MCI directs physicians to prescribe drugs by their generic names; order in force in city

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MCI directs physicians to prescribe drugs by their generic names; order in force in city

Juthika Baruah | July 01, 2017 12:13 hrs

The highly suspected nexus between doctors and pharmaceutical companies will now come to a definitive end as the Medical Council of India (MCI) has instructed doctors to adhere to its guidelines of prescribing drugs by their generic names. 

The MCI has also asked the medical practitioners to ensure that they provide rational prescriptions and failure to adhere to its order will invite strict disciplinary action against the errant doctors. 

Clause 1.5 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 was amended in 2016 and notified in the Gazette of India on 21st September, 2016 which states, “Every physician should prescribe drugs with generic names legibly and preferably in capital letters and they shall ensure that there is a rational prescription and use of drugs.”

All the registered medical practitioners under the IMC Act are directed to comply with the aforesaid provisions of the regulations without fail.   

The MCI reiterated its 2016 directive a few days after Prime Minister Narendra Modi stressed on putting in place a legal framework to ensure that doctors prescribe low cost generic medicines to patients. “The MCI has taken a good step as patients suffer a lot while buying medicines. They have to ignore the prices, however high they may be, because the necessity of the medicines cannot be discounted irrespective of its prices. The doctors always write the brand name and the patients have to buy only that particular medicine although there are hundreds of medicines with the same composition with huge difference in prices. The doctors write the brand name as they have some tacit understanding with the companies like, if a doctor can give a sale of Rs. 1 lakh then the company will offer 30% to the doctor’s monthly income which is called Propaganda Company,” said President of Assam Medicine Dealers’ Association NL Agarwala, while speaking to G Plus.

However, according to Dr. Bikash Rai Das, Senior Consultant Cardiac Surgeon, GNRC Hospital, in India there are hardly any original drugs discovered. Most of the drugs the doctors prescribe are actually copies of the original drug. That way, these drugs are actually “branded generic.” “Generic medicines bear only the name of the molecule and don’t bear any brand name. Therefore, they are cheap. But, the quality of these generic medicines is always doubtful if not procured from a reputed company since they don't have to protect any name as such. It's like buying a shirt either from the roadside stall at Fancy Bazar or from a Levis store. Obviously Levis will guarantee a certain quality for fear of going out of business if it provides a poor quality garment. Here it doesn't mean that the shirt which you have bought from the roadside stall at Fancy Bazar is of low quality. But chances are high that it might turn out to be a bad purchase since the company which manufactured it doesn’t have a brand name to protect,” Dr. Das said.

The doctor stated that same thing goes for medicines also. Yes, the branded medicines are expensive and should always be prescribed judiciously. Obviously the patient has a choice to choose what is best for them. “Doctors are a little hesitant to prescribe the generic medicines since they are still not confident about the quality of the generic medicines. The quality assurance and quality control maintained at these manufacturing plants are not stringently regulated by the government at present. Once that is made certain, doctors will not hesitate to prescribe the generic medicines in a bigger way. Till that time the government shouldn't force the doctors to prescribe only the generic names. Similarly, doctors should also take the patient's preference and economic condition into consideration before writing a branded drug. But at present both generic and branded medicines have roles to play in the present health scenario,” stated Dr. Das.

According to the doctor, accessibility to quality affordable medicines has always been a major cause of concern in India. To provide quality drugs at low cost to the common man always has been a challenge for everyone. A generic drug is a bioequivalent of a drug with a brand name, also called an innovator drug. It may look different from the innovator drug but will have the same properties. Generic medicines cost 30%-60% less than branded drugs. A branded drug can be 10 times more expensive than a generic variant sometimes.

“The union government and regulatory bodies appear to be serious in ending the pharma-doctor nexus and curb unethical marketing practices. In its latest effort, the Medical Council of India has directed doctors, hospitals and medical colleges to prescribe generic medicines as far as possible. Generic medicines are more affordable versions of branded medicines sold by companies,” the doctor added.

Over the past couple of years, there have been a slew of efforts to curb unethical marketing practices followed by pharma companies, end the use of branded drugs and bring down the prices of medicines. Though the government has opened the retail store "Jan Aushadhi," which market generic medicines in certain states, availability of quality generic medicines is a huge concern.

“Doctors are of the view that the focus should be on the quality of the drugs prescribed. For the benefit of patients and to get the best possible results, highest quality drugs with best possible pharmacological properties should be used by all doctors. If the quality of generic drugs is of high standard, doctors should prescribe generic medicines. The medical fraternity fears that this directive on generic medicines can't be incorporated unless stricter quality control norms are in place. Measures are needed to build confidence about the efficacy of non-branded medicines if they are to compete with multinational drugs that now enjoy a near monopoly,” said the doctor.

However, Joint Director of Directorate of Health Services, Kamrup (M), Ganesh Saikia said that the circular has already been implemented in Guwahati and it has been instructed to the physicians to prescribe generic medicines to the patients.

• Doctors to prescribe drugs by their generic names as instructed by MCI

• Generic medicines cost 30%-60% lesser than branded drugs

• The order has already been implemented in the city by the health department

• Availability of quality generic medicines is a huge concern

• A generic drug is a bioequivalent of a drug with a brand name, also called an innovator drug 

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