Prime Minister Narendra Modi’s plan to bring in a law insisting doctors to only prescribe low-cost generic drugs, and not high-priced branded ones, has not found many takers among doctors in Kerala, which consumes a tenth of India’s trillion-rupee annual pharmaceutical market.
In a speech at Surat on Monday, Mr. Modi said his government intended to create a legal framework that would force doctors to prescribe generic drugs only. This was to bring down the health-care cost.
Most doctors The Hindu spoke to said this was impracticable and that it would prove to be counterproductive. V.G. Pradeeep Kumar, neurologist and State president of the Indian Medical Association, said that while the intention to help the poor patients was laudable, it was not practicable.
“Doctors usually prescribe branded medicines because of quality concern,” he said. “In India, we have very few facilities to test the quality of drugs; doctors prescribe branded ones because their quality is tested and assured.”
Onus on State, Centre
For instance, he noted, Kerala, which has the highest drug consumption rate in the country, had the lab facilities and staff to test the quality of around 6,000 drug samples a year, while the requirement was for 3 lakh tests. “If the State and Central governments can make available quality-assured generic drugs, the Prime Minister’s proposal would be a good idea,” he said.
Otherwise, in the name of low-cost medicine, the patient would be getting low-quality or even harmful drugs. Dr. Kumar contended that it would not be the doctors but the medical shops who would decide what medicine a patient should take.
“As an ophthalmologist with 25 years’ experience, I only prescribe branded medicines as their quality is assured,” K.V. Babu of Payyannur, a campaigner for medical ethics, said. He noted that the pharmaceutical market was flooded with spurious, unbranded, cheap medicines.
Mr. Modi’s initiative might end up supplying poor quality medicines to the poor if an extensive drug quality-assurance mechanism was not set up.
He pointed out that pharmacists naturally would promote low-quality generic drugs, which would give them much higher profit margins than the branded ones. “It will not be the poor patient but the pharmacist who will benefit from Mr. Modi’s initiative.”
Initiative hailed
C. Sanal, chairman of the Kerala Retail Chemists Forum, however, welcomed the initiative, which he said would bring in deep changes in the pharmaceutical sector. But, he noted, quality assurance was the key to the success of the reform as spurious and substandard drugs were commonplace. Though there were some 80,000 branded medicines in the market in Kerala, only a small fraction of the samples were tested.
Mr. Sanal said the government should take over pharmaceutical distribution to eliminate intermediaries and also invest heavily in drug manufacturing.
B. Ekbal, people’s health campaigner and head of the committee set up by the LDF government to draft a health policy, welcomed the proposed measure.
He underscored the need for stiff quality control and also for taking the doctors into confidence as they are naturally worried about the effectiveness of the medicines they prescribe to their patients.
He called for strengthening the public distribution of drugs through Karunya, Neethi and Jan Oushadhi networks, which sell medicines at low prices.
