Step in the right direction
Prime Minister Narendra Modi said at Surat earlier this week that the Government was contemplating introducing a legislation that would make it obligatory for doctors to write only generic names of medicines and that too in a clear and legible form. The current annual turnover of the Indian drugs industry is estimated to be over $14 billion. The same medicine (generic name) having the same quality and the same efficacy is sold under different names (brand names) manufactured and marketed by different companies. It is the price of the same medicine which varies, from the very cheap to the very costly. The giant drug companies, often multinationals, have an advantage over their less fortunate competitors. The ‘unholy trinity’ of the manufacturers, their widespread string of salesmen (who call themselves ‘medical representatives’) and the ‘gifts’ liberally given by the manufacturers to the prescribing physicians always keeps the patient or his relatives at the receiving end. They have to buy what the doctor prescribes and what the doctor prescribes is dictated by the drug manufacturers.
The Prime Minister’s announcement was like stirring the proverbial hornets’ nest. Associations of drug manufacturers, organizations of doctors – all are up against the policy decision announced (not yet implemented) by the Prime Minister. Some say the choice of medicines in the proposed system will be shifted from doctors to chemists, not patients. As if now it is the patients who choose their medicines. In fact in the proposed new system it is the patients who will, for the first time, be able to choose their medicines. How? Well, the doctor prescribes a medicine by its generic name. The patient goes to the pharmacy and says: “Tell me how many medicines of this generic name made by different companies and sold at different prices do you have?” The pharmacist tells him and he makes his choice, depending either on the price or on the name of the company the patient trusts.
Already, dark warnings are being given that, making a tenuous difference between a ‘safe and effective’ medicine with a brand name and a ‘similar’ which may be neither safe nor effective, under the new prescription regime the chemists will be able to ‘substitute’ products of different manufacturers. ‘Substitute’? What does it mean? Substituting which drug by another? And why should the patient (or his relatives) be supposed to be so ignorant as not to distinguish the difference. The Prime Minister has taken a long overdue step in the right direction. He should stand firm and not allow the powerful drugs lobby to undo his decision by high-decibel anti-propaganda.