling considerations for rare diseases. Value Health J., 2018, 21(5), 515–524.
  • Surve, R. R. et al., Detection of the beta sgene: an evaluation of the solubility test against automated chromatography and haemoglobin electrophoresis. Br. J. Biomed. Sci., 2000, 57(4), 292–294.
  • Mgonja, C. T., Enhancing the university–industry collaboration in developing countries through best practices. Int. J. Eng. Trends Technol., 2017, 50(4), 2016–2025.

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  • Rare Diseases in India:Time for Cure-Driven Policy Initiatives and Action

Abstract Views: 350  |  PDF Views: 85

Authors

Anjali Taneja
Department of Biology, Ashoka University, Sonepat 131 029, India
L. S. Shashidhara
Department of Biology, Indian Institute of Science Education and Research, Pune 411 008, India
Alok Bhattacharya
Department of Biology, Ashoka University, Sonepat 131 029, India

Abstract


India is estimated to have a large number of patients suffering from rare diseases (RDs). More than 95% of such diseases are incurable. In many cases, the available treatments are expensive and often have to be provided lifelong to the patients. As a result, the direct and indirect costs of these diseases are significantly high, adding to the country’s socio-economic burden. It is time for India to implement healthcare policies that are focused on encouraging domestic production of drugs against RDs and finding innovative cures for them. This article delineates the existing social, economic and policy scenario governing RDs in India.It also examines someof the global policy approaches in this field. Taking a cue from such international practices, this article advocates the need for a comprehensive regulatoryframework for RDs in India with the ultimate goal of ensuring ‘cure for all patients’.

Keywords


Diagnosis and Treatment, Health Policy Initiatives, Orphan Drugs, Rare Diseases.

References





DOI: https://doi.org/10.18520/cs%2Fv118%2Fi10%2F1500-1506