Unavailability of generic medicines raises concern
GUWAHATI: The absence of easily accessible generic medicines in Guwahati is providing private drug store owners a free hand in exploiting customers, allege doctors and patients.
They have claimed that there are very few centres where they are readily available.
With only a few outlets in the city providing these medicines; patients, especially those who belong to the underprivileged backgrounds, face a tough time in purchasing expensive medicines in the absence of their relatively cheaper alternative generic variants.
While doctors working in government-run hospitals say they are bound to prescribe generic medicines, they say they also provide an alternative name of a branded drug for the ease of patients.
“In the government sector, we have to prescribe the generic medicines to the patients. But they are not always easily available in the open market,” informed Dr Tanma Saikia Das, a city-based gynaecologist in a government hospital.
Generic medicines are medications which are created on the lines of an already existing marketed and branded drug. It is also similar to the brand name drug in terms of composition, quality, performance characteristics and intended use.
A generic drug works in the same manner and has similar clinical benefits as that of its branded version medicine. However, generic drugs are substantially cheaper when compared to their branded counterparts.
However, experts maintain that contrary to popular belief, generic medicines are not of poorer quality which is usually believed since they cost less.
As per state government directives, the pharmacies can sell medicines from different brands but they have to stock generic medicines as well.
Business-driven agenda of pharmacists
Dr Tanma Saikia Das told G Plus that since generic medicines are available at a very few places in the city, apart from prescribing the name of generic medicines, the doctors usually also have to write the name of an alternative branded medicine. Thus, the patients belonging to underprivileged sections of society are not able to avail the benefits of the generic medicines.
“A majority of the other pharmacies, apart from the ones managed by the government, do not stock these medicines. If the generic medicines are not available at the government pharmacy or at the hospital’s pharmacy, the patients have no option but to go to the private medicine outlets outside,” Das told G Plus.
Doctors say that once the patients approach any private pharmacy, then it is the discretion of the pharmacist as to which brand the pharmacist wants to sell.
“The pharmacists are the ones making a business out of it so they will suggest a drug in which they have the maximum cut, rather than the maximum benefit for patients. The concept of generic medicines is a very good idea but it’s not being properly implemented,” informed another city-based doctor.
Further, he added that it is not the discretion of the pharmacist to change the drug. “If a particular medicine is not available, they should inform the patients that it is not available with them. But they often suggest drugs of similar composition to the patients, and then the onus is on the patient. The pharmacists are often in an agreement with big pharmaceutical companies from where they get a cut on sale of their brand’s medicines.”
Doctors say that sometimes the private pharmacists would only inform the patients of a few alternatives of different brands which are expensive, in order to make more money.
At present, generic medicines are available only at the pharmacy at Gauhati Medical College & Hospital (GMCH) and a few AMRIT pharmacies and medicines shops managed by National Rural Health Mission (NRHM) stores.
The state got its first AMRIT (Affordable Medicines and Reliable Implants for Treatment) pharmacy in Guwahati in September 2016 at the Gauhati Medical College & Hospital (GMCH).
More outlets were then inaugurated in other five medical colleges including Dibrugarh, Silchar, Barpeta, Tezpur and Jorhat in January, 2017. At the time of the first inauguration at GMCH, health & family welfare minister, Himanta Biswa Sarma said, “In continuing with our commitment to bring in the best healthcare facilities and access to affordable treatments and medicines for the people, we shall be launching five Affordable Medicines & Reliable Implants for Treatment or AMRIT pharmacies across the state. The AMRIT retail outlets, which sell drugs at highly discounted rates, have a very comprehensive list of medicines that are available across range of products.”
Assam was the first state to introduce AMRIT pharmacies in the entire northeast region. For this, the state government had signed an MoU with HLL Lifecare Limited to provide essential drugs at 50 to 70 percent discount to the people.
Rajasthan had begun a highly-popular scheme called the Mukhyamantri Nishulk Dava Yojana (MNDY) or the Chief Minister’s Free Medicine Scheme in 2011. Under this, the state government provides quality, generic drugs at no expense to all. This has helped in reducing the out-of-pocket expenditure on healthcare for the people of the state.
The scheme was implemented in stages, in which initially 200 types of generic medicines were made available. As some time went by, more medicines were added to the list which later made 612 medicines available.
Following the success of the scheme in Rajasthan, the central government had planned to introduce the generic medicine under the National Rural Health Mission (NRHM).