Prescribe medicines by generic, not brand, name, doctors at public hospitals told; doctors say the well-intentioned move can lead to fleecing of patients by unscrupulous chemists
Mumbai : Doctors at public hospitals have been told to prescribe medicines by their generic and not brand names to nullify the doctor-chemist-pharma nexus. However, doctors are opposed to this regime. Acknowledging the existence of black sheep within the fraternity, doctors say that this system leaves the unscrupulous chemist free to fleece the patient.
“We generally used to refer the medicines of the cheapest brand. For example, paracetamol is a generic name used for pain reliever and antipyretic, which means it is also a fever reducer. Earlier we used to mention brand name for example – crocin for paracetamol due to which the chemists were bound to give crocin only to the patients. Now, they can give paracetamol of any brand to the patients so that they get better margins,” said Dr Ramesh Bharmal, dean, Nair Hospital.
Dr Bharmal also say that the patients are losing through this, as there is no system in place for scanning the actions of chemists. “The patients are the losers in this system due to which we have regulated the system and not accepted it yet. It is still in experimental stage and we still have to modify it,” said Dr Bharmal
Dr Suleiman Merchant, Head of Radiology department, Sion Hospital, also said that many a time the chemists don’t stock medicines of cheaper brands. “We can take example of Azithromycine which is used for common cold, sore throat and respiratory infections. Commonly the cost of Azithromycin (500mg) which is a 3-tablet course ranges from Rs 40 to Rs 95. The chemists rarely stock the cheaper brand of Azithromycin,” said Dr Merchant.
Dr Merchant pointed out that there is no compulsion from FDA to the chemists for keeping the stock of every brand and especially the cheaper brand so that it is easily available and affordable for the lower income group.
Dr Avinash Supe from Sion Hospital, however, said that both the doctors and the chemists have been gaining in the absence of a proper regulatory system for the sale of medicines. “Even the doctors get undue benefits from the pharmaceutical companies. However, amid this arrangement, the patients stand to be a loser. But we need a better regulatory system in place for understanding the need of the patients and working for their welfare,” said Dr Supe.
A chemist from a BMC-run hospital said the doctors have been gaining heavily from the system. “The doctors get hefty commissions from pharmaceutical companies. Sometimes even we used to get shocked when we had to sell medicines of a costly brand to a poor person. We cannot be blamed. This change in rule of mentioning just the generic name and not the name of the brand is because of the misuse of power from doctors.”
Pointing out to a few solutions, Dr Merchant said that apart from the generic, the doctors must be given the list of the names of two or three brands from which they must refer the medicines to the patients. “We have to keep in mind the fact that most of patients visiting a BMC hospital are from lower class background. They cannot afford expensive medicines. Therefore, a solution should me evolved as soon as possible before the patients start suffering from losses,” said Dr Merchant.