MODI’S BITTER PILL
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.