The Central government is considering the introduction of a law to make it mandatory for doctors to prescribe generic drugs so that patients can access affordable medicines provided through state-run Jan Aushadhi stores.
The legal route to counter doctors’ preference for branded medicines is expected to be discussed with Prime Minister Narendra Modi at an upcoming meeting to assess the progress made in the plan to set up 3,000 Jan Aushadhi stores across the country this year, a promise made in the Union Budget.
“A major hurdle we face is that doctors don’t prescribe generic medicines supplied through Jan Aushadi stores, so patients find it tough to ask for the correct generic equivalents. We have proposed an ordinance or Act of Parliament to ensure that doctors prescribe generic drugs or include a clause ‘or equivalent generic drug,’ when they prescribe a branded drug,” MD Sreekumar, chief executive officer at the Bureau of Pharma PSUs of India (BPPI) told The Hindu .
The BPPI is the agency under the Department of Pharmaceuticals entrusted with implementing the Jan Aushadhi programme which was launched in 2008.
“Our main focus is accessibility, affordability and availability. But if generic equivalents are not prescribed by doctors, sales won’t take place. Pharmacists should have the option to give the generic substitute,” Mr. Sreekumar explained.
Ex-factory cost of medicines gets marked up multiple times owing to supply chain costs and incentives for medical representatives. The Jan Aushadhi stores are able to provide drugs at Rs. 19, if the ex-factory cost is Rs. 10. “A similar branded drug would cost Rs. 100,” the BPPI CEO said.
A senior official said similar norms ensure generic prescriptions in the U.K. National Health Service and a convergence list could be prepared to match branded drugs with generic substitutes. “Giving paracetamol to a patient with a prescription for a prominent branded drug is simple… it gets a little tricky with combination drugs. But it should be possible to create an IT-enabled prescription system that automatically includes the formulation of such drugs when a doctor prescribes a branded drug out of habit or because they don’t know the exact formulation,” this official said. “The PMO is holding a meeting soon to ascertain if we are on track to set up 3,000 stores this year. We have flagged the prescription norms as an issue of concern as stores won’t see adequate sales. A law will be more effective than directives from the Medical Council of India asking doctors to write generic drug names,” he said.
State governments may also be asked to focus on buying generics rather than splurge on expensive branded alternatives, by tweaking the norms of the National Rural Health Mission. By 2014-15, just 99 Jan Aushadhi stores had opened in 16 States, and there are 283 stores in 22 States and Union Territories at present. BPPI is confident of setting up over ten times the existing number of stores this year. Over 100 private pharma firms have enlisted to supply generic drugs.
