Patients may end up with drugs that "may not be effective at all" if doctors were made to prescribe only generic medicines as indicated by Prime Minister Narendra Modi, according to pharma industry body IPA.
The Indian Pharmaceutical Alliance (IPA) said that due to the nature of the current off-patent medicines market in India, if such a step were to be followed, the choice of products will be shifted from doctors to chemists, not patients.
Elaborating on the challenges, IPA Secretary General D G Shah (rpt) D G Shah told PTI that India is predominantly a market of off-patent medicines with two types of products -- generic and similar. While generic has established bioequivalence with the originators' products, a similar does not have.
"This difference has significant impact on the public health. A generic is safe and effective, but a similar may or may not be safe and effective as it has not been tested," Shah said.
Reacting to Modi's remarks that government may bring in a legal framework under which doctors will have to prescribe generic medicines, he said: "The prescribing in the INN (International Nonproprietary Names) -- popularly referred to as generic -- will enable chemists to substitute products of different manufacturers."
Shah further said the choice of product will be shifted from doctors to chemists, not patients. "As the patient is unaware of the difference between a generic and a similar product, he/she may end up with products that may not be effective at all," he added.
Yesterday, while inaugurating a charitable hospital in Surat, Modi had said: "We will bring in a legal framework by which if a doctor writes a prescription, he has to write in it that it will be enough for patients to buy generic medicine and he need not buy any other medicine."
IPA represents top Indian drug makers like Sun Pharma, Dr Reddy's, Lupin, Glenmark, Cipla and Cadila, among others. Analysts are also of the opinion that there could be some "practical problems" with the announcement.
"If the doctor only prescribes the generic name, it will be left to the chemist to decide which particular brand to push. So, the marketing focus of pharma companies will now have to shift from the doctor to the chemist," said Pharma Sarabjit Kour Nangra, Vice-President, Angel Broking. She felt that most pharma experts believe that this change may be feasible in government hospitals but not on a pan-India basis.
The last time when the government had attempted something similar was in 1978, but the idea had to be shelved after the pharma industry challenged the order in court, Nangra said. "If the step is to be implemented, the pricing pressure on the industry is here to stay. Overall logistics and implementation could be the key," she said.
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