Dr. BR Jagashetty, former Karnataka drugs controller is pressing the need for a swift implementation of prescription audit by the union ministry of health across the Indian healthcare space to ensure control of indiscriminate medicine consumption not to just prevent multidrug resistance but also control medical expenses. This would be the first step for the execution of the Planning Commission mandate of Right to Heath(RTH) on similar lines that of Right to Information(RTI) and Right to Education(RTE).
The execution of a prescription audit would ensure a strict surveillance across hospitals, nursing homes and clinics. It would create an environment of transparency, effectiveness and accountability among the medical professionals in the country.
Prescribing a multiple drugs covering anti-inflammatory, antibiotics, anti-pyretic along with multi-vitamin supplements and a ethically promoted nutraceutical drink or powder has been frequently observed in scores of prescriptions written by highly qualified physicians. In addition, the medical specialists also insist on multiple diagnosis including blood samples, x-rays, CT-MRI scans at frequent intervals. Some of the doctors call for pathology labs reports for a simple fever and cold. This is seen to be causing ample suspicion not just among the patients but also drug regulators, he added.
Drugs constitute a mere 15 percent of medical costs but it is the diagnostic costs and consultation fees for every visit to the same doctor which seems to ring an alarm. This is further supplemented by the lack of audit and control on the mushrooming of path labs and diagnostics centres. Pharma companies are aggressive in promoting new brands which has seen physicians refrain from prescribing generic drugs. The reality is a nexus between pharma firms and physicians apart from the general practitioners favouring specific diagnostic centres. Therefore, government should immediately consider a prescription audit for the benefit of the patient population, Dr. Jagashetty told Pharmabiz.
The regular recommendation for nutritional therapeutics to control cholesterol and for diabetes care are also viewed as unnecessary for long durations. Most doctors do not even bother to consider the affordability of the patients as most of these diet supplements are expensive.
“In a similar manner we are also highly suspicious about the pathology and diagnostic labs which are springing up in the country. All the tests conducted here are based on doctor’s prescription and more often not required for certain health conditions”, pointed out Dr. Jagashetty.
The unwanted drugs and diagnostic tests are fueling the costs of a patient healthcare in India making it largely unaffordable. The government should now immediately look at the creation of a technical committee manned by regulatory and medical experts to put in a place a surveillance system for prescription audit. It should also have list of generics to be prescribed for certain disease conditions and recommend a branded drug only if essential or in a situation where the generic drug is not available. The healthcare providers need to embark information, education and communication (IEC) for both general public and patients. This would not just lead to rational use of drugs but also Right to Health where patients could question the healthcare provider on the need for particular medications and diagnostics tests, said Dr. Jagashetty.