IMA slams NMC rules for docs to only prescribe generic drugs

The IMA said in a statement on Monday, “If doctors are not allowed to prescribe branded drugs, why should such drugs be licensed at all, given that modern medicines can be dispensed only on prescription of doctors.”

Doctors have also spoken out against the guidelines since they were put up online on Friday. The guidelines list the new prescription requirements along with other directives on professional conduct, continued professional development, interactions on social media, etc.

The guidelines on professional conduct by the ethics and medical registration board under NMC says, “Every RMP (registered medical practitioner, or doctor) should prescribe drugs using generic names written legibly and prescribe drugs rationally, avoiding unnecessary medications and irrational fixed-dose combination tablets.”

The NMC justified this by noting that generic medicines on average are 30% to 80% cheaper than branded ones, and may thus improve access to quality care.

Doctors contended that this will lead to substitution by pharmacies. The biggest impediment, they argued, is the variation in quality of generics.

Delhi Medical Council president Dr Arun Gupta said: “Medical stores generally do not stock them (generics) because profits margins are narrow. This means patients will have to go looking for these medicines, a branded version of which might cost just Rs 50. Second, if the generic version is not available, the responsibility of substitution is shifted to pharmacists.” This, he said, would “promote only brands — whether good or not — that have good profit margins”.

IMA president Dr Sharad Agarwal said quality can also be a big challenge. “Imagine a patient with fever comes to my clinic (and) I write the generic name. They take it and do not get better. Then they either get the branded medicine or someone in their circle suggests it. Think of what it does to the doctor’s reputation.”