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LATEST NEWS UPDATES | Call to doctors to shun drug cocktails -GS Mudur

Call to doctors to shun drug cocktails -GS Mudur

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published Published on Dec 11, 2016   modified Modified on Dec 11, 2016
-The Telegraph

New Delhi: A health consortium today questioned a decision by Delhi High Court earlier this week to quash the Centre's ban on 344 cocktails of two or more medicines and urged doctors across the country to stop prescribing them.

The Jan Swasthya Abhiyan (JSA), the Indian section of the global People's Health Movement, said it was shocked at the judgment because there was "no scientific rationale" for the continued use of the 344 fixed-dose combinations.

In March, the health ministry had banned the 344 combinations, ranging from cough syrups and pain relievers to anti-allergy medications, saying many of them were "likely to involve risk to humans" and had "no therapeutic justification".

Delhi High Court, responding to pleas from drug companies, quashed the ban on Thursday, saying the Centre had not followed certain procedures such as consulting the Drugs Technical Advisory Board.

The consortium, in a statement today, said all the 344 fixed-dose combinations were irrational. "Medical students are not taught about their use as no textbook of medicine or pharmacology recommends the use of these combinations," it said.

The consortium said its statement was meant as an appeal to all individual doctors, associations of medical professionals, and hospitals not to prescribe the 344 drug combinations and to the government to challenge the high court ruling in the Supreme Court.

"It is disappointing that the (high) court appears to have raised procedural issues but disregarded the broader public health interests for which the government had banned these drugs," said Narendra Gupta, a physician with Prayas, a non-government health organisation in Rajasthan and member of the Jan Swasthya Abhiyan.

A fixed-dose combination is a formulation containing two or more medicines. Irrational combinations expose patients to unnecessary drugs and therefore to their adverse effects, and increase their expenses. Sometimes one of the drugs in the combination may counteract another.

The consortium has pointed out that the World Health Organisation's model list of essential medicines includes only 24 fixed-dose combinations among 358 drugs, and India's national list of essential medicines includes only 16 such combinations among 348 drugs.

Yet, the consortium said, the fixed-dose combinations represent nearly 40 per cent of India's pharmaceutical market.

"None of the 344 irrational FDCs find mention in standard medical textbooks. They are primarily promoted through aggressive marketing by the drug companies' representatives," said Amit Sengupta, a physician and convener of the consortium.

The consortium said the high court order did not appear to address the rationality of the banned combinations and the resultant harm to public health.

"The JSA calls upon the esteemed judiciary of the highest courts to support and uphold people's fundamental right to access affordable, rational medicines over the interest of profiteering companies who might see the lifting of the ban as a renewed opportunity to inundate the market with irrational FDCs," the consortium said.

Some irrational combinations may also expose patients to inappropriate doses of drugs, one example being a combination of two antibiotics, cefixime and cloxacillin.

While cefixime is typically prescribed twice a day, cloxacillin needs to be taken four times a day. So these drugs should ideally be taken through separate pills or tablets. A single formulation containing both exposes the patient to inappropriate medication.

The health ministry's ban in March this year had followed recommendations from an expert panel that had described each of the drug combinations as having "no therapeutic justification".

The Telegraph, 4 December, 2016, http://www.telegraphindia.com/1161204/jsp/nation/story_122909.jsp#.WEz5-LmdeyA


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