There are a number of systemic gaps without addressing which the government’s latest plan for the pharma sector won’t work
There is no policy of the Indian government for promotion of generic medicines. Decades ago, the Medical Council of India (MCI) made it mandatory that all medical practitioners must prescribe medicines only in brand names. This policy still continues.
For years, the Indian pharmaceutical industry has developed a culture of ‘brand popularity’, initially among doctors and then among the public. This culture is now so strong that a large section of doctors does not even know the actual composition of the brands they prescribe. In public perception, the notion that branded drugs are the best in quality and efficacy and generics not since they are cheaper has taken root completely.
Shops under the Jan Aushadhi Scheme (which was started in September 2015), which sell only generic drugs, are a private-public model which cannot address fundamental problems of generic drug use.
Without addressing this state of affairs, the mere mandate of prescribing in generic names would not work. A few months ago, while inaugurating a private hospital in Rajasthan, Prime Minister Narendra Modi announced that prescribing of medicines in generic names shall be made mandatory for all medical practitioners.
This was vociferously protested by many in the medical profession. Following this, the Union Ministry of Health informed that though generic prescription is a must, brand names can be mentioned in parenthesis. Thus, the very purpose of prescribing in generic names has been defeated.
The use of colour codes to identify generic medicines and keeping generic medicines in separate shelves are of no use as there is no compulsion for a chemist to keep generic medicines in stock. The other problem concerns patients’ choice. There is wide difference of prices in generic medicines also. A huge amount of trade discounts are often given by the generic manufacturers benefit of which does not reach to the buyer. A chemist will always push medicines which offer more margin even if the generic medicine of that company remains higher than other same generic medicine.
It because of this reason that the government needs to make it mandatory for open display of prices of all generic medicines at the chemist’s shop which is more important than using colour codes. Patients can then identify which generic medicine is cheaper.
It is good to see that the Competition Commission of India (CCI) had expressed concern on the high trade margin and had asked for a policy prescription on generic medicines. It would have been better for the CCI to ask for a policy which would effectively reduce prices of all medicines. A very unequal competition exists when the same medicine of mostly-sold brands are sold at 200 times higher than other brands, let alone generics.
Amitava Guha is the national co-covener of Jan Swasthya Abhiyan
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