Domestic pharmaceutical companies now meet nearly 100 percent of Bangladesh’s medicine demand, with the market valued at over $3 billion. The country’s presence in the global pharmaceutical market is also growing stronger each year.

In a recent interview with Bonik Barta, Abdul Muktadir, Chairman and Managing Director of Incepta Pharmaceuticals and President of the Bangladesh Association of Pharmaceutical Industries (BAPI), discussed the sector’s policies, planning, and future strategies; post-LDC graduation challenges; Bangladesh’s position in the international market; the relationship between doctors and pharmaceutical companies; and the industry’s long-term prospects.

Welcome to Bonik Barta.

Thank you for having me and for giving me the opportunity to let everyone know about the pharmaceutical industry.

Bangladesh’s pharmaceutical sector is now often described as a $3 billion market. In Bangladeshi currency, it is roughly BDT 350–400 billion. We would like to know the story of how such a substantial industry developed.

The pharmaceutical industry is inherently knowledge-based, and Bangladesh’s sector reflects that. The pharmaceutical factories that existed during British India, many of them were located in then Bengal (Bangla). It covered both East and West Bengal. The companies that received licenses between 1944 and 1948 in what is now Bangladesh, studying them reveals that many of the country’s inspired youth went to study in England or the United States. They studied pharmacy. Upon returning to the country, they became the founders of local pharmaceutical companies. This pattern continued both during the late British period and after 1947, leading to the establishment of multiple pharmaceutical companies.

Later, in 1964, the University of Dhaka launched its Department of Pharmacy. By 1967, when the first graduates began entering the workforce, many multinational companies set up pharmaceutical operations in what was then East Pakistan. This was made possible because these companies relied on those pharmacy graduates who provided the technical expertise required to run their operations effectively.

Thus, the development of this industry is closely connected to the University of Dhaka’s pharmacy department. Today, the country has sufficient pharmacy education, and local pharmaceutical companies in Bangladesh possess skilled professionals across all stages of drug production. This well-trained workforce is a key reason the industry has reached its current scale.

It is said that local companies supply 98 percent of medicines in Bangladesh’s healthcare sector, producing these drugs domestically. At the same time, many multinational companies once operated here, but why are they now withdrawing their businesses? Is it because they cannot compete with the local industry, or is there another reason?

The equation here is entirely different. The equation is different here because in 1984, the pharmaceutical industry underwent a significant transformation. The transformation was that brand-name multinational companies were no longer interested in low-cost medicines. Their focus shifted to new innovations, patented drugs, and higher-priced products.

The economics behind this shift are the subject of extensive discussion. That is too much complex. The situation that Western industries face, why they evolved in a particular way, is largely irrelevant for us, for our people. That’s because these companies don’t operate here. There can be separate discussions regarding this. The U.S. pharmaceutical industry once stood at $300 billion and has now grown to $700 billion. There are discussion on what challenges and evolutionary dynamics that entails in those countries. We are not facing those same issues in Bangladesh, which is a significant advantage for us.

Most emerging economies have rejected the Western model. Here, we have embraced a brand-generic model. The benefits and drawbacks of this approach can be explored in a more theoretical discussion.

Recently, there has been considerable discussion about medicine prices. And then came the issue of LDC graduation. The government is yet to decide whether to request postponing it. How do you think the LDC graduation might affect drug prices?

Before answering that, I want to expand a bit on the previous question. Local companies are supplying 98 percent of the country’s medicines, why did the multinationals left? The simple answer is that those companies are not interested in the low-cost medicines we produce here. Their focus is on patented drugs. Patented drugs are priced far beyond the reach of most people. While these drugs are necessary, the market here did not grow. So they have chosen not to operate here.

Bangladesh now has roughly 28,000 medicine brands. Even if price adjustments are needed every five years, you’ll find that daily price changes affect roughly ten drugs at a time. For example, paracetamol is one of the most widely used drugs. It was sold for BDT 0.65 per tablet 40–50 years ago. Today, it costs BDT 1.20. By comparison, the price of beef has increased more than twentyfold over the same period, yet the most widely used medicines have only doubled in price. Inflation, wages, or utility bills cannot fully justify such minor increases. So if prices are increased gradually for 28,000 then prices will be adjusted every day for one medicine or another. That’s natural. We have to look at how often prices are increased. And international pricing must also be considered.

Compare the prices of the 20 most used drugs in Bangladesh with those of neighboring countries. These statistics are now available on the internet. Out of the 20 most commonly used medicines in Bangladesh, only one is cheaper in India. The remaining 19 medicines are more expensive in India than in ours. In some cases, a drug that costs BDT 10 in Bangladesh is priced at BDT 40 in India. Considering these realities, it’s clear that medicine in Bangladesh remains affordable. Patients traveling to India, Singapore, Thailand, or China. Buy medicine there and then in Bangladesh, then compare if medicine prices are higher here.

Another important point: the cost of basic medicines here remains low and affordable. New medicines are invented every day. In the case of asthma, arthritis, and cancer, the medicines for such chronic diseases are new biologics. In the case of these biological medicines, for example, if a person suffering from cancer has to be given chemotherapy, then Filgrastim and Pegfilgrastim are given to increase WBC (white blood cell) count. Even 10 years ago, the price of these medicines was over BDT 100,000. Today, Bangladeshi companies produce that basic “raw material” and offer these medicines for BDT 8,000 only. So, all kinds of chronic, biologics, all kinds of new medicines for cancer, Bangladeshi pharmaceutical companies have acquired the capacity to manufacture them. The medicine that used to be bought for BDT 165,000, now can be bought for only BDT 15,000.

But in Bangladesh, the pharmaceutical industry in the 1980s developed under a form of government patronage. It grew with policy support. Now, the government itself is saying that pharmaceutical companies are making excessive profits. At one time, the government and pharmaceutical companies were on friendly terms, but why has the relationship turned adversarial?

The fundamental reason for this adversarial relationship is that raising medicine prices is an extremely unpopular move. You increase the prices of everything—gas, electricity, workers’ wages—but when I apply to raise medicine prices, check whether it has actually increased despite their policies? Examine whether the price adjustments allowed under government policy are being revised in line with inflation. What can be the counterweight to this? The counterweight is that the government is afraid to take this unpopular decision. That is why they come forward saying that prices are being raised repeatedly, claiming they will not allow price hikes, accusing pharmaceutical companies of profiteering, doing this or that, and so on.

The government is also raising oil and gas prices. These are also unpopular. Even water prices are going up.

Yes, these are also unpopular. But these affect the government directly. The government does not produce medicines; it only sets the prices. That is why it is much easier for the government. Here, a kind of counter-philosophy has been established. In every area, a negative perception has been associated with our name, which is extremely harmful to this industry.

How will LDC graduation affect the pharmaceutical industry?

Previously, there was no treatment beyond symptomatic or palliative care for chronic conditions such as arthritis, macular eye diseases, diabetes, as well as cancer and autoimmune diseases. Many diabetic patients, for example, would go blind with age. But now, medicines have emerged that can prevent such blindness. In the past, elderly people often became bent or deformed in their hands, feet, and fingers due to arthritis. We have now introduced medicines that can free them from these conditions.

Another major area is aging. The root cause or the “mother of aging” is atherosclerosis, meaning fat accumulates inside all types of blood vessels and bodily ducts, reducing their functionality. Gradually, this leads to physical weakness. Now, medicines are available where a single injection every six months can build the body’s resistance to these effects. Hundreds of such medicines are now on the market. However, their prices are extremely high. As a rule of thumb, one injection per month costs between BDT 150,000 and BDT 200,000.

Bangladesh, however, has developed the capacity to produce these medicines locally. We can provide them for BDT 10,000 to BDT 15,000. Many of these medicines have already been introduced and are being administered. We aim to change the perception that the people of Bangladesh cannot afford treatment for chronic, autoimmune, and cancer-related diseases. Our goal is to provide these medicines at one-tenth the international price.

This is possible only if patents do not block production. If patents exist, local production at low cost will be prohibited, and the same medicines would cost BDT 165,000 instead of BDT 15,000. If we get an additional three years before graduation, 150 new medicines can be introduced during this period. We will produce them locally without patents. This will allow treatment to continue for 10–15 years before new replacements arrive.

With one year, we can produce 50 medicines at lower cost; with two years, 100; with three years, 150. This is the advantage. The medicines we currently provide at low cost will continue, and new ones entering the market will also be affordable. If graduation is delayed by three years, we can offer the newly innovated medicines, as well as those that will arrive in the next three years, at lower prices. Existing medicines with available technology will also be affordable.

However, unexpectedly, no new medicines have been registered in Bangladesh over the past two years. Registration has stalled because the responsible authorities simply did not act. Nearly 1,000 medicines remain on hold. Meetings are underway with the authorities, but approvals are not being granted. Hopefully, these approvals will come soon.

Shifting focus, while local pharmaceutical companies meet domestic demand, is there any question about the quality of Bangladeshi medicines in international markets?

The global generics market is worth $460 billion, with the total pharmaceutical market at $1.3 trillion. The top 10–12 companies in Bangladesh export medicines to highly regulated countries, including the United States, Europe, Canada, Australia, and virtually every country in the world. Nowhere has the quality of our medicines ever been questioned. In 2007, we entered the European Union’s regulatory framework. In these 18 years, we have not received a single complaint.

All companies are highly conscious of quality. Speaking for the pharmaceutical industry, we can say that Bangladesh is home to high-quality manufacturers and reliable suppliers. We keep our word. We do not compromise on quality, and we deliver on our commitments on time.

Recently, there have been reports that the U.S. administration plans to impose a 100 percent tariff on Indian pharmaceuticals. Could this create an advantage for Bangladesh’s pharmaceutical industry? Could you use this opportunity to increase exports to the U.S. market?

The U.S. is imposing the 100 percent tariff only on branded products. The reason is that American companies are mostly the inventors of patented branded medicines. To avoid America’s tax burden, many of these companies manufacture in Ireland and then export to the U.S. About 27 percent of medicines in the U.S. are imported from Ireland, with additional manufacturing done in Switzerland and other countries. The Trump administration’s point is: You are American companies, yet you are manufacturing in tax haven countries and not paying U.S. taxes. That will not be allowed. Manufacture here in the U.S. If you don’t, a 100 percent tariff will apply. If you establish operations here and commit to production, the tariff can be waived.

There is also an economic dimension. About 91–92 percent of U.S. medicines are generics. But in value terms, that represents only about 10 percent. In other words, out of a $700 billion market, America’s generics market is only $40 billion. In terms of volume, this accounts for the 91–92 percent figure. So if a person takes 10 medicines a day, nine of them are imported.

If I were leading the U.S. government, I would have set this tariff at 200 percent to ensure these medicines are manufactured domestically. I think such measures could come soon. If the U.S. applies country-specific variations, Bangladesh could benefit. We are currently waiting to see when tariffs on pure generics might be applied. India is currently the main exporter, supplying 41–42 percent of the total U.S. pharmaceutical volume. If any variation occurs, even a 20–25 percent shift, American distributors would line up at Bangladesh’s airports. We are observing the situation. Even if nothing changes, the global market remains open to us.

Previously, we could not produce APIs (active pharmaceutical ingredients); now we can. We could not produce APIs for vaccines, now we can. We could not produce APIs for biologics, now we can. This has made us competitive. We will sell medicines worldwide, Insha’Allah. You will see Bangladesh emerge as a leading exporting country.

There has been widespread debate about the relationship between healthcare providers and pharmaceutical companies. There is a public perception that pharmaceutical companies pose a kind of obstacle to doctors’ professionalism. How would you explain this from the standpoint of a leading pharmaceutical company? Why is this perception developing?

It is a matter of narratives. When something is repeatedly highlighted and gradually amplified, such perceptions emerge. If you look back 40–50 years, you will not find a single country in the world where pharmaceutical representatives did not visit doctors. Yet in our country, some say such interactions are unnecessary. The development of medical science is closely intertwined with pharmaceutical companies. When a new drug arrives, there are complex questions: how to use it, what side effects it may have, and what benefits and risks are involved. That is why every country holds medical conferences, medical treatment conferences, and drug-specific conferences. Exhibitions and symposia also take place to share information about clinical trials.

In our country, the way this is being portrayed overlooks an important perspective: the effectiveness or risk of a drug in one country may differ when applied in another. Therefore, large tertiary and specialized hospitals, as well as major clinical research centers, are essential. Pharmaceutical companies must engage in these centers so clinical research can be conducted. Conducting clinical research requires close collaboration between pharmaceutical R&D and the doctors at tertiary hospitals.

Globally, “clinical lots” are standard practice. For example, Incepta Pharmaceuticals collaborates with Imperial College London, Oxford, and Leeds University. The dean of the Faculty of Medicine at Imperial College works directly with us. We produce GMP-certified experimental medicine batches for them. Many hospitals conduct drug-versus-placebo research, comparing a medicine’s effect to an inert substance. Without the involvement of pharmaceutical companies, such research would be impossible. Therefore, improving public health and medical science requires pharmaceutical companies and doctors to work together.

It is possible that some of our actions were over-amplified. For example, photographing which doctor prescribed which medicine, and company representatives rushing to record it was inappropriate. The pharmaceutical industry association has made it clear that no company is allowed to do this. In other countries, the pharmaceutical companies get information without doing this. That’s because they have established research centers. We hope Bangladesh will have such centers too from where we can get data. Based on that data, pharmaceutical companies would be able to do their marketing accordingly.

I want to raise another point: if you removed every billboard from every street in Bangladesh, you would eliminate diversity and marketing efforts. Similarly, if pharmaceutical companies are completely removed from marketing opportunities, there will be no competition among them. Competition, however, drives down drug prices and encourages technological advancements, which improve quality and reduce costs. Competition and marketing are, therefore, essential components of an open economy. Restricting competition in the pharmaceutical industry is another attempt to harm Bangladesh’s economy.

Abdul Muktadir, thank you very much for coming to Banik Barta and giving us your time.

Thank you too.

[This interview was originally conducted in Bangla and published in both the Print and Online editions of Bonik Barta. It has since been translated for the English edition.]