Does your doctor follow the Ethics of MCI (Medical Council of India), and write the generic name of drugs and not Brand names on the prescription?
99% of practicing doctors write brand names in illegible handwriting which is in clear violation of the code.
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.
This, however, is in complete contradiction to the MCI Code of ethics 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”.
The FDCA however continues to approve drugs according to the generic names and their quality standards prescribed.
Globally, the US FDA notes: “Any generic drug modeled after a single, brand name drug must perform approximately the same in the body as the brand name drug. There will always be a slight, but not medically important, level of natural variability just as there is for one batch of brand name drug compared to the next batch of brand name product. This amount of difference would be expected and acceptable, whether for one batch of brand name drug tested against another batch of the same brand, or for a generic tested against a brand name drug.”
All this are not coherent 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 Human Angle:
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
High Court of Rajasthan has taken a note of the same and in it’s judgment supported the patients case: “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.”
But, ground reality is that the patients are being denied their RIGHT TO LIVE!! As they cannot afford expensive medicines in most cases but can easily afford the cheaper alternatives known as generics.
It gives all the information needed to make a strong case for scrapping self regulation for doctors and making them responsible and accountable to their patients. Patients in the developed countries have the right to choose their brands as the doctors’ prescribe generic names so why not in India. Framing rules for them to make sure patients are not shortchanged. France on the other hand took 7-10 years for this transition to happen which was particularly painful but rewarding in the end. The strong grip by the pharmaceutical companies on the entire chain from doctors to hospitals needs to end for the patient to benefit.