With a view to prevent doctors from flouting government norms for generic prescriptions and from promoting branded drugs instead of implementing government policies, the health ministries of Assam and West Bengal have initiated steps to monitor and scrutinize the prescription pattern at government hospitals.
The state governments in West Bengal and Assam have introduced a policy to distribute cheaper and quality generic drugs to the patients coming to the government hospitals. Before implementing the generic prescription policy, the health departments in these two states convened a meeting of medical officers and physicians to arrive at a consensus for not promoting costlier and branded drugs. Even then, according to sources, some doctors are flouting the governmental norms and prescribing only branded drugs under the pretext that brands are quality oriented. To address these violations and save the poor patients from out of pocket expenses, the two eastern state governments have introduced certain steps including auditing of prescriptions.
While the West Bengal government introduced auditing of prescriptions at the state run hospitals, the government of Assam introduced prescription pads with duplication facility at the hospitals. The Pads are supplied by NRHM and it is designed in such a way that a copy of the prescription written by the doctor should be kept in the hospital for auditing /verification and the original should be issued to the patient. In every month, a random of 10 per cent of the prescription will be checked by a Committee for generic prescription and auditing. Besides, a quarterly check of 20 per cent of all prescriptions will be carried out by the member-secretaries of the district health societies. The member-secretaries are officers in the rank of joint directors in the health services.
In a circular sent to all the hospitals and health institutions, Prateek Hajela, the Commissioner & Secretary of health, government of Assam, said in order to help doctors prescribe the available generic medicines, the stock position of different generic drugs should be communicated to them and to the nurses by the concerned pharmacists on every fortnight. In case of shortage of drugs prescribed by a doctor, the pharmacist must put a stamp on the patient’s copy indicating that ‘generic equivalent is not available in the store’.
When asked whether state government hospitals are able to provide all generic items, a medical officer working at Golaghat in Assam answered negatively and added that no final decision has come over what to do on non-availability of generics. The government has also instructed the district medical officers, principals of medical colleges and superintendents of civil hospitals from top to bottom that a list of available and non-available generic medicines should be displayed on the signage boards in front of the pharmacy and of the office complex. The health secretary’s circular says that disciplinary action will be initiated against erring officials for violation of government directives.
For the smooth conduct of auditing of prescriptions, the health department in West Bengal formed special pharmacovigilance committee comprising pharmacology specialists. Even though all the doctors have been given strict instructions, not all of them are prescribing generics only. Since MCI and IMA have issued circulars already supporting generic prescriptions, doctors are silent over the move as they are concerned about the loss of freebies from pharma companies.