Mumbai: Despite the rapid expansion of organised generic medicine chemist shops across multiple states, their adoption among common citizens remains strikingly low, accounting for only about 4% of the overall drug retail market. This stark reality highlights a fundamental challenge: while availability has increased, it has failed to translate into widespread usage, as prescribing and purchasing behaviour continues to be overwhelmingly dominated by branded medicines.
Jan Aushadhi and similar initiatives improve access but fail to change habits
Over the last few years, initiatives led by several players, including Jan Aushadhi Kendras, have significantly improved access to affordable medicines. These outlets offer price transparency, regulatory compliance, and assured quality standards. Yet, the intended benefit to patients remains limited, largely because doctors continue to prescribe branded medicines, leaving little room for generics to gain ground.
According to Prasad Danave, President of the Retail and Dispensing Chemist Association (RDCA), patients typically purchase medicines exactly as prescribed, showing little inclination to explore alternatives. Even though government directives actively promote generic prescriptions, many doctors still prefer branded drugs. Consequently, patients rarely consider generics independently, and when chemists suggest lower-cost alternatives, hesitation prevails due to loyalty to the brand mentioned in the prescription.
This scenario exposes a clear disconnect between policy intent and on-ground adoption. While generic medicine stores successfully address affordability and availability, broader acceptance depends heavily on prescriber confidence and patient trust. “Patients tend to associate branded medicines with superior quality and are reluctant to question a doctor’s prescription, limiting the potential impact of generic medicine initiatives despite their proven cost benefits,” Danave said. He added that promoting generic medicine will also help retailers to keep multiple brands of the same medicines. “Out of 140,000 crores business of medicines, generic medicine contribution among citizen is hardly 4 to 5 percent,” said Danave.
Generics account for only a fraction of India’s massive medicine market
Reinforcing this argument, a study published in Sage Journals in September last year revealed that rising medicine costs pose a significant burden for low- and middle-income households in India. The study found that households purchasing generic medicines saved nearly 40% on medication expenses. For chronic conditions such as diabetes and hypertension, those relying on branded medicines spent up to four times more than households using generics. These savings were often redirected towards better nutrition, improved healthcare, and children’s education—underscoring the broader socio-economic benefits of generic medicines.
At the policy level, the Government of India and the National Medical Commission actively promote generic prescribing through ethical guidelines that mandate the use of generic names to reduce treatment costs. The Ministry of Health and Family Welfare further supports this objective through the Pradhan Mantri Bhartiya Janaushadhi Pariyojana.
However, on the ground, Danave notes that availability alone is insufficient. “Generic medicines availability in the market will help only if doctors start prescribing. As of today, we hardly come across prescriptions with generic medicines,” he said. Compounding the challenge, patient perceptions continue to favour branded drugs, as higher prices are often equated with better quality, prompting many patients to actively demand well-known brands.
Aggressive branding and marketing influence doctors’ preferences
Industry dynamics also play a critical role. One major reason doctors hesitate to prescribe generics is the aggressive marketing and investment by branded pharmaceutical companies. “Branded drug manufacturers invest heavily in medical representatives, conferences, sponsorships, and educational programs, building familiarity and trust among doctors. Generic medicines, by contrast, lack comparable promotional visibility,” said a doctor who requested anonymity.
Adding to these concerns, doctors also worry about accountability and patient outcomes, fearing repercussions if a patient does not respond well to a generic alternative. Dr Aniket Mule, Consultant Internal Medicine, KIMS Hospitals, Thane said that several factors matter: clinical evidence, reliability of the manufacturer, patient affordability, availability, and past patient experience. For chronic illnesses, consistency and predictability of response are key considerations. However, he added that clinically, both branded and generic medicines contain the same active ingredient and are expected to work similarly.
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