14 February 2012
Brand names of drugs could soon disappear from prescriptions issued in government hospitals. The health department is about to issue an order making it mandatory for doctors to mention the generic name ofmedicines instead of their brands while writing prescriptions.
This is being done to prevent pharmaceutical companies from pushing their products in government hospitals, which are supposed to provide medicines free of charge to patients. The decision will be conveyed to the superintendents of government hospitals on February 24.
The move was planned about a year ago and could be implemented by the end of this month. Though millions of patients are set to benefit from the decision, doctors are sceptical. Prescribing generic drugs could pave the way for inferior products, which are cheaper but ineffective, they point out.
The health department is now preparing a list of generic drugs for which brand names can no longer be used.
Antibiotics and life–saving drugs top the list. Brand names, however, can be used in exceptional circumstances, health officials said. "A doctor can mention a brand name only if he believes the particular brand to be more effective and essential in that particular case. The doctor must write a justification certificate, explaining why he has mentioned the brand," said Tridib Banerjee, chairman of the task force for infant mortality.
Each hospital will have a designated drug store from where medicines can be bought in case it is not available at the hospital medical store. Prescribing generic drugs will not only thwart pharmaceutical firms from hard selling their products, often through unfair means, but also ensure that doctors prescribe medicines that are available at the hospital store, Banerjee said.
"There is a tendency to prescribe drugs which have to be purchased from the market. This is not what they are supposed to do. Doctors should be prescribing medicines which are available at the store, to the extent possible," said Banerjee. He added that the list of generic drugs would be ready in a few days. It will include all groups of medicines that are generally recommended for a wide range of medical conditions.
A section of doctors says the plan is welcome but it will work only in an ideal situation. Unless the government ensures that all brands in the market conform to a basic standard, treatment will suffer, they argued. "There are dozens of brands for, say, paracetamol. Now, patients will have to accept what the drug store gives them and you can't rule out the possibility of inferior brands being pushed. Since doctors are accountable to patients, we shall be held responsible for failing to cure them. So, the government should introduce a quality control and assessment system, which will make sure that only good quality drugs are available in the market," said Subir Ganguly, senior oncologist at NRS Medical College Hospital.
Rezaul Karim, of Sagar Datta Medical College Hospital, agrees. "There are loads of inferior and spurious stuff available in the market. These firms will now be encouraged to pay a higher commission to drug stores and push their products. The move will do more harm than good unless you have quality control," said Karim.
Penal action will be taken against doctors in case they are found violating the rule, the health department made it clear. "We shall have a cell that will address complaints," said Banerjee.
Cardiac surgeon Kunal Sarkar feels generic prescriptions will lead to confusion and errors in drug delivery.
"Before implementing the decision, the health department has to make sure that their designated pharmacies and stores have adequate supply of the listed drugs, which is often not the case. Secondly, we don't have a uniform drug manufacturing standard which means quality is not guaranteed. In the absence of brands, spurious and unscrupulous manufacturers might try to take advantage. Finally, few of our pharmacies have trained chemists who will now have to identify drugs by their generic names rather than brand names which is infinitely more difficult.
I would request the authorities to think twice before introducing the system," said Sarkar.