Generic drugs look good on paper only

The government may pass a new law making it compulsory for doctors to prescribe only generic drugs. The Prime Minister has been personally impelling this move to make healthcare more affordable for the widest sections of Indian society even at the cost of taking on big pharma, which would fight this move tooth and nail considering the vast amounts it has spent on establishing brands and promoting them not only in India but worldwide. The Prime Minister has said so about big pharma and how unpopular he could become in aiming to break the doctor-pharma nexus of kickbacks, incentives and even sponsored holidays via international conferences. What is being planned is an idealistic policy, which if implemented properly should bring down the cost of drugs to the public. As with most such policies in India, it is the implementation that will lag behind leaving myriad problems in its wake as well as leave open avenues for black marketing, etc.

There are practical problems to be associated with a move that may have only a lesser impact in India as the country already uses generic drugs in public health care and about 80 per cent of the market — set to go up to 90 per cent by 2020 — is to do with bulk medicines of the generic variety, which are essentially drugs on which the patent protection has expired for the original developer. What the move forcing doctors to prescribe only generic medicines would do is empower the chemist. Doctors may be disciplined by a code that is being envisaged by which penalties will apply and in a worst case scenario even cancellation of the licence to practice. The chemist will rule the roost in dispensing generic drugs of different pharma firms and the fate of the entire exercise may land in his hand and he could become the target of seductive marketing practices. Experts aver that the change may be feasible in government-run hospitals but not on an all-India basis. Arming the consumer with informed choices cannot, however, be a bad thing provided a choice is given to the user by a doctor prescribing a branded drug as well as its generic alternative.

Where the government can perform wonders is through its actions in controlling the prices of the most common drugs taken for chronic diseases and conditions. The prices of 700 common drugs are being controlled through the new health policy that was revised after 15 years. As the Prime Minister pointed out, the cost in the case of some medicines has been brought down from about Rs 1,200 to as low as `80. Also, by controlling the prices of stents, the Centre is doing a big favour to the middle class people who have to cough up a huge amount of money for dealing with something as common as heart ailments. Tackling logistics and policing the implementation will, however, be the key to the bigger issue of generic drugs. Big pharma won the legal battle the last time such an experiment was talked about 40 years ago. Whatever be the end results, the government cannot be blamed for not trying.