A 67-year-old woman in Tumakuru visited a private doctor for a chronic ailment. She was advised some expensive drugs. Even though she was short on funds and struggling to make ends meet, she set aside money to buy medication for two months. Two months later, when she ran out of money, she stopped taking the medicines and discontinued treatment.
Another woman in her fifties in K.G. Halli, Bengaluru, takes her medicine for hypertension only when ‘her legs swell’, something she has noticed happens every time her blood pressure shoots up. Once the swelling stops, she stops taking medicines, because she cannot afford them regularly.
Branded drugs sometimes cost as much as 7 to 8 times as generic drugs. But in spite of their low cost, the public remains suspicious of the effectiveness of generic medicines.
“There is a strong perception among the public, and to our surprise, even practitioners and pharmacists, that generic medicines are of sub-standard quality," said Praveenkumar Aivalli, Research Officer, Institute of Public Health (IPH), Bengaluru. A team of researchers from IPH, including Dr. Aivalli, have conducted a three-year study on access to generic medicines for non-communicable diseases, the results of which will be published shortly.
As part of the study, three taluks in Tumakuru district were randomly chosen and around 1,000 to 1,200 houses surveyed. The team found that public awareness of generic drugs was very low and people hesitated to visit primary health centres (PHCs), preferring private hospitals even when they could barely afford to. They found a similar poor perception of generic drugs among residents in K.G. Halli, Bengaluru.ÿ Comparing figures from 2013 to 2016, the availability of drugs in PHCs had greatly improved in the period.
The government has been pushing for generic drugs and plans to open 200 more Jan Aushadi Kendras in the State in 2016-17.
“Such moves will not help,” said Dr. Aivalli, unless there is a concerted effort to improve public perception of unbranded drugs.
The team sent samples of generic and branded drugs to different test laboratories and found them to be identical in composition.
Shinto Devassy, resident doctor at St. John's Hospital, said that physicians generally prescribe branded drugs because patients are familiar with them.
"In some countries, like Belgium, doctors are obliged to prescribe generic drugs. The pharmacist is also expected to offer a generic drug first. Whereas in India, you have doctors who write at the bottom of prescriptions — please don’t change the brand," said Upendra Bhojani, Assistant Director, IPH.
It is also necessary to build trust among patients about generic drugs, he felt, as this is one reason they choose brand over cost.
What are generic drugs?
Chemically equivalent, lower-cost versions of branded drugs
Type of drugs
Branded drugs are developed and marketed by pharmaceutical companies who hold patents for them
Branded generic is a drug that is bioequivalent to the original product, but marketed under another company's brand name
Medicine cost can be as much as 70% of treatment cost for some chronic diseases
