Do you ever compare prices of different brands of medicines before purchase ?
The central government and many state governments have now
instructed all hospitals, dispensaries and health centres under their
jurisdiction to prescribe only generic drugs and avoid brand names.So whenever
your doctor prescribes a medicine, ask him to write the generic name too. If
it's a government hospital or dispensary, then the doctor has to give only the
generic name. In fact, the Indian Medical Council (Professional Conduct,
Etiquette and Ethics) Regulations 2002 mandate that "Every physician
should, as far as possible, prescribe drugs with generic name and he/she shall
ensure that there is a rational prescription and use of drugs". So demand
that the doctor prescribes medicine by the generic name.
One solution would be to insist that doctors are allowed to only prescribe generics . While this would take some problems away, it would create a whole set of new problems instead , and many doctors will protest strongly against this encroachment on their autonomy ! A better choice is to educate patients , so that they learn to ask for inexpensive generic alternatives. I think this is extremely doable – and patients be encouraged to ask their doctors when they write a particular brand , as to whether an inexpensive generic is available instead . And even if doctors don't have the time or the inclination to do so, patients can always ask the pharmacist !
Let’s not forget that it’s sometimes patients who demand the more expensive branded medicines ! Many believe that the more expensive drugs are better and more effective than their cheaper versions – just like they believe that expensive branded jeans are better than unbranded ones ! This is why we need to spend a lot of time and energy in educating and empowering our patients, rather than focusing only on doctors.
"Pharmacists have an important role in helping patients choose the right drug. "
Generic prescribing allows for any suitable drug, rather
than a particular brand of drug, to be dispensed. This can lead to cost savings
because cheaper alternatives can be prescribed. It may avoid delay because the
chemist can dispense a wider range of alternative preparations, rather than
being limited to one which may not be stocked.
One solution would be to insist that doctors are allowed to only prescribe generics . While this would take some problems away, it would create a whole set of new problems instead , and many doctors will protest strongly against this encroachment on their autonomy ! A better choice is to educate patients , so that they learn to ask for inexpensive generic alternatives. I think this is extremely doable – and patients be encouraged to ask their doctors when they write a particular brand , as to whether an inexpensive generic is available instead . And even if doctors don't have the time or the inclination to do so, patients can always ask the pharmacist !
Let’s not forget that it’s sometimes patients who demand the more expensive branded medicines ! Many believe that the more expensive drugs are better and more effective than their cheaper versions – just like they believe that expensive branded jeans are better than unbranded ones ! This is why we need to spend a lot of time and energy in educating and empowering our patients, rather than focusing only on doctors.
"Pharmacists have an important role in helping patients choose the right drug. "
Conclusion :
This can only be achieved by Education of doctors and pharmacists,Education and information for patients,Good quality control and regulation to maintain therapeutic equivalence*,Incentives to encourage generic prescribing and Careful selection of brand names.
References
1. Walley T, Burrill P. Generic prescribing: time to regulate the
market? BMJ 2000;320(7228):131-2.
2. Medsafe. New Zealand regulatory guideline for medicines. Section
15. Bioequivalence testing of oral medicines. 5th ed, 2001.
3. Rheinstein P. Therapeutic inequivalence. Drug Saf 1990;5(Suppl
1):114-9.
4. Mott D, Cline R. Exploring generic drug use behaviour: The role of
prescribers and pharmacists in the opportunity for generic drug use and generic
substitution. Med Care 2002;40(8):662-74.
Note: The views expressed in the article
are solely that of the author. The incidents about patient experiences (if any)
stated in this website are highly fictionalised and any resemblance to any
person(living or dead)and/or incident is purely co-incidental.
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