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Branded, generic and the missing ingredient of quality

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Branded, generic and the missing ingredient of quality

  • Patients in India often seek a second opinion on medications from salespersons in medical shops, particularly regarding generic medicines.
  • Patients often rely on non-pharmacists to interpret prescriptions and recommend medicines.

NMC Directive

  • On August 3, 2023, the NMC mandated doctors to prescribe only generic names, leading to protests.
  • In 1975, the Hathi Committee demanded that all brand names should be weeded out gradually.
  • Brand names are avoided due to cost, and the perception that generic names are more affordable.
  • There is an alleged nexus between pharmaceutical companies and doctors.
  • They can be influenced to give in to unethical marketing and promotional offers or kick-backs.

Quality Assurance

  • National drug surveys indicate a prevalence rate of 4.5% for spurious medicines and 3.4% for "not standard quality" medicines.
  • The government should ensure the quality of medicines through Universal Health Coverage and private healthcare networks.
  • Existing mechanisms for quality control are in place but not earnestly implemented.

Recommendations

  • There should be periodic sampling for testing, banning batches that fail quality tests, and taking punitive action against manufacturers.
  • Tamil Nadu's practice of keeping supplied medicines under quarantine until quality testing is done can be replicated.
  • Until the government can assure the standard quality of all medicines, the doctors should be allowed to mention the company name in their generic prescriptions.
    • Without such assurance, control over brand choice may shift to chemists or less-informed sales staff.
  • The availability rate of essential medicines should be above 90%.
  • There must also be a ban on unscientific combinations of medicines - currently around 40% of the retail market in India.

Conclusion

  • Following protests, the NMC withdrew the order on generic prescribing.
  • While this is a step forward, challenges remain in achieving universal access to affordable generic medicines without brand names.

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