The Prime Minister’s recent speech asking doctors to use generic drugs is a reiteration of the directive of the Medical Council of India (MCI) in its notification of October 2016. ‘Every physician should prescribe drugs with generic names legibly and preferably in capital letters and he/she shall ensure that there is a rational prescription and use of drugs’. The Prime Minister earlier in his election speeches, too, has raised the issue of the price of stents and medicines and talked of streamlining it. making them affordable for common citizens.
As a result of the shift in the economic policies and changes in the patent rights laws under the WTO in 1995, cheap vaccines produced by private companies were out of reach of the common man.
When one talks of prescribing medicines by the generic names, it means that they should be prescribed by their pharmacological formulation. After time restrictions imposed on the manufacture of the medicines by the companies other than the original innovator were off, many companies started selling generic medicines by different branded names. These came to be known as generic brands. The difference between the actual price and Maximum Retail Price (MRP) in this category is sometimes up to 1000 per cent, whereas this difference in the actual and retail price of main branded medicines is nearly 20-30 per cent.
Even after prescribing generic medicines, the real benefit does not percolate to the patients and the retailers make huge profits. This defeats the whole purpose. Quality control is another point of contention. These need to be rectified if medicines are to be made affordable in the real sense.
It is also a fact that pharma companies make huge profits and influence doctors by giving freebies to write their products — including foreign travel, expensive gifts and other incentives. Regulation of these companies through the Uniform Code of Pharmaceutical Marketing Practices (UCPMP) has so far been voluntary. This voluntary clause was being given extension for every six months.
The order was to be made mandatory in June 2016 but was given extension in September for an indefinite period, presumably under pressure from the pharma lobby. This must be made mandatory. The price structure must be streamlined and medicines should be marketed only on the pharmacological names.
The price of medicines has to be fixed on the basis of the cost accountancy, including the cost of raw material, cost involved in production and in bringing them to the market. The government fixes the price on the basis of best-selling products. This is a faulty method and leads to over pricing.
If it is serious, the government should strengthen public sector units for bulk drug production. It would be naive to expect things to change with one speech of the Prime Minister if infrastructural development is not taken care of. But doctors have a huge responsibility on their shoulders to set right things that are certainly going awry. The medical community has grown to be the most corrupt and greedy in the country. It needs to mends its ways.