Doctors want a notification mandating generic prescriptions deferred, saying it was “ill-advised”, as it transferred decision-making on medicines from the doctor to the retailer.
In fact, the decision could increase the potential for violence against doctors, they point out, when a less-effective medicine failed to produce the desired outcome in a critical patient, resulting in the aggrieved family blaming the doctor.
“Doctors prescribe a medicine based on their clinical experience on which works better in a certain condition,” says Sharad Agarwal, National President with the Indian Medical Association (IMA). Shifting decision-making away from the doctor to a retail chemist, creates a dangerous situation where a medicine could be given to a patient, based on a higher trade-margin rather than efficacy, he explains, adding that it created greater distrust between doctor and patient.
A generic drug is a chemically-similar and less expensive version of an innovative drug. But this category also sees branding to differentiate on quality, resulting in similar drugs selling at varying price-points.
Call for discussion
The Centre’s intention may be to keep treatment affordable for patients, but mandating generic prescriptions will not help, Agarwal, told businessline, calling for more discussion on the issue.
The IMA represents about four lakh doctors from across specialties, and they have sought a meeting with the Union Health Minister and the head of the National Medical Commission. The National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2023, issued earlier this month, was done without discussion with the doctors, he alleged. “The ill-advised steps taken by NMC on generic drugs is an emergency,” the IMA said.
While such proposals have been discussed in the past, it was given a fresh life by the Prime Minister, in 2017. Doctors were expected to prescribe the generic names of medicines. “Earlier it was an advisory, now its become mandatory,” says Agarwal, calling for it to be put on hold.
Quality concerns
“If the Government was serious about implementing generic drugs, it should have give licences only to generics and not to any branded drugs while ensuring quality of generic drugs. Making quality brands available in the market but disallowing doctors who are responsible for patients’ health, from prescribing them seems dubious,” the IMA said.
Pointing out that quality was a serious concern, the IMA said, “Less than 0.1 per cent of the drugs manufactured in India are tested for quality. This step should be deferred till the government can assure the quality of all the drugs released into the market.”
Tackling pharma
Companies sold branded, branded generic and generic medicines, at varying prices, he said, the Government has the power to plug such loopholes and regulate prices and margins. A “fool proof system of quality assurance before switching over to generic drugs”, the IMA said. If the Government and NMC want doctors in the country to prescribe only generic drugs, they should order pharmaceutical companies to manufacture all drugs without brand names, they said. Meanwhile drugmakers said they were still trying to understand the implications of the move.