The Ministry of Health has proposed reducing the prices of cancer drugs while increasing the cost of multivitamins and multimineral supplements. This recommendation was made in a letter sent by Health and Family Welfare Advisor Nurjahan Begum to the Chairman of the National Board of Revenue (NBR) on January 15. In the letter, she suggested lowering the Advance Income Tax (AIT) and Advance Tax (AT) imposed on cancer drugs and their raw materials while increasing these taxes on multivitamins and multimineral supplements. According to her estimates, this tax adjustment could generate an additional revenue of BDT 340-350 crore for the government.

However, experts argue that all medicines serve essential purposes, and it is unjustifiable to lower the cost of one while raising the price of another. They stress that there are numerous other ways to enhance revenue collection, and imposing higher taxes on essential drugs is both inhumane and unacceptable. Additionally, they point out that the number of malnutrition-related cases far exceeds that of cancer patients in the country.

Dr. Syed Abdul Hamid, a professor at the Institute of Health Economics at Dhaka University, emphasized that medicines should ideally be exempt from taxes altogether. If taxes are necessary, they should be kept at a minimal level. While the health ministry’s proposal aims to increase government revenue, he noted that patients do not purchase multivitamins and multimineral supplements voluntarily but rather follow doctors’ prescriptions. These supplements are primarily recommended for weak or malnourished individuals. While the initiative to reduce cancer drug prices is commendable, imposing higher taxes on multivitamins and multimineral supplements is questionable, as it would disproportionately affect poorer patients.

In the letter to NBR Chairman Md. Abdur Rahman Khan, Health and Family Welfare Advisor Nurjahan Begum highlighted the growing number of cancer patients in Bangladesh. She noted that due to the high cost of treatment, impoverished cancer patients often exhaust their financial resources, pushing their families into financial distress.

The letter explained that cancer treatment involves multiple approaches, including surgery, chemotherapy, and radiotherapy. Although there are 30 local manufacturers of chemotherapy drugs in Bangladesh, the country still relies entirely on imported raw materials for production. The taxes imposed on these raw materials are borne by manufacturers and importers, ultimately leading to higher drug prices, which poor patients struggle to afford. While customs duty and VAT exemptions exist for cancer drug raw materials, a total tax of 10 percent, including 5 percent AIT and 5 percent AT, is still levied on finished cancer drugs and raw material imports. The letter suggested that waiving this 10 percent tax could significantly reduce cancer drug prices. However, the resulting revenue loss, estimated at BDT 40-50 crore per year, would need to be compensated through other means.

To offset this revenue shortfall, the health advisor proposed discouraging the import, production, marketing, and consumption of less essential drugs like multivitamins and multimineral supplements. The domestic market for such supplements is worth over BDT 3,500 crore. By imposing a new 5 percent AIT and 5 percent AT on the import of raw materials for these supplements, the government could generate additional revenue of BDT 340-350 crore annually.

When asked whether multivitamins and multimineral supplements are unnecessary or less essential, Professor Dr. Ahmedul Kabir, General Secretary of the Bangladesh Society of Medicine, disagreed. He stated that these supplements are crucial for many patients, particularly elderly individuals with multiple nutritional deficiencies. Additionally, patients with kidney disease and diabetes often require vitamin and mineral supplements to maintain their health. He also pointed out that hospitalized patients frequently need these supplements to recover from physical weakness, and children suffering from malnutrition benefit significantly from them. Furthermore, a large number of Bangladeshi women suffer from Vitamin D deficiency due to limited sun exposure, making supplementation necessary.

Following the health advisor’s letter on January 15, a subsequent letter was issued by the NBR on January 27 for further action. Signed by Mukitul Hasan, Second Secretary (Customs Policy) at NBR, the letter stated that the matter falls under the jurisdiction of the Income Tax Policy and VAT Policy divisions, which have been instructed to take the necessary steps.

When asked about the implementation of the Health Ministry’s recommendations, NBR officials declined to comment, leaving uncertainty regarding the proposed tax adjustments.