A recent circular issued by the Food and Drug Administration,
Maharashtra to retail chemists in Mumbai has made cutting of tablet
strips mandatory. The circular directed the chemists that strips should
be cut if the customer so desires. In fact, most of the chemists in the
country are indulging in this practice for several years now. Therefore,
the rationale to issue such a circular is not very clear. What is
actually required is to curb this practice in the interest of the
consumers. It is possible that some poor patients may ask for strip
cutting if the prescribed drug is an expensive one. But that is to be
discouraged by the pharmacists at the counter in the interest of the
patient safety as it could lead to under dosing and consequent
ineffectiveness of the drug. Incorrect and inadequate dosage of medicine
by the patients is one of the main reasons for the recurrence of
diseases among the poor. As such the strip cutting is not a desirable
practice as that can lead to sale of expired drugs to unsuspecting and
illiterate customers. At a time when some of the drug companies are
colluding with retail chemists to sell expired drugs, strip cutting can
actually help such unethical practices to flourish. It is obvious that
when the strips are cut, the ingredient details, expiry date and batch
numbers may not be there on the cut portion of the strip. This could be
dangerous to patients.

Although Maharashtra FDA directed the
chemists in the state in this regard, there is a lot of confusion on the
issue amongst the pharmacist community including amongst regulatory
officials. Indian Pharmaceutical Association, the national body of
pharmacists in the country has already taken objection to idea of
legalising strip cutting. It has informed the DCGI that there is no
clear-cut provisions in the law whether strip cutting is allowed or not
and regulatory officials have different views on the matter. IPA has
rightfully urged the DCGI that the issue should be included in the
agenda of the next meeting of the Drug Technical Advisory Body for
discussion and appropriate action. Earlier pharmaceutical companies used
to sell almost all drugs belonging to different therapeutic categories
in strips of 10. Marketing of tablets in multiple strip sizes and
different strength developed over the years as the drug companies wanted
to escape price control. Today, many pharmaceutical companies including
reputed ones have strip sizes of 6 to 10 and 15 to 30. In some cases,
there are even strips of 30, 40 and 50. Such huge sizes of strips can
certainly create a chaotic situation and some discipline needs to be
brought in. A rationalization of strip sizes is necessary based on the
therapeutic value of the drug, dosing and cost of medicine.