Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
What are generic medicines?
Word generic comes from gener which means basic ingredients, its identity. So the identity of the medicine is its chemical name that is called as generic name. The World Health Organization (WHO) defines a “generic” as a bioequivalent to a brand name drug.
From generic to brand medicines
In India, the paradox is one medicine is made by several companies, comes in several sizes and shapes and packaging. This is where the whole confusion in medicine dispensing arises. Previously lesser companies were there in market. Those companies which used to export the medicines which were cheaper, so Indian companies’ medicines are demanded the most as they are best.
Anybody can register a company and ask to pack and stamp in their name. They can print prices as per their wishes and there is no control over it. The drug control does not control prices in all the general medicines. It has control over lifesaving medicines which it is doing for many decades.
Change in the situation
The PM wants to deliver the live saving instruments like stents and lifesaving medicines at the right price to all, especially poor. India has a large number of poor population. When they fall ill and fall in trap of expensive hospitals, many have to sell their assets to pay those bills. The expenditure about injections, tablets, stents, antibiotics, implants are enormous. Government means to deliver these at basic price so that patients save money and the original value of the medicine remains established and no one can claim one superiority over another.
This means that generic medicines can be adapted and the name sake companies generating extra profits can be avoided.
But the psychology of the patient is very important at the same time. Some patients think if the medicine is costlier and branded, it is superior.
There were sodamint tablets which were available in the same name. It did not need any branding. Today, there is renitec medicine which is generic. But it has atleast 30 brands in the market. So that is how somebody will claim their product superior to others and then charge more from patients.
Problems of generic medicines
One key requirement for generic makers is to submit bio-equivalence (BE) studies. A BE study is a process where companies have to test their generic products as against the innovator’s product for their effectiveness. In India, the requirement of BE study is a grey area. Only 15% of the products of various brands will be bio equivalent. The rest might just be ‘similar’ products. Unless the safety and efficacy of similar products are not proven, they cannot be interchangeable. So, there needs to be a demand to get these products qualified as ‘generics’.
The fear of buying generic medicine is there in the patient. They will be getting an inferior ingredient which may not help them to recover fast.
The government should make generic medicines compulsory in all general hospitals in the initial phase. The companies should be also supporting the generic medicines and maintain the cost and quality.
The supply of any medicine should be proper including its transport. In summers, the temperature rises and the foil packaging of medicine may contribute in deterioration of quality of any medicine. Hence there is a need to educate the stakeholders in the drug manufacturing to supply chain to maintain the best packaging standards. For this, there can be a law on packaging standards too.
There are companies which have certain medicines through which they have more sales. Those medicines can be maintained by those companies but the essential medicines should be recommended as generics. The leading companies can take over certain companies or their products so that unnecessary competition is not disrupting the price structure.
The government should be concerned that the patient should not be spending more for a medicine which he can get at lesser price.
The chemist should be made party to any discussions as they are the final distributor of medicines. The argument that all generics are of poor quality and all branded drugs are best is misleading. For this proposal to work, the government must make sure chemists have full stock of generic medicines to make its sales convenient.
Every medicine that goes from India is marketed and distributed in generic way. Thus the message should be that generic medicines are not inferior. They have same ingredients and are cheaper and hence they should be adapted.
Connecting the dots:
Recently PM announced the proposal of law mandating doctors to prescribe medicines with their generic names instead of brand names. Examine the advantages and risk associated with it with appropriate illustrations.