February 26, 2024, New Delhi: The Ministry of Health and Family Welfare is reported to be mulling bringing nutraceuticals and health supplements supervision and pricing under the Central Drugs Standard Control Organization (CDSCO) for better regulation of this growing sector, The New Indian Express has reported quoting official sources. The unsupervised growth in demand and consumption of nutraceuticals/ probiotics and health supplements for medical purposes are currently unregulated as the Foods Safety and Standards Authority of India (FSSAI) only looks into the quality of the products, and not its usage or marketing. The news report states that the health ministry is proposing to set up a committee headed by the Secretary of Health to address overlapping concerns between nutraceuticals and drugs. The committee would have representatives from various key entities such as FSSAI, CDSCO, Indian Council of Medical Research (ICMR), Ministry of Ayush, and the Department of Pharmaceuticals.

Over the last four years due to rise in lifestyle diseases and impact of pollution, poor diets, propagation of certain diets to build muscle strength, control weight gain, manage diseases like diabetes, blood pressure, etc., boost immunity as seen during COVID-19 pandemic, households have started buying different nutraceuticals products. A medical journal defines nutraceuticals as a combination of “nutrition” and “pharmaceutical”, used as a dietary supplement to provide medical or health benefits. This includes vitamins, minerals, fiber, omega, herbs, probiotics and other products. Sad thing is that while people are aware of the benefits of taking supplements, they are not aware of how much is good and what can cause problems as many health reports highlight. For instance, experts have warned that taking too much of Vitamin D can lead to high calcium level in blood which can prove dangerous and may result in kidney damage and abnormal heart rhythms.

At one end of the spectrum are ‘better for you’ nutritious foods and beverages targeting wellness, and on the other, are more pharmaceutical products aimed at illnesses. At the cusp of the two, lies functional foods, supplements, and nutraceuticals, states an EY report. The consumer health products market size in FY21 was INR 1.03 trillion and witnessed a compound annual growth rate (CAGR) of 14% over the last three years (FY18-21). The dietary supplements market is estimated to have reached INR 331 billion last year. “This, on one hand, comprises healthy variants of foods and beverages such as digestive biscuits, low fat snacks and on the other hand, comprises dietary supplements,” states EY. Led by the rising demand for functional foods, which have certain health and medical benefits, the India plant based nutraceutical market is expected to grow at a CAGR of 15% in the forecast period of 2022-2027, according to expertmarketresearch.com. The company estimates that functional foods and drinks account for 60% and dietary supplements account for the balance 40% of the nutraceutical market in the country.

However, a large number of nutraceuticals available in the market, including imported products, have been found to be mislabelled on the contents and health benefit claims, and also found to be deficit on quality standards. In 2022-23, over 40,000 cases were filed against sale of unsafe protein powders and dietary supplements sold in the market that did not meet the food safety standards, Health Minister Dr Mansukh Mandaviya told parliament in a written reply on August 4.

A year ago, the Food Safety and Standards Authority of India (FSSAI) had issued an advisory to the states regarding special enforcement drives to check the compliance of Nutraceuticals and Health supplements. The advisory states that the Food Authority will ensure a tight vigil on the manufacturing and sale of these products and carry out enforcement drives to check the compliance of the products with respect to the FSSAI regulations and take strict action against non-compliant FBOs.

LocalCircles has conducted a comprehensive national survey to observe how Indian households consume various nutraceuticals products, along with their point of purchase. The survey received over 47,000 responses from citizens residing in 318 districts of India. 62% respondents were men while 38% respondents were women. 45% respondents were from tier 1, 31% from tier 2 and 24% respondents were from tier 3, 4 and rural districts.

71% of consumers surveyed say they are taking nutraceuticals (vitamin, mineral, fiber, omega, herbs & others) on a regular basis

The first question in the survey asked consumers, “Are you taking any vitamin, mineral, fiber, omega, herbs or other nutraceutical tablets on a regular basis?” In response, 16% said “Yes, several of them”, 30% said “Yes, 1 or 2”, and another 25% said “Yes, on and off, not regularly”. Breaking down the poll, 3% of citizens said “No, doctor has prescribed but haven’t taking”, and 26% said “No, not taking”. On an aggregate basis, 71% of consumers surveyed say they are taking nutraceuticals (vitamin, mineral, fiber, omega, herbs & others) on a regular basis. This question in the survey received 12,561 responses.

Most nutraceutical products are available in the form of tablets, syrups or powders. Several researchers have pointed out that nutraceutical products limit the severity of various lifestyle diseases. However, medical experts advise its medium-heavy usage only after consulting a doctor including experts in traditional or alternate medicine.

Most of the nutraceutical products can be bought over the counter in regular medical stores, while some are available at Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) kendras besides medical stores, local general stores, eCommerce platforms, online grocery platforms, ePharmacy platforms as well as direct selling channels.

68% of consumers who consume nutraceuticals (vitamin, mineral, fiber, omega, herbs or others) say they buy them from local medical or general stores

How are you purchasing the nutraceuticals (vitamin, mineral, fiber, omega, herbs, or others) that you consume?” In response the majority, 63% of consumers said they get it from “Medical stores”. 5% get it from “Local general stores”, 13% said “eCommerce platforms”, 4% said “Online grocery platforms”, 8% said “ePharmacy platforms” and 5% said “Through direct selling channels”. 2% couldn’t say. On aggregate, 68% of consumers who consume nutraceuticals (vitamin, mineral, fiber, omega, herbs or others) say they buy them from local medical or general stores. This question received 11,757 responses.

69% of consumers surveyed are taking some or all the nutraceuticals without a doctor’s prescription

The survey sought response to another key question “the nutraceuticals like vitamins, minerals, fibre, omega, herbs, etc., that you are taking on a regular basis, what percentage of them were prescribed by a qualified doctor”. The responses revealed that less than one third or 31% consume products “prescribed by a qualified doctor”. Of the total 10,873 respondents to this query, 23% revealed they are not consulting any doctor for “none of them”; 14% are taking “0-10%” based on doctor’s advice; 5% are consumer “10-20%” on medical advice; 27% in the case of “50-100%” of them. In all it appears, 69% of consumers surveyed are taking some or all the nutraceuticals without a doctor’s prescription.

78% of consumers surveyed want the Government to cap prices of supplements

The last survey question sought to know “Should the government cap prices of vital nutraceuticals like Vitamin A, Vitamin C and other immunity boosters?” The query received nearly 12,000 responses with 78% of consumers surveyed wanting the government to cap prices of supplements like Vitamins and other immunity boosters; 17% of respondents felt such a step is not necessary and 5% of respondents gave no clear response. To sum up, 78% of consumers surveyed want the government to cap prices of supplement like Vitamin A, C and immunity boosters.

In summary, the findings suggest that the majority of Indian households use nutraceutical products on a regular basis to keep themselves safe from various ailments and lifestyle diseases. This is evident with 71% of the consumers surveyed saying that they are taking nutraceuticals (vitamin, mineral, fiber, omega, herbs & others) on a regular basis. 68% of consumers buy nutraceuticals products from local medical or general stores. Less than one-third of consumers take nutraceutical products solely on qualified doctors’ advice. That being the case, there is a need for more prominent advisories to be put on the labels to inform consumers which product can cause harm to those with known allergies and other medical conditions. On the question of price, as the survey shows, 78% of consumers who purchase nutraceuticals want the Government to cap prices of supplements like vitamins and immunity boosters. Besides the price, as the FSSAI advisory has highlighted there is need for more stringent checks on manufacturing practices so that people do not have to pay the price of consuming nutraceuticals that harm rather than benefit the health. The reported proposal of the health ministry to bring the sector under the purview of the CDSCO is welcome as it will help bring more accountability in how these so call health products are prices, marketed and used. Once this happens, the National Pharmaceutical Pricing Authority (NPPA) can regulate pricing of nutraceuticals making them more affordable for consumers at large.

Survey Demographics

The survey received over 47,000 responses from consumers located in 318 districts of India. 62% respondents were men while 38% respondents were women. 45% respondents were from tier 1, 31% from tier 2 and 24% respondents were from tier 3, 4 and rural districts. The survey was conducted via LocalCircles platform and all participants were validated citizens who had to be registered with LocalCircles to participate in this survey.