On Monday, Prime Minister Narendra Modi said that the government is contemplating a law that will make it binding for doctors to prescribe generic medicines. The proposed legislation has the potential of offering the patient a greater say in the choice of a medicine. “We will bring in a legal framework by which if a doctor writes a prescription, he has to write in it that it will be enough for patients to buy generic medicine and he need not buy any other medicine,” the PM is reported to have said. The PM has signalled the government’s intention to end the malpractice of doctors dispensing only costly drugs.
Making it incumbent on the doctor to prescribe a generic drug would mean that the prescription will detail the medicine’s composition — the salts — leaving the choice of the brand on the patient. However, for such a choice to be effective, the proposed law needs to go beyond the doctor-patient binary and target each link in the pharma industry’s chain of corruption.
A large number of patients in the country are illiterate and even many literate patients are not well-versed with medical terms and drug composition. There are, for example, more than 500 generic versions for the anti-bronchial pneumonia formula, amoxycillin and potassium clavulanate, that cost between Rs 70 to Rs 300 for a packet of 10 tablets. A patient armed with a prescription detailing the composition of the medicine could still be dependent on a pharmacist to make the most suitable drug choice for her. And by all accounts, a pharmacist is likely to be even less sensitive to a patient’s medical — and financial — condition than the doctor. The efficacy of the proposed law will hinge on the ways in which it brings pharmacists — and not just doctors — under its ambit.
The generic medicine industry will also have to pull up its socks. Last year, 27 commonly-used medicines in the country failed quality tests. The drugs were found wanting on several counts, including false labelling and inadequate quantity of ingredients. Ensuring quality of drugs is a problem in the absence of adequate regulations and shortage of drug inspectors and lab facilities to check drug quality.
In most cases, failure to comply with standards results in a short-term suspension of a manufacturer’s production licence — hardly an effective deterrent when manufacturers have several production units. The government’s push for generic drugs is likely to come a cropper if it cannot ensure quality drugs in the first place. The move needs to be backed by adequate regulatory and legal provisions.
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