Affordable Medicines: A nanny approach towards doctors is not the answer
Rachna Mantri Delhi
The recently proposed move by the Modi government to create a legal framework to ensure prescription of generic names of medicines by doctors needs serious reconsideration before it is formalized as a law.
While the government’s seemingly ‘pro-poor’ healthcare movement is aimed at delivering accessible and affordable treatment, the two critical pillars needed to address India’s healthcare crisis, short sighted steps such as these are likely to cause more harm than good in meeting the intended goals.
Quality is the third most critical pillar in healthcare provision, particularly in the Indian context. It should remain a key consideration when formulating solutions to alleviate the perilous state of healthcare in the country. Not only will this move eat into the consultation time of doctors in the case of multi formulation prescriptions, it will inevitably lead to shifting of decision making from the medical expert to the pharmacist, thus compromising patient safety (assuming that the patient will turn to the pharmacist for the choice of brands if the doctor is barred from doing so).
If the intention of the government is to cease malpractices by the pharmaceutical industry, this purpose will be defeated as this move will only shift the focus of the pharma marketers from the doctor to the pharmacist. Given the widespread distribution of spurious and substandard drugs in India’s highly fragmented branded generics market, it is important for the doctor to prescribe a trusted brand that ensures quality (safety, efficacy and availability). This is the primary reason why doctors are not confident prescribing generic drugs (salt name). In this context, the recent move by the government to make bioequivalence studies compulsory for certain class of generic drugs is a welcome step. In fact, this law should be extended to include all generics.
Recognizing that the doctor-pharma relationship is commonly marred by unethical practices, a sustained moralistic b2b communication campaign in combination with close monitoring of interactions between doctors and the pharma companies may be the answer to kindle the desire to champion ethical practices amongst the medical fraternity.
Adopting a nanny approach to controlling prescribing behavior in doctors is unlikely to yield any major change until doctors gain confidence about the quality and availability of generic drugs. A strong regulatory and quality control process for generic drug manufacturing is needed to bring about this mind set change amongst doctors.
The author has a Master’s degree in Pharmaceutical Chemistry and is a Health Communications Consultant.