What if an infection does not die out with the medicine that your doctor prescribed? You change the doctor.

But the blame could be with the medicines that you pop.

Doctors in the Health Services in Thiruvananthapuram and Wayanad told The Hindu that quite a few times the generic medicine has proved to be a dud in curbing the infection in desired doses. The efficacy of the medicine becomes a suspect when this repeats in their clinical practice.

Most of the time patients do not come back to say the medicine was ineffective. They just change the doctor.

However, a doctor in the Health Services in Ernakulam said there had not been much room for suspecting the efficacy of generic medicines given from hospitals. There could be a lobby of the pharmaceutical companies working to brand the government medicines as sub-standard, he said.

But, quite a few doctors insist that quality check is lagging as there is only one drug analytic laboratory in the State, for which it becomes an impossible task to take up random quality check. Doctors in the Health Services told The Hindu on condition of anonymity that the lack of quality check in medicines might channel patients either to a private practitioner or to the private consultancy of same doctor who can prescribe branded medicines.

A medical officer from the Malabar area told The Hindu that the government must ensure the quality. The drug testing laboratory takes 3-4 months in coming out with the results. By this time the medicines procured would have been distributed, he said. There were instances where the government withdrew certain batches which had already been consumed, said a doctor in Thiruvananthapuram.

“Many a time doctors have to write double prescriptions. The patients after standing in the queue at hospital pharmacy are told that the medicine is not available,” he said. This leaves the patient with two options. Either they go back to the doctor to get the prescription to buy it from outside or take the generic medicine prescription and depend on the medical store to provide him medicines of standard quality. To avoid this trouble for the patients, the medical college professor writes the generic name of the medicine and a brand name in brackets to help the patient buy it from an outlet outside if the same is not available in the hospital pharmacy.

R. Kamalahar, managing director of Kerala Medical Services Corporation Ltd, told The Hindu that there was three-step pre-purchase quality assurance, which includes sample testing and visit by a team of medical experts to the drug companies’ manufacturing facility. The companies also need to qualify with World Health Organisation certification, good manufacturing practices and should have a good market standing to send in their quotations for the tender.

After purchase, samples are chosen according to the number of batches bought and are sent to eight empanelled drug laboratories outside the state. Mr. Kamalahar said they get the feedback in 15 days for non-sterile drugs and 30 days for sterile drugs. If any of the batch fails the test, another sample is sent to the State’s drug laboratory.

If the drug failed the test for two batches, a stop memo would be issued for the drug to all government pharmacies and the company was blacklisted from participating in any further tender, he added. The whole processes takes about a month, said Mr. Kamalahar.

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