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Can doctors judge best quality in medicines? -Jyotsna Singh

-The Hindu

Doctors’ objections to prescribing medicines by generic names fly in the face of a recent report on substandard drugs

In a surprise move on April 17, Prime Minister Narendra Modi announced that his government will soon make it mandatory for doctors to prescribe medicines by generic names. The decision was to ensure drug prices remain affordable and patients get a wider bouquet of options instead of being forced to purchase a particular brand.

Within days, the Medical Council of India (MCI), apex regulator of the sector, issued a notice reminding doctors that according to a 2016 amendment to the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, they are supposed to prescribe drugs with generic names.

Doctors reacted sharply, insisting that branding of drugs assured them on quality. The Indian Medical Association (IMA) issued a statement: “The judgment to choose a rational drug and its format vests only with the Registered Medical Practitioners. This right of the medical profession is sacrosanct."

Survey on substandard drugs

As the debate about affordable medicines gets upstaged by drug safety, it is instructive to look at the findings of a recent report on substandard and spurious drugs by the National Institute of Biologicals for the Central Drugs Standard Control Organisation. Released in late February, the report established that branded medicines are in no way assurance of quality.

The report, based on a one-of-a-kind drug survey conducted from 2014-2016 and in which 47,954 samples of drugs were collected from across the country and put to test, revealed that while only 13 samples (0.024%) were spurious, as many as 1,850 samples (3.16%) were substandard. It also showed that while in retail outlets 3% of the medicines were substandard, in government pharmacies the figure was a staggering 10%. For example, as many as 26 out of 46 samples (56.52%) from the Maharashtra facility of pharmaceutical giant Pfizer Limited were found to be substandard in the survey. “Pfizer is a big name in the industry. If so many of their medicines are substandard, then it shows that big brands are no guarantee of good quality,” says S. Srinivasan of All India Drug Action Network.

Moved by the evidence from this report, the Health Ministry has initiated action against defaulting pharmaceutical companies. “We have sent notices to drug manufacturers whose products have been found substandard. Some companies have already surrendered licences,” says K.L. Sharma, Joint Secretary, Health Ministry. The ministry refused to give details of companies which have been issued notices or have surrendered licences.

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