METRO PLUS

At what cost health?



The branded medicine vs. generic medicine debate is on. But you could cut down your medical bills by paying more attention



Most of us are very concerned about our health and the cost involved, but end up spending enormous amounts on medicines as we think we have no other choice. This is due to a large gap in information in a system that totally ignores the consumer.

Our trustee Dr. Suchitra says that medicines are of two types — generic and branded. When a medicine is discovered, the inventor gets a patent for a specific period. During this time, he / she or a company has exclusive rights to manufacture and sell this medicine. Once the patent expires, this medicine is available for open manufacture by other companies and becomes a ‘generic medicine’. They are then sold as either generics or branded medicines. A generic is marketed only under its International Non-proprietary Name (NIN).

For example, the antibiotic Ciprofloxacin will be marketed only as Ciprofloxacin. A branded medicine is given a specific name by the company that makes it. For instance, Ciprobid, Cifran, etc. are brand names of Ciprofloxacin. Generics are usually manufactured, packed and distributed in bulk. Generic medicines are in demand for State distribution, direct doctors’ dispensation, for over-the-counter sales in pharmacies and other such large-scale distribution. They bring in money from sheer volumes and are cheaper.

On the other hand, branded medicines profit because of higher trade margins and perpetually higher market prices. Branded medicines are packed for retail distribution. According to a conservative market estimate, there are more than 40,000 brands of medicines in the market! An example is Paracetamol, a common drug for fever, which has over 1,200 brands!

The mention of cost difference brings to the mind the question of quality. However, Suchitra says that a small manufacturing company with a good quality control lab produces medicines that are as good as that produced by a big manufacturing company. And, not all big companies have great quality controls.

So, a generic drug is not inferior than a branded drug provided it has been produced under good quality control.

That brings us to the basic question. Why are branded medicines more expensive? It is largely because of the promotional expenditure. Manufacturing companies create a myth about quality (that does not hold out to scientific verification) and often market the same product under various names and at varying prices. Moreover, several pharmacies do not stock cheaper generic options.

It is unfortunate that most of us do not know that the formulations of generics and branded medicines are essentially one and the same, and that it is only the packaging that is different. We are unaware of the vast difference in prices and are, therefore, unable to make an informed choice.

Apparently, even a few doctors are unaware and prescribe expensive branded medicines when cheaper options are available. Can you believe that the cost difference, at times, can be more than 300 per cent? The situation is grave considering the lack of knowledge amongst the majority of consumers. The National Pharmaceutical Pricing Authority (NPPA)* governs only the prices and quality of drugs under the Price Control Order. It is high time the Government acted constructively by getting manufacturers, medical practitioners and civil society to debate these issues, and arrive at a proper system that will enable people to make informed choices and provide affordable health care to the poor and proper health care to all sections.

*(The CAG, in collaboration with NPPA, runs the Centre for Information Facilitation and Grievances. Complaints about cost and quality can be made about drugs under price control.)

(The writer works with CAG, which offers free advice on consumer complaints to its members. For membership details / queries contact 24914358 / 24460387 or >helpdesk@cag.org.in)

S. SAROJA

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