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Doctors oppose NMC decision to prescribe generic medicines
However, health activists have welcomed the decision and urged the government to direct pharmaceutical companies to manufacture more generic medicines
After the National Medical Commission (NMC) on August 2, asked doctors to prescribe generic drugs instead of branded drugs or face penalties, the Indian Medical Association (IMA) has raised concerns. However, health activists have welcomed the decision and urged the government to direct pharmaceutical companies to manufacture more generic medicines.
As per the NMC’s new regulation, doctors can face licence suspension if they do not prescribe generic drugs.Currently, there are fewer generic medicines available in the market and most of them are branded generics. Health activists believe the power balance will shift from physicians to pharmacists and the government should take steps to prevent this. However, the major challenge will be for companies that give huge cuts to doctors and chemists to push up the sale of their products.
As per health activists, India has over 8,000 registered propaganda-cum-distribution (PCD) companies. These companies sell medicines manufactured by a third party and promote it via their sales team. Their survival is at stake if doctors start prescribing generic medicines. Such companies, now have to look for other alternatives as they survive only by giving huge cuts to doctors and chemists to push sales.
Abhay Pandey, national president, All Food and Drug Licence Holder Foundation(AFDLHF) said that these companies work cash and kind, give gifts and sponsor programmes for the doctors in exchange to prescribe their drugs. “It is simple to identify if the drug prescribed to you is from a PCD. When the drug prescribed is from a little-known local pharma company and manufactured in some different state, it is a red flag. It will be available only in the chemist shops in and around your doctors’ clinic. The cost of these medicines is higher than the same ones produced by reputed pharmaceutical companies. However, the doctors insist that no other substitute will work,” he said.
NMC order
As per the NMC’s new regulation, incorporating the telemedicine prescription guidelines restricts Registered Medical Practitioners (RMP) from getting involved in any third-party educational activity like continuing professional development, seminars, workshop, symposia and conferences which involves direct or indirect sponsorships from pharmaceutical companies or the allied health sector.
“India’s out-of-pocket spending on medications accounts for a major proportion of public spending on health care. Further, generic medicines are 30% to 80% cheaper than branded drugs. Hence, prescribing generic medicines may overtly bring down health care costs and improve access to quality care,” stated NMC
The RMPs should advocate for hospitals and local pharmacies to stock and prescribe generic drugs that are available in the market and accessible to the patient, stated the order.
What health activists say
Welcoming NMC’s decision,health activist Dr Sanjay Dabhade, of Jan Arogya Manch said, “The decision concerns their bioavailability, efficacy, and overall effectiveness in treating diseases using generic medicines. The government should regularly conduct quality checks of generic medicines. Research and studies should be conducted to show the efficacy of generic medicines to doctors. This will increase the trust about generic medicines in doctors and the public.”
According to Dr Abhijeet More, a health activist, the power balance will now shift from physicians to pharmacists and they will decide which generic medicine can be given to the patients. “Most pharma companies are not interested to manufacture generic medicines and the government should push for it,” he said.
Kailas Tandale, president Maharashtra Registered Pharmacist Association said, “The pharmacists will now have an upper hand. Sometimes, when the doctors’ prescribe expensive medicines, the patient does not complete the course as they cannot afford it.”
Health activist Sharad Shetty said that the entire medical community is ruled by the pharma industry. “Pharma companies must manufacture generic medicines and the government should reduce price of branded drugs by reducing tax. However, generic drugs are yet to win the confidence of doctors,” he said.
IMA calls decision as unjust
The IMA has called the NMC decision unjust and demanded deferring the regulation for wider consultations and called for serious intervention by the government.
“The decision directly impacts patients’ care and safety. We should refrain from just cost cutting. If the doctors are not allowed to prescribe branded drugs, then they shouldn’t be licenced and only generic drugs should be given a permit,” said an IMA official requesting anonymity.
