Steeply rising medical costs among the millions of middle class and poor people of this country in the absence of inadequate insurance cover are pushing many of them into indebtedness and poverty. The spread of lifestyle diseases amongst these people is the main reason for the overall spurt in the medical expenditure and this trend is only going to further rise in the coming years as most of these diseases cannot be cured and can only be controlled. It has been noticed that over prescription of drugs even for minor ailments and physicians’ insistence on multiple diagnostic tests are other reasons for the increased medical costs. Unethical prescription practices by physicians, avoidable diagnostic costs and consultation fees for every visit to the same doctor are also pushing up the treatment costs. Aggressive promotion of branded drugs by the pharmaceutical companies with the support of  physicians is yet another reason contributing to high medical costs. Patient groups and social activists have been representing to the government to bring some kind of curbs on rising medical costs for some time now. But no effective steps have been taken so far by the Union health ministry or any other concerned departments.

A proposal to introduce auditing of prescription practices of physicians was thus mooted sometime back in 2010 with the aim to have some kind of control on over prescribing of medicines and avoidance of unwanted diagnostic tests. Nothing worthwhile had happened since then. Effective implementation of an audit should help to ensure surveillance of prescription practices across the hospitals, nursing homes and clinics both in public and private sectors. That may create an environment of transparency and accountability among the medical professionals in the country. With the issuance of guidelines on standard prescription format for the physicians by the Medical Council of India last year, prescription auditing should be rather easy for the regulatory officials. In fact, prescription auditing needs to be more stringent in case of diagnostic tests as such tests are much more expensive than medicines. Detailed pathology tests, X-rays, CT-MRI scans and other medical investigations are highly expensive and often unnecessary but are being prescribed by the doctors repeatedly for simple disorders just to help these diagnostic centres. Such unethical practices need to be strictly discouraged amongst the medical professionals to control the treatment costs. To achieve the objective of a prescription audit in the country, the Union health ministry has to first issue an order in this regard and direct the state governments to enforce the same both in the public and private hospitals.