Medical prescription guidelines: Go for well-calibrated adoption

Source: The post is based on the article “Medical prescription guidelines: Go for well-calibrated adoption” published in “Live Mint” on 23rd August 2023.

Syllabus: GS2- Statutory, regulatory and various quasi-judicial bodies & Issues relating to development and management of Social Sector/Services relating to Health.

News: In this article, author discusses the challenges and considerations of India’s new medical guideline urging doctors to prescribe generic drugs over branded ones. He also emphasises the need for quality assurance, better infrastructure, and collaboration among stakeholders to ensure affordable and quality healthcare in India.

About India’s new medical guideline.

Issue by: On August 2nd, the National Medical Commission (NMC), which oversees India’s medical sector, issued guidelines for registered medical practitioners. These guidelines cover various topics, including medical ethics.

Preference for Generics: An important instruction for registered medical practitioners is to recommend INN generics (International Non-Proprietary Name) rather than branded medications.

Promotion of Government Centers: Urges patients to purchase drugs from government centres and generic pharmacy outlets.

Educational Aspect: Doctors should inform patients about the equivalence of generics to branded drugs in terms of efficacy.

Quality Assurance: Emphasizes the need to ensure the quality and standardization of INN generics.

What are the challenges of India’s new medical guideline?

Challenges of India’s New Medical Guideline

Trust in Quality: Many doctors lack confidence in the quality and reputation of generic drug manufacturers. They’ve used branded generics for years and are hesitant to switch due to concerns about clinical outcomes.

Comparison with Western Markets: Unlike the West, where generics must meet strict quality standards, India’s criteria are less stringent, leading to doubts about drug equivalence.

Transfer of Drug Choice: The guideline might shift drug choice from doctors to chemists. There’s a fear that chemists might dispense pricier drugs for higher trade margins instead of cheaper generics.

Availability Issues: Currently, generic drugs only account for 1-2% of the market share in India.

Quality Assurance: India lacks adequate drug control inspectors and testing labs, making regular inspections of manufacturing facilities challenging.

Prescribing Challenges: Generic drugs often come in fixed-dose combinations, making it hard for doctors to prescribe the right strength variations. Without the flexibility found in branded medicines, doctors might find it challenging to match the exact needs of their patients using generics.

What should be done?

Enhance Trust: Educate doctors on the quality of generic drugs and their manufacturing standards to build confidence in prescribing them.

Quality Control: Increase the number of drug standard control inspectors and expand testing laboratories. Regular inspections of manufacturing facilities are crucial.

Improve Availability: Expand the network of Jan Aushadi centres beyond the current 9,000+ to ensure easier access to generic drugs.

Review Trade Margins: Evaluate and possibly regulate trade margins to ensure that cost savings from generics are passed on to consumers.

Open Dialogue: Encourage discussions between the government, medical bodies, patient groups, and pharmaceutical industry to address concerns and collaborate on solutions.