India Today - - INSIDE - —M.G. Arun

Prime Min­is­ter Naren­dra Modi’s hint that the govern­ment may bring in a le­gal frame­work to make doc­tors pre­scribe drugs by their generic names has kicked off a de­bate. Soon af­ter, the Med­i­cal Coun­cil of In­dia (MCI), the statu­tory body that reg­u­lates med­i­cal ed­u­ca­tion and reg­is­ters doc­tors, is­sued a no­tice to all doc­tors to pre­scribe drugs only by generic names. Generics are medicines whose patents have ex­pired; they can be man­u­fac­tured and sold by lo­cal pharma com­pa­nies at a frac­tion of what patented drugs cost. Branded prod­ucts com­prise 90 per cent of the Rs 1 lakh crore In­dian pharma mar­ket.

While Modi’s sug­ges­tion was os­ten­si­bly to lower the cost of drugs and break the nexus be­tween doc­tors and pharma com­pa­nies, those in the in­dus­try feel it might not pay off. Last year too, the MCI had is­sued guide­lines to this ef­fect. The prob­lem is that this is a dif­fi­cult change to im­ple­ment. If the govern­ment man­dates that doc­tors only pre­scribe generics, phar­ma­cists will be­come the ones sug­gest­ing spe­cific brands to pa­tients. They too could, then, be ac­cused of be­ing in­flu­enced by pharma com­pa­nies. Another prob­lem is the po­ten­tial job loss for tens of thou­sands of med­i­cal rep­re­sen­ta­tives— who in­form doc­tors about branded medicines—fol­low­ing the MCI di­rec­tive. Ex­perts feel the move may not even lower prices. “The pa­tient will end up pay­ing more,” says D.G. Shah, sec­re­tary gen­eral, In­dian Phar­ma­ceu­ti­cal Al­liance. “Chemists are de­mand­ing 50 per cent mar­gins for generics against the cur­rent 30 per cent for branded generics.”

Another prob­lem re­lates to drug qual­ity. Generics are ex­pected to un­dergo bioe­quiv­a­lence stud­ies in In­dia, in which their ef­fec­tive­ness is tested against the patented drug. But this is of­ten flouted. Shah says only 15 per cent of branded generics have un­der­gone such test­ing. How­ever, Leena Meng­haney of Doc­tors With­out Bor­ders, an NGO, feels Modi’s step is “path-break­ing” and can have the de­sired im­pact—if phar­ma­cists are strongly mon­i­tored and the qual­ity of generics is en­sured by the govern­ment.

Il­lus­tra­tion by TANMOY CHAKRABORTY

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