Generic drugs: Medicines for all

Pushpa Girimaji

Recently, Prime Minister Narendra Modi promised to bring in a legal framework to ensure that doctors prescribe generic medicines. How much will such a move help consumers?

As we all know, consumers have a right to information, informed choice and right to quality goods (medicines in this case) at reasonable prices. When a doctor prescribes only a brand name, he is actually taking away all these rights of consumers because you have no choice but to buy what is prescribed. And that prescribed brand may well be far more expensive than other brands or non-branded generic drugs. On the other hand, if the doctor prescribes the drug by its generic name, then, as a consumer, you have an option of comparing prices and buying what you want.

Today, there are websites that help you make this choice. But I do feel that the government should now come out with a mobile app through which, by scanning the name of the drug, a consumer can get all the options available to her or him, in not just English, but also in the local language. This would facilitate the consumers’ right to informed choice.

There are several other advantages of prescribing the drug by its generic name rather than the brand. Many times, certain brands are available in only certain parts of the country and I have often heard consumers complaining about the problems that they faced in buying the drug when they were travelling. On the other hand, if they have the generic name, this kind of a problem will not arise. Secondly, there are a number of similar sounding brand names and given the poor handwriting of most doctors, prescription errors are not rare. Only recently, a doctor told me about how a relative was prescribed an anti-diarrhoeal drug, but the chemist mistook it for a drug meant for diabetes. The patient went into a coma and died as a consequence. If you have the generic name, such mistakes can be avoided.

Prescription of generic drugs will also end the unholy nexus between doctors and pharmaceutical companies, thereby bringing down the prices of drugs. Today, pharmaceutical companies have huge budgets for promoting their products through doctors and since this expenditure becomes part of the costing of the drug, we, as consumers, end up paying for this too. In the United State, the Food and Drug Administration recently said that the health care system had saved as much as 1.68 trillion dollars in the last 10 years on account of using generic drugs.

However, having said that, I must underscore the need for better quality control vis-à-vis generic drugs and consumer education on this issue. Many doctors working in state-run hospitals express concern over the poor quality of some of the generic drugs and the even poorer enforcement of quality norms vis-à-vis these drugs. This has to change so that there is no difference in quality between the generic and the branded drug. It is equally important to educate consumers on all these issues so that they make an informed choice.

If this move can bring down the prices of drugs, why did the government not introduce it before?

The Indian Medical Council (Professional Conduct, Etiquette and ethics) Regulations, 2002, mandated that “every physician should as far as possible, prescribe drugs with generic name and he/she shall ensure that there is a rational prescription and use of drugs.” Obviously, the words “as far as possible” gave medical professionals an escape route and this was never followed.

Subsequently, on several occasions, the central government as well as state governments issued directions to doctors in government hospitals to write the generic name in prescriptions, but this was never strictly enforced. Then last year, the Medical Council of India amended the 2002 regulation to remove the ambiguity in it and make prescription of generic names mandatory. It said: “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.” This was, however, never enforced.

It’s not clear whether the government will now enforce it or bring in a new legal framework, but obviously, the government is keen to ensure the availability of drugs at cheaper prices and also give consumers the right to choose.

Consumers can, in the meanwhile, also bring about a change by insisting on doctors writing the generic name.