To break the doctor-pharmaceutical company nexus, the administration of the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, has asked chemists that they are not bound to sell medicines of specific brands, even if a doctor prescribes them.
In a recent move, the PGIMER has started putting a stamp on all the Outdoor Patient Department (OPD) registration-cum-prescription cards, saying that "Supply following drugs or equivalent generic drugs". Each card will bear this stamp besides doctor's prescription.
Going by the move, now chemists at the PGIMER will not be bound to sell the brand of the medicine prescribed by a doctor. The chemist will be free to substitute it with any other brand of the same composition. The medicine shouldn't be more expensive than the one prescribed by the doctor.
According to a head of a clinical department, the current move is likely to break hegemony of the doctors. "Earlier, if a chemist would substitute a medicine, doctors with help of the estate branch would impose heavy penalties on chemists. They would literally force which brand of medicine the chemist would sell and which brand of medicine a patient will consume," he said.
Following the medical code of ethics laid down for doctors by the Medical Council of India, the PGIMER administration has asked its doctors numerous times to prescribe generic medicines. Earlier this year, even a circular in this regard was issued by the PGIMER administration.
But the strong lobby of doctors backed by big pharmaceutical companies blocked this move completely on various pretexts. It was done despite the fact that there can't be any difference between quality of a branded and generic medicine.
It is quite common practice among doctors of the city, in private as well as government sector to prescribe expensive medicines with their brand names instead of prescribing them with their generic names.
The nexus between different pharmaceutical companies and doctors at the PGIMER is such that a recent audit of doctors' prescription carried out at the emergency of the hospital revealed that more than 70% of the total medicines, which are being prescribed at the emergency to the patients are being prescribed with their brand names.
Branded, generic: Know the difference
Branded: Those medicines, which are innovated, marketed and sold as a new chemical product by a particular company.
Generic: The generic medicines always contain same ingredients which, branded medicines comprise. It is a copy of the branded medicines, which are produced after expiration of the original patent.
The cost factor: According to experts, it is common misconception about generic medicines that they are inferior in quality as compared to branded drugs. The biggest difference, however, is the cost. Generic drugs are generally much cheaper as compared to branded medicines because companies manufacturing generic drugs don't have to spend money on research and innovation.
What MCI guidelines say
As per clause 1.5 of the Medical Council of India's (Professional Conduct, Etiquette and Ethics) Regulations, 2002, "Every physician should, as far as possible, prescribe drugs with generic names and he/she shall ensure that there is a rational prescription and use of drugs."