Do No Harm? Unintended Consequences of Pharmaceutical Price Regulation in India.

This article examines the impact of India's Drugs (Prices Control) Order (DPCO) of 2013, which regulated prices of essential medicines to improve affordability and access. Using a synthetic control method with sales data from India and the Philippines, along with multiple robustness checks, the study finds that contrary to policy goals, sales volumes of regulated drugs declined after the regulation. The authors identify that pharmaceutical firms reduced marketing efforts—specifically detailing to physicians—due to lowered profit margins, which disproportionately affected prescriptions by non-MBBS physicians who serve poor and disadvantaged populations and rely heavily on such detailing. The findings highlight unintended consequences of selective price regulation, suggesting that regulators should consider the entire pharmaceutical ecosystem, including marketing practices and physician information channels, to avoid adverse effects on vulnerable patient groups.