mph Bangladesh

Healthcare

Healthcare System in Bangladesh

HIGHLIGHTS

Ministry of Health and Family Planning, GoB controls the health care system in Bangladesh in it’s total geography covering vast rural & urban areas. Back in 80s the rural healthcare facilities comprised sub-district health centers, family welfare centers and rural dispensaries which were poorly administered due to lack of infrastructures as well as ensuring availability of medical professionals. The situations have not changed till date to any significance. However, private/ non-government healthcare organization proliferated significantly over last two decades that largely meet healthcare needs of this 160 mio population country.

Stakeholders in Bangladesh Healthcare Market & their influence:
Stakeholders Expected changes / developments Implications /Actions
Payors  Private market, no reimbursement No influence on industry or service provider
Lack of market opportunity  Not viable option at given healthcare structure
Small market segment public hospital  
Wholesalers  Distributors for upcountry markets No influence on industry or service provider
Drives brands through discounting Manipulative trade channel for manufacturer
Shrinking business opportunity   
Pharmacists Dispenses according to prescription Single key role player in dispensing
Increased  focus by companies Trade campaigns, business partnering, substitution, retail chains
Strengthening of Association Influencing voice on the industry
General Physicians (GP) Continue as first line health service provider  & major prescriber pool High frequency of visits & reminders
Extension to rural population  Marginalize Rural Medical Practitioners
Values relationship and quality image of mfg.
Specialists Growing & KOL (Key Opinion Leader) segment  High frequency of visits & reminders
Drivers of disease management Shift of marketing focus from GPs
Shift of GP patient population Trend setters to disease mgt & KOLs for new launches 
Hospitals Geographical expansion  Shift of patient from doctors chamber
Enhancement of facility Price pressure, trade discounting & KAM implementation
Patients Growing awareness on quality & healthcare facility  Importance on quality 
Patient Advocacy Groups Patient clubs and health awareness programs

 

However, govt. healthcare support services extends from primary to tertiary level healthcare support system not equally distributed throughout the country. Capital city Dhaka and Port City Chittagong hosts most of the large govt. healthcare institutions. There are 15 Govt. Medical College hospitals (and growing) throughout the country providing quality medical education; some of them (DMC, CMC, RMC etc.)  approved by GMC, UK. However, some more new govt. medical college hospital already started Student admission recently. Besides, there are 48 private medical college running in different parts of the country for years, a few of them running for decades. For higher education, govt. approved 2 other Medical University (Chittagong & Rajshahi) apart from BSMMU.

 

 

 

Pharma

 

Pharma Market - Bangladesh

Bangladesh Pharmaceutical industry is the most technologically developed manufacturing sector and 3rd largest industry for contribution to government's revenue. This pharma industry contributes approx. 1% of the total GDP of the country. Out of many, about 250 pharmaceutical manufacturers are, although, around 40% companies are in operation and they produce >500 generic drugs. This market is highly concentrated as top 20 companies produce 85% of the revenue.

According to IMS, the retail market size is around BDT 118 billion as on 2014 where as it was around BDT 47 billion in 2008. It should be noted that IMS report points to the retail-level sales of pharmaceutical products not the institutional businesses (government and other organizational purchases) or export numbers.

Local pharmaceutical companies focus primarily on branded generics, mostly using imported APIs (Active Pharmaceuticals Ingredient). Unlike the international market, this generics constitute about 85% of the drugs sold in Bangladesh and 15% are patented drugs. Bangladesh produces as much as around 97% of it’s national consumption and thereby can be said to be self-sufficient in medicine production.

Presently, 15 Bangladeshi companies are involved in API (active pharmaceutical ingredients) production, The proposed API park is under development, in Munshiganj, about 40 kilometres from the capital. This park will accommodate 40 API industries with central effluent treatment plant and incinerator and other modern facilities. 

 

TRIPS Implications

Being LDC, Bangladesh will continue to enjoy patent-free production rights domestically until 2016 and limited exporting advantage. Having said that, as long as Bangladesh has to import APIs however, they will have to buy these from firms which are compliant with TRIPS laws and hence will have to incorporate the higher royalty patent price for these.

TRIPS also allow Bangladesh to export drugs patent free. The advantages that TRIPS does offer is somewhat offset by the pace and aggressiveness of the Indian and Chinese generic market, where companies can produce drugs, even including the patent costs, at an enormously competitive rate. As the days are counting, Bangladesh may export to any country if the drug is not under patent only until 2016. However, Least-developed country (LDC) members of the WTO will be allowed to maintain maximum flexibility in their approach to patenting pharmaceutical products until at least 2033, following a decision taken by the WTO’s Council for Trade-Related Aspects of Intellectual Property Rights (TRIPS) on 06 November '15 as published on WTO website.

 

Further reading: 

WTO members agree to extend drug patent exemption for poorest members.

 

 



 

BMI banner

Body Mass Index (BMI)

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.

BMI Categories:

  • Underweight = <18.5
  • Normal weight = 18.5 - 24.9
  • Overweight = 25 - 29.9
  • Obesity = BMI of 30 or greater

BMI 19-35

To use the table, find the appropriate height in the left-hand column labeled Height. Move across to a given weight (in pounds). The number at the top of the column is the BMI at that height and weight. Pounds have been rounded off.

BMI1920212223242526272829303132333435
Height
(inches)
Body Weight (pounds)
58 91 96 100 105 110 115 119 124 129 134 138 143 148 153 158 162 167
59 94 99 104 109 114 119 124 128 133 138 143 148 153 158 163 168 173
60 97 102 107 112 118 123 128 133 138 143 148 153 158 163 168 174 179
61 100 106 111 116 122 127 132 137 143 148 153 158 164 169 174 180 185
62 104 109 115 120 126 131 136 142 147 153 158 164 169 175 180 186 191
63 107 113 118 124 130 135 141 146 152 158 163 169 175 180 186 191 197
64 110 116 122 128 134 140 145 151 157 163 169 174 180 186 192 197 204
65 114 120 126 132 138 144 150 156 162 168 174 180 186 192 198 204 210
66 118 124 130 136 142 148 155 161 167 173 179 186 192 198 204 210 216
67 121 127 134 140 146 153 159 166 172 178 185 191 198 204 211 217 223
68 125 131 138 144 151 158 164 171 177 184 190 197 203 210 216 223 230
69 128 135 142 149 155 162 169 176 182 189 196 203 209 216 223 230 236
70 132 139 146 153 160 167 174 181 188 195 202 209 216 222 229 236 243
71 136 143 150 157 165 172 179 186 193 200 208 215 222 229 236 243 250
72 140 147 154 162 169 177 184 191 199 206 213 221 228 235 242 250 258
73 144 151 159 166 174 182 189 197 204 212 219 227 235 242 250 257 265
74 148 155 163 171 179 186 194 202 210 218 225 233 241 249 256 264 272
75 152 160 168 176 184 192 200 208 216 224 232 240 248 256 264 272 279
76 156 164 172 180 189 197 205 213 221 230 238 246 254 263 271 279 287

Source: U.S. Department of Health & Human Services

BMI >35

To use the table, find the appropriate height in the left-hand column labeled Height. Move across to a given weight. The number at the top of the column is the BMI at that height and weight. Pounds have been rounded off.

BMI36373839404142434445464748495051525354
Height
(inches)
Body Weight (pounds)
58 172 177 181 186 191 196 201 205 210 215 220 224 229 234 239 244 248 253 258
59 178 183 188 193 198 203 208 212 217 222 227 232 237 242 247 252 257 262 267
60 184 189 194 199 204 209 215 220 225 230 235 240 245 250 255 261 266 271 276
61 190 195 201 206 211 217 222 227 232 238 243 248 254 259 264 269 275 280 285
62 196 202 207 213 218 224 229 235 240 246 251 256 262 267 273 278 284 289 295
63 203 208 214 220 225 231 237 242 248 254 259 265 270 278 282 287 293 299 304
64 209 215 221 227 232 238 244 250 256 262 267 273 279 285 291 296 302 308 314
65 216 222 228 234 240 246 252 258 264 270 276 282 288 294 300 306 312 318 324
66 223 229 235 241 247 253 260 266 272 278 284 291 297 303 309 315 322 328 334
67 230 236 242 249 255 261 268 274 280 287 293 299 306 312 319 325 331 338 344
68 236 243 249 256 262 269 276 282 289 295 302 308 315 322 328 335 341 348 354
69 243 250 257 263 270 277 284 291 297 304 311 318 324 331 338 345 351 358 365
70 250 257 264 271 278 285 292 299 306 313 320 327 334 341 348 355 362 369 376
71 257 265 272 279 286 293 301 308 315 322 329 338 343 351 358 365 372 379 386
72 265 272 279 287 294 302 309 316 324 331 338 346 353 361 368 375 383 390 397
73 272 280 288 295 302 310 318 325 333 340 348 355 363 371 378 386 393 401 408
74 280 287 295 303 311 319 326 334 342 350 358 365 373 381 389 396 404 412 420
75 287 295 303 311 319 327 335 343 351 359 367 375 383 391 399 407 415 423 431
76 295 304 312 320 328 336 344 353 361 369 377 385 394 402 410 418 426 435 443

Source: U.S. Department of Health & Human Services

BMI Table US NIH

 

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