Generic Vs Branded Drugs, this debate has taken the public healthcare sphere by storm this week. It all started with the new set of norms by the National Medical Commission (NMC) which has asked doctors to mandatorily prescribe generic drugs.
While the move is aimed to lessen the out-of-burden pocket expenditure of poor patients, doctors have questioned the efficacy and quality of generic drugs. The Indian Medical Association, the largest body of private doctors, is vocally disapproval of the move. Dr Sharad Kumar Agarwal, the association’s national president, tells Ashish Srivastava that the move could be counter-productive and may defeat its prime purpose of ensuring better access to drugs. Excerpts:
The new NMC guidelines ask medicos to prescribe generic medicines. It is seen as controversial and counter-productive. IMA is opposing this decision by questioning its quality and effectiveness. Your views?
The move is far from ground reality and ill-thought-out. It is a matter of great concern for the IMA since this directly impacts patients’ care and safety. Generic drugs fail to manage the symptoms of chronic illness. The move is counterproductive and if forced, will only worsen the condition for the doctors which the NMC aims to improve through the ‘Right to Refuse.’ The patients will not see why the drugs didn’t work. Their ire will be directed towards the medicos. Who will take the responsibility if a prescribed generic drug to a diabetes patient worsened his illness instead? The doctor will be crucified for this.
You have questioned the quality of generic medicines but don’t all drugs go through a rigorous process of research and trials?
The research doesn’t ensure that each batch of the drug will have the same quality and efficacy as it produced during clinical trials. That’s why we have the mechanism of quality control. How will it be ensured that the same quality is enforced in the manufacturing of every batch? Can NMC share the data of the qualitative checks done on the generic drugs to ensure their efficacy? The whole process of making generic drugs is dubious. We don’t know whether quality control measures are taken. Their bioavailability is unknown. Whether the salt (of medicines) is able to generate an effective proportion of elements in the blood is unchecked. With such uncertainty, how does the NMC imagine eliciting confidence among doctors to prescribe generic drugs? All those advocating for it should first consume and then preach about it. Let NMC and the government ensure quality generic drugs or accept responsibility if patients fail to respond to prescribe generics.
There’s a reason why the government promotes generic drugs through various schemes. In the end, they are the same drugs without any brand association.
If the generic drugs are so wonderful then why don’t we have such drug stores on every nook and cranny? Why do people hesitate to purchase these drugs? Did generic drugs manage the Covid pandemic? If the NMC wants doctors to prescribe only generic drugs then they should totally ban the branded drugs and improve the quality of generic medicines, or they can simply order all pharmaceutical companies to manufacture the drugs without brand names.
The genesis of the problem is the alleged malpractice prevalent among doctors who favor drugs, influenced by medical representatives of certain brands.
This is a completely false and biased notion towards private practitioners. Such things happen everywhere but you can’t paint a whole community in the same color. The malpractices exist everywhere, even in government departments. If such things are happening then why didn’t the government act so far? People have the liberty to choose medicines from government hospitals but how many of the patients purchase them?