Availability of life saving drugs depend upon a foolproof drug distribution system that is well organized and well planned. Gujarat being a hub of the pharmaceutical sector, has a very competent and proficient drug delivery structure that is reckoned to one of the best systems in the country. One of the main reason that helps in the level functioning of the drug supply chain is the state can be traced back to the presence of a strong drug regulatory system that keeps an invariable check on the activities of the stake-holders.
The effective communication strategy and the supply chain management technique adopted by them have created a hallmark for itself in the state, as it ensures that the drugs are made available to the public on time, right from the cities to the remotest village in the state. According to Pradip Trivedi, Secretary, Federation of Gujarat State Chemist & Druggist Association (FGSCDA), the stakeholders in the state constantly keep themselves updating on all the latest requirements and developments prepared by the state regulatory system so as to ensure that no details are overlooked by them that may hamper their work and impact the accessibility of drugs to the patients.
FGSCDA, a state affiliate of the 5,50,000 strong All India Organisation of Chemists and Druggists (AIOCD) , is constantly engaged in preparing the members to compete with the organised chain stores and making them aware of possible future competition. As a state representative of the countries largest trade body,AIOCD acts as the voice of this vast industry in Gujarat, by regularly improving itself to meet the changing needs of its members, so as to make the drug supply chain more apt as per the requirements of the public.
Collective responsibility
The FGSCDA is an important trade body in the state, which represents chemists, druggists, wholesalers and retailers from across Gujarat. As a trade association, it constantly interacts and work with the government on various concerns and agendas that is aimed at improving their performance in the state. Trivedi avers, “We constantly work to ensure and safeguard the interest of the public so that we can appropriately contribute in their welfare and health needs. The approach that we have taken for this task is simple. We make sure that we always have a very close working relation with the regulatory officials in the state as only they have the resource and authority to address our issues.”
The exceptional harmony between the drug department and the trade associations in the state gives the required push to the industry to flourish in the state. This becomes easier as the association and its members do not indulge in any activities that support illegal activities, says Trivedi . In fact, FGSCDA plays an important role in keeping up with the regulatory requirements by notifying the drug authority on any indiscreet activities that come to their notice.
Dr H G Koshia , commissioner, Gujarat Food and Drugs Control Administration (FDCA) point out that FGSCDA’s role as the fundamental source to distribute the medicines to the patients is indisputable, as they execute their duty very well, by following all the required mandates as deemed necessary. “For us to implement the rules and regulation in the state efficiently, it is essential to have a strong support from the industry and all the stakeholders. We are fortunate that in Gujarat we have a strong trade body who is co-operative and comply with all the necessary requirements as needed, reducing our work” Dr Koshia informs.
The association has closely worked with the FDCA to sensitise the traders and the public on the various aspects about the regulation and on the regulators expectations. They constantly undertake activities stressing on the importance of pharmacists in the society and in outlining their role in the society as well.
Praising the regulatory system in the state, Jashvant Patel, president, FGSCDA says that it is a very industry friendly organisation, which always pro-actively supports most of their ventures intended to develop and support the well-being and interest of the trade and industry.
Building community pharmacy
With a view to strengthening the role of a pharmacist in the society from being a dispenser of medicines to some thing more central and significant, the FGSCDA has launched a mission that will broaden the scope of this vocation. Over some time now the association has been working on encouraging more and more members to take part in activities that will help the progression of community pharmacy in the state.
Trivedi stressed that the role of a pharmacist goes beyond just selling medicines. They should be more pro -active and supportive in this endeavour and should explore their role as a counselor to patients as well. Since the pharmacists widely deal with the medicines and drugs , they should also start participating in counselling patients by guiding them on the implication of the drug, ways to medication techniques, side effects etc so that the patients are appropriately informed about the same.
For this purpose, the FGSCDA has prepared a unique software specifically to help the chemists and druggist to get the required information on any given brand with all the details and information on that product along with its ingredients, strength, approximate price, indication and contra indications etc. The information on the drugs are filled in the software as per the brand name as well as its generic name. Trivedi informed that as of now it contained information on approximately 50,000 brands and their properties.
The main aim behind this initiative was to encourage more pro-active involvement from the chemists and druggist while dispensing the drugs to the patients since it is their duty to provide counselling services to the patients while dispensing medicines. This is also a step towards strengthening the right of the pharmacists in dispensing medicines that is affected due to the malpractices of doctors.
Voicing concerns
Over some years now, FGSCDA has been constantly voicing their angst against some of the practices that are being misrepresented for the benefit of selected few. The association has been constantly sending representation to the state as well as to the central government demanding some changes and amendments in the Drugs and Cosmetics Act (D&C). They point out that if the government will make the required changes in the provisions of the law as requested, most of the problems with respect to the pharmacy distribution chain can be sorted out effectively.
The chemists and druggists in Gujarat has urged the government to omit Schedule K (5) from the D&C) Act, which deals with provisions with regard to drugs supplied by the registered medical practitioners to the patients directly. They believe that the removal of Schedule K (5) will stop the distribution and dispensing of medicines by doctors at their clinics. This demand was made by the FGSCDA in a representation to the commissioner of FDCA in Gujarat to ensure that the doctors do not indulge in unfair distribution and dispensing of medicines to the patients directly.
The requirement under Schedule K (5) was inserted looking to the need at the time of framing the rule in the year 1945. As there were only limited number of medical stores in the country then, under Schedule K (5) the doctors where allowed to dispense medicines at their clinics.
Similarly they also have been pushing to the government to amend the rule 65 11 (a) of the D&C Act and make provisions in the law to empower the chemists and druggist to dispense cheaper alternative medicines to the patients from the one that is prescribed by the doctors. This demand is made to ensure easy accessibility of affordable medicines to the patients in the wake of the current practice of prescribing expensive branded drugs to the patients when cheaper substitutes are available.
Today, Rule 65 of the D&C Act restricts all the chemists and druggists from dispensing a substitute brand to the patients when there are enough alternate brands available in the market that are far more cheaper and affordable than the brands prescribed.
Trivedi point out, “Pharmacists should be given the right to suggest and give an substitute prescription to the patients for their benefit especially when they have the understanding and the expertise in the field. Most importantly, this is a patient- centric mandate made with an objective to give relief to all the patients across the nation by proposing them an option to choose between the available brands based on their economic capability.”
One of the other notable disagreement is over the present drug pricing policy that the government has proposed to implement. As per the analysis done by the stakeholders, the margin of the trade associations is going to be affected greatly, if this pricing policy comes into existence. But most importantly, stakeholders claim that the current pricing policy is not in line with the requirements of the public as well and is more manufacturer friendly than patients, which is not acceptable. Patel emphasizes, “We strongly oppose the governments stand on the current drug pricing policy and want them to reconsider and replace it with some other option that is more acceptable and economically feasible to us, so that it does not affect our margins and business but also provides some kind of benefit to the patients as well. The real benefit needs to be for the consumer and their welfare, thus the government should rework on the policy and also involve us in the whole process as well.”
Further Trivedi pointed out that Ahmedabad is known as a hub for manufacturing quality based low cost drugs that are easily accessible and available to the patients. There are many companies in the state who manufacture and sell drugs at affordable rate like Unison Pharma. Similarly, even Delhi based Mankind Pharma also manufactures drugs at a far more affordable price than the others. “If they can manufacture high standard drugs at low cost, why can't the other companies do the same. These factors need to be considered by the government before deciding the pricing policy as it is the welfare of the patients at stake,” he adds.
The experts from the trade bodies believe that to improve the pharmacy system in the country, all that the government needs to do is to adopt the recommendations submitted by the stakeholders for the good of the industry as well as the public.