Prescribing Medicines in India: It’s A Quality And Price War

Prescribing Medicines in India: It’s A Quality And Price War

Medicines are the need which is never going to end or even slow down as health requirements will continue to rise with increasing population. That makes it evident why medicinal spending has crossed a $1 trillion dollar mark globally and is expected to reach $1.4 trillion by 2022.

In India too, the pharmaceutical industry has been gaining speed and shown an impressive advancement in recent years. According to Indian Brand Equity Foundation, In March 2018, the Indian pharmaceutical market witnessed the sales of ₹ 10,029 crores ($ 1.56 billion), registering a 9.5% growth year-on-year.
Realizing the crucial of medicines for well-being, and in an attempt to make affordable care accessible to all irrespective of their socioeconomic status, the Indian government and the Medical Council of India (MCI) made it mandatory in October 2016 for the doctors to prescribe generic medicines to people.

What are generic drugs?

To learn about generic medicines, let us first understand what a branded drug or medicine it. When a pharmaceutical firm invests in research and production of a certain medicine and earns patent rights to do that, the medicine is called a branded-medicine.
A generic medicine is actually duplicate of the branded drug on which the patent has expired. It, however, is similar to the branded medicine in terms of key ingredient ratio, quality, performance, dosage etc.
The key differences between a branded and generic medicine are:

  • Only the patent-holding company is allowed to manufacture branded medicines. Others can only manufacture them after the patient expires. Since there is no patent with generic drugs, there is no prohibition on manufacturing them.
  • Branded medicines are costlier when compared to generic ones due to the investment involved in research and development.

Quality and price war in generic drugs

Role of medicines, as we know, is critical. Quality cannot be compromised when it comes to medication. It deserves a mention that on an average, more than half of the treatment cost goes into medication. While the rich and affluent can afford branded drugs with costly tags, it is the poor who face difficulty, especially considering that most of them do not have an insurance coverage and medicines are an out-of-pocket expenditure. That is the reason why the government is now serious about the prescription of generic medicines.
Although affordable care is one of the prime objectives of the government, accessing quality medicines at lower prices has been challenging due to quality issues and availability. Here are a few key pointers to make a note of the challenges that exist:

  • Although the composition of the ingredients in generic medicine is same as that in a branded drug, the quality of branded drugs is ascertained by the level research gone in processing and manufacturing of a research molecule. Since there is no research involved in the manufacturing of generic drugs, the confidence level associated with them goes a little down.
  • Besides, the effectiveness of the generic drugs on biology needs to be tested. What is concerning is only a nominal percentage of generic drugs undergoes the required testing without which it is impossible to guess their quality.  Which means the quality of such medicines is not attested.
  • There is limited awareness about generic drugs in the market. Since not many people know about them, patients largely depend on medicines which doctors and chemists prescribe or rather decide for them. Thus, they end up paying a higher amount for branded drugs.
  • Also, retail pharmacists may not be keen on selling low-priced medicines because of lower margins associated with them, especially when they are not fast-moving drugs.
  • Many doctors and pharmacists avoid promoting generic drugs and prescribe branded ones instead as there are heavy commissions linked to the latter.
    How to control this warIt is only the government intervention that can mitigate, if not end, the prevailing challenges when it comes to prescribing and keeping available generic drugs. A few suggestions to address the concerns can be:
  • Primarily, it requires a certain period of quality control and periodic audits to verify the quality of each generic medicine. There should also be a clause of punishment for the companies violating quality standards. It needs proper regulations, a sufficient number of drug inspectors and adequate lab facilities.
  • It is advisable that the National Pharmaceutical Pricing Authority cuts down the maximum retail price of these medicines so that the manufacturers are unable to manipulate with it. Additionally, there needs to be strict price control for essential and life-saving drugs, in particular.
  • The government can consider introducing a uniform marketing approach to popularize these medicines so as to bring their cost and hence price down.
  • All formulations, representation and dosages of an enlarged list of essential and life-saving drugs to be put under price control.

Once these regulations are in place and strictly implemented, bringing generic drug prescription into regular practice will not difficult. The government appears to be taking right measures in this direction and it appears that affordable medication to all is around the corner.

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