The Central government’s decision to make it mandatory for all pharmacies to display generic drugs on a separate shelf is a classic case of wrong diagnosis leading to wrong prescription, say chemists. The action, aimed at promoting the use of generic drugs, will prove to be an exercise in futility unless there are changes in the regulatory mechanism and chemists are allowed to suggest generic products to patients in place of medications prescribed by doctors, they say.
In a circular issued to all drug controllers on June 12, the Drugs Controller General of India (DCGI) Dr S Eswara Reddy stated: “It has been decided that every retail outlet should provide for a separate shelf or rack reserved exclusively for stocking generic medicines in the licensed premises.” Though the chemists are annoyed and remain doubtful about the effectiveness of the new measure, the DCGI’s action is not a bolt from the blue. The step was recommended by the Drugs Technical Advisory Board (DTAB), the country’s highest drug advisory body on technical matters, at its meeting in February.
“They have got the wrong end of the stick. The authorities should understand that chemists have limited say in the sale of a medicine, whether it is generic or not. The Drugs and Cosmetics Rules should be amended to allow chemists to suggest generic medicines to patients in place of medicines prescribed by doctors. Any step to promote generics should start from the doctor, not chemist,” All India Organisation of Chemists and Druggists (AIOCD) north zone vice-president Sanjiv Pandit told Pharmabiz.
Other traders’ associations also echoed the views of the AIOCD. “It’s a meaningless initiative. Keeping a separate shelf for generics is not a big deal for drug stores. But it won’t make medicines affordable. The government had planned to make it mandatory for doctors to prescribe generic medicines. It has not materialised so far. We can stock generic medications and display them prominently, but where is the demand? Most doctors prefer to prescribe well-established brands,” president of North Delhi Chemists Association Ashok Jain pointed out.
The step is the latest in a slew of measures announced by the government to push generic medicine sale. The health ministry recently tightened labelling norms for generic drugs making it mandatory for pharmaceutical companies to print generic names of drugs in a font which is two font sizes larger than the brand name. The rule will take effect in September.
Many healthcare professionals are of the view that overt promotion of generics will eventually boomerang on the healthcare sector in a country like India were quality standards are frequently flouted. “The government has instructed us to use salt names of drugs on prescriptions. But most unbranded generics cannot provide quality assurance despite affordability. Whether to put quality or affordability first is a dilemma for us too,” a senior doctor opined.
“Cosmetic changes such as separate generics rack in pharmacies or bigger font size on drug packages won’t be enough. The government should focus on bringing value by enforcing stringent quality protocols apart from investing in better healthcare infrastructure,” principal of NC Medical College Haryana Dr Mukesh Yadav opined.