The “Consumer Rights” in its third Right i.e. “Right to Choose” states:
“Means right to be assured, wherever possible of access to variety of goods and services at competitive price. In case of monopolies, it means right to be assured of satisfactory quality and service at a fair price. It also includes right to basic goods and services. This is because unrestricted right of the minority to choose can mean a denial for the majority of its fair share. This right can be better exercised in a competitive market where a variety of goods are available at competitive prices.”
How does a patient get his Right to Choose, a difficult yet pertinent question which is striking every concerned patient today.
In the country today there are over 3000 manufacturers right from USFDA approved ones to those conforming to virtually no guidelines. The prescriptions contain products from any and every company who can reach the doctor. The price of a drug from any company does not remotely correlate with the quality of the product. The price difference between the companies for the same drug (off patent) can be as much as 95%. Trade margins to retailers have reached unbelievable limits so much so that every other doctor has an attached medical store. To make matters worse doctors have started prescribing brands which are only available at their next door store and nowhere else (sometimes even made to order).
On May 13, 2016, the Drugs Technical Advisory Board (DTAB) of the Union health ministry had turned down a proposal by the ministry to amend Rule 65 of the Drugs and Cosmetics Rules, 1945 to provide that the chemist may offer for supply a drug formulation containing the same ingredients but in generic or other cheaper brand name. It felt that there is no guarantee that the bioavailability of the generic medicine so offered by the chemist will be the same as prescribed by the physician and the lack of same effectiveness of the generic medicine may lead to harmful effect on the patient.
The above paragraphs are in complete coherence and forces us to believe that there are vested interests behind such decisions. A recent book “Dissenting Diagnostics” talks about the ill-practices and its origin in a profession which is portrayed closest to GOD. The rot is not stopping anywhere and needs a solution.
According to an official Government of Gujarat release:
• WHO says that 65% of the Indian population still lacks regular access to essential medicines.
• Over 23% of the sick don’t seek treatment because they are not having enough money to spend
• A World Bank study shows that as a result of single hospitalization 24% of people fall below poverty line.
• 74% of total private out of pocket expenses are on drugs.
• Drug prices have risen sharply in recent decades
The MCI Code of ethics 2002 which says “Every physician should, as far as possible, prescribe drugs with generic names and he/she shall ensure that there is a rational prescription and use of drugs” if implemented in full shall be an effective tool to rescue a patient.
Given the will of the various authorities safeguarding this Nobel profession in the most unethical ways it seems unlikely that anyone including the government would be interested in taking on either the doctors or the pharma companies to task given their enormous and proven lobbying capacity. It is time that the legal fraternity i.e. the courts who have from time to time come to the rescue of the individual be coming forth to clarify, enact or force the government to act in the interest of the nation at large.
In one such instance the High Court of Rajasthan in it’s judgment said: “No person and particularly, the have-nots cannot be made to suffer as they cannot afford the luxury of purchasing the branded medicines at much more cost than generic medicines. The right to obtain treatment is tacit of Article 21 of the Constitution of India and right to obtain treatment at affordable prices of medicines is one of the concomitant of the same. Not prescribing the medicines in generic names may in given facts tantamount to violation of Article 21 of the Constitution of India. The combination of drugs and life saving drugs which are available in generic names, have to be prescribed in generic names otherwise the action would amount to violation to right to life itself.”
A prescription with generic medicines would give the patient/customer the right to choose the company at his price, a right he must have. But, ground reality is that the patients are being denied their RIGHT TO LIVE!! as they cannot afford the expensive medicines and are denied the affordable cheaper alternatives known as generics!!