We have always been vocal about how the entire mechanism from visiting the doctor to getting the prescription and buying the medicine works. Even the way we buy medicines involves little to no brains as we simply go and buy what is written in the prescription. And our non-questioning boils down to our exploitation by the following entities;

- Doctors we visit

- Hospitals where our loved ones or we are admitted/make a visit

- Pharmaceutical companies

- Medical Representatives

- Drug Stores

Most of you are handed the branded medicine prescription that is priced higher than the generic ones. Almost 75% of the branded medicine producers are manufacturing generics that are priced 60% lesser than the branded ones. Why so? They follow the same compliance and are made on the same premises. Still, there is such a stark price difference. The reason is simple – everyone in the nexus eats their share of the pie. 

These people are the reason why you are paying more medicines. Let's explore how medicine buyers are sold branded drugs at a higher price. 

A. The commission-driven business model of medical stores

Whenever you go to buy medicines at a pharmaceutical store, you will merely handover the prescription that bears the name of a doctor or his/her clinic. And most often, you will find a medicine store near the doctor's clinic or vice versa wherein the prescribed medicines will only be available in the store next door to the clinic. Every drug you buy will have a cost that is split between the manufacturers, medical store owners, and doctors. Doctors get the commission on prescribing certain medicines that the nearby medical shop sells. Their network is vast and not just limited to a few shops in the nearby vicinity. As a medicine buyer, it is your right to know the medicines' contents by questioning a doctor and even from the medical store owner. And you can also ask for the generics replacement and try it out for yourself to understand the difference as there is none.

B. Medical Representatives tying up with small clinics 

As mentioned above, most small clinics and individual medical professionals tie-up with the medical store; they also join hands with the Medical Representatives (MRs). Some medicines are given to doctors by MRs as gifts, and these come from leading pharma companies and agencies. Again, some of these medicines are provided on an experimental basis to check its implications on patients upon consumption. You can recall your last visit to General Physician in the neighbourhood and think of those yellow, white, and pink capsules. The ones that have no brand or labels but are given to you without any charges. Such medicines are not documented, and there is no costing or billing is done, which itself is alarming as this gets into the zone of sales promotion in the industry to claim tax benefits. 

C. Pharmaceutical Companies tying up with Hospital Chains

Another entity in this network is that of the chain of hospitals that ties up with the big pharmaceutical companies. Since the amount of inward patients are high in big hospitals, the margin for profits gets more significant for everyone in the nexus – doctors, pharma stores, companies, and hospitals. The working is similar to the models we discussed above, albeit with a difference. Here, the hospital chains are getting a considerable share of profits by recommending medicines bearing a specific brand name. The pharma companies look to drive higher sales by tying up with hospitals having a large number of beds. And since there are many agents in the supply chain, everyone gets their share of cut over here, including the visiting doctors in a hospital whose signature your prescription. 

Remember, none of these agents recommend generics as it does not benefit them, and therefore you will always end up paying more for the medicines. The best way to save money and avoid being exploited is to stay vigilant and question the points of authorities. It means you should question doctors when they prescribe medicines, ask pharma seller to what they are giving it to you, and ask hospitals to write you generics as well. We already talked about how generics are as effective as branded ones<link to listicle>, so you need not worry about the quality.