Late Dr. Abdul Kalam had a dream of seeing India as a developed nation by 2020. For which he traveled the length and width of our nation, even in his advanced age, to inspire and stimulate the young generation. Only when you start the work now, you can reach the goal by 2020, he said. That is true and applicable to all fields, including the life saving noble profession of pharmacy. Let us evaluate our profession, sector wise in the light of those words.

Pharma industry
Thanks to GATE and TRIPS agreements, Pharma industry in India has grown tremendously in the past decade, that, its export has more than doubled. We earned the prestigious name of ‘Pharmacy of the world’ by exporting to dozens of countries including USA. We could produce cheap, yet standard generic drugs and supply to scores of African countries to save the people from treaded diseases like, AIDS, TB, Cancer etc. Thus pharma industry of India is marching towards prosperous 2020, no doubt. But can we say the same with other arms of pharmacy profession?

Pharma trade
In the past decade we have seen number of developments in this field. Starting of chain of pharmacies in all the metropolitan cities of India by corporate and industrial houses is the biggest event that shook the otherwise sleepy and conservative retail and whole sale pharma trade. These chains of pharmacies have brought in competition by way of large discounts and some professionalism to the trade. They have started air conditioned pharmacies with spacious beautiful interior and graduate pharmacists. But all these are confined to the posh areas of cities and not percolated to the bottom. Even for this there is lot of cue and cry from the old timers of the trade, who want huge profit from minimum expenses.

Pulling the cart backward
These people try to pull the professional cart backward, not realizing that the wheels of scientific developments have no reverse gear! Instead of modernizing the pharma trade, they struggle to maintain status quo. The main reason they put forth is insufficient income from the business for not air conditioning or for not appointing full time pharmacists or for not providing value added services by graduate pharmacists. There are considerable numbers of self employed [D. Pharm] pharmacists in these pharmacies who too struggle for survival. We cannot shut our eyes to these realities.

What to do?
Large proportion of profit from drug trade is going to pharma industry, which is proved by the fact that no big pharma industry was closed because of loss in the near past. On the other hand we see acquisition, mergers, new ventures and huge investments in India and abroad by Indian pharma industry. Hence more percentage of profit margins should be given to the retailers by the industry. It should not be less than 25% of MRP as in developed countries. Another source of income to the trade can be collecting service charge for dispensing each prescription. It should be minimum, say Rs 5 per prescription or 2 or 3% of total bill depends on its value in descending order. Pharmacy Practice Regulations recently published by Pharmacy Council of India permits this service charge. But all these should be implemented on the condition that the service must be by a qualified pharmacist and in pharmacies with proper storage like AC, etc. Drugs Control Department and Consumer Organisations should ensure this and violators should be punished. In order to implement the modernization of pharmacy trade, the pharmacies should be graded into A, B or C depending on the services and facilities available in them.

Ban dispensing biz by doctors
Yet another hurdle in taking India to the status of developed nation is the good old practice of dispensing by doctors to their patients. It drastically cut the income to the medical shop that many are not getting even double digit prescription per day and that is one of the reasons for illegal counter sale of prescription medicines. Dispensing by doctors or hospitals should be banned immediately. It was permitted in olden days when there was no pharmacy around the hospitals in India. Now we have 2 or 3 pharmacies per street. The bad practice of dispensing by doctors is continuing out of greed, not for any service to the patients. When the protests increased, the hospitals circumvent that by opening pharmacies in the front portion of their hospitals. Even it should be banned, as it indirectly compel or influence the patients to purchase from these pharmacies, preventing them from purchasing in pharmacies of their choice or from their neighbourhood pharmacy with which they have rapport or credit facilities.

The rule of not permitting doctors or hospitals from dispensing is implemented in majority of developed countries including gulf countries. If they can why not India? In the meanwhile if any doctor or hospital is dispensing (selling) drugs without bill (that is the case with 99% of the patients) that should brought to the notice of sales tax or commercial tax authorities as the Kerala traders did in the recent past. Let there be income, if not to the pharmacies, at least to the government by way of these taxes.

Pharma education
No doubt Pharmacy Council of India has a vision of future and hence started Pharm D course in 2009. It has also proposals to upgrade the profession and recently announced 2 years Bachelor of Pharmacy Practice course for D. Pharm holders. But it is far behind in implementing these proposals or taking further follow-up steps. Thus Pharm D graduates are left in streets without knowing where to get jobs and Bachelor of Pharmacy Practice course is nowhere near in sight, though new academic year has commenced in June. Starting Department of Pharmacy Practice in all big hospitals is yet to get materialized. PCI is not able to convince Medical Council of India or Central govt in this regard. Consequently Pharma Vision 2020 is still a distant dream for pharmacy students.

A silver lining in otherwise gloomy picture is, because of health insurance company’s requirements, corporate hospitals started appointing clinical pharmacists - albeit namesake - without any authority or dignity to them. Unless and until a separate Department of Pharmacy Practice is opened in these hospitals as in developed nations and pharma trade is modernized we cannot claim we are moving towards the status of a developed nation as far as healthcare sector is concerned. Let us unite to realize that dream of the great people’s president Dr. Kalam!