E-drug: Concept of generic drugs (cont'd)
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Dear e-druggers,
There is a source of genuine confusion due to the different contexts
in which the term "generic drug" is used. On one hand it would
appear to describe drugs which are off patent, whether sold under a
brand or otherwise. On the other hand, the term "generic drug" is
used to describe drugs that are not sold by brand.
India is a market where the bulk of the drugs would be described as
"branded generics". That would mean that most of the drugs are off
patent but sold under brand names. For example, paracetamol may
be available under more than 20 brand names with a unit price
variation of up to 50%. It is rare to find truly generic (unbranded)
drugs being prescribed and sold in retail.
One of the reasons why such a situation has come to pass is that
India has a federal structure and hitherto the enforcement of drug
quality control has been delegated to states, which has resulted in
variable enforcement of the law. This has lead to a perception that
not all drugs in the market meet the minimum quality. Therefore, over
years companies have built brands mainly using the desire of
customers for assured quality, though the cheapest drug may be as
good as any in the market, quality wise. In fact, a common belief is
that all unbranded drugs are of questionable quality. This is due to
propaganda of drug companies through doctors and also due to
perceived lax enforcement of quality standards.
Another reason for perpetuation of this generic drug market is the
influence exercised by drug companies on doctors for prescription of
their brands. All the incentives and temptations in the book and out of
it, are used. A World Bank sponsored study revealed that drug
companies routinely used "informal" practitioners or quacks also to
promote their products through gift schemes and free samples. In a
scenario like it exists at present, the implementation of a rational drug
prescription policy is a distant dream. In fact, the availability of cheap
drugs has in a way spoilt the prescribing habits of Indian practitioners
and post 2005, when product patents come into vogue, could be a
major source of problem, unless some form of universal rational drug
prescription policy is worked out. The difficult is, of course, ensuring
the compliance of the private and informal practitioners who are
responsible for more than 50% of the prescribing.
Dr Srinivas
Deputy Secretary Public Health
Ministry of Health and Family Welfare
Room 202, Nirman Bhavan
Delhi-110011
(Comments made in personal capacity only)
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