Prime minister’s announcement of making a law to force the use of generic medicines is welcome but needs careful study of issues.
The issue is complex and in reality may not help majority of patients who are poor, uneducated. There are all sorts of manufacturers who have shades of good manufacturing practices and facilities. A simple example – consider a company who is in lower stratum and gives a high commission to retailers. He will pass that medicines to poor unfortunate patient.
Good manufacturing practice ( GMP ) is the key. In fact many drug manufacturers have to maintain high standards of FDA which are very, very expensive.
Till we sort out the complexity I would suggest
- Use generic name first and into bracket ( give 2-3 manufacturer names ).
- Identify essential medicines with generic name.At present exclude costly medicines which require high standards ( FDA type ) GMP.
- This will lower our manufacturing standards and even corruption ( manufacturer and authorities ).
- Allow only manufacturers who maintain GMP or have satisfactory plants to sell generic names.There should be a periodic third party check ups.
- Current practice of manufacturing drug companies is to five generic names in small un-readable fonts.
- Make them readable with large fonts and readable till the last tablets is used up.Preferably same size as the brand name.
- Many times in a strip of 10 tablets the name of medicine is over written on tablets only. This often is unreadable halfway. Particularly so on aluminium type shiny foil as it gets mutilated
- Good way should also be an extension of extra 2 cm long strip which gives essential info on that extra length as it would be readable
- In fact why not make medicines available in plastic bottles as they do in US!
- Or identify retailers who only can dispense generic medicines ( with laid down caveats and preconditions )
- People should be trained to look for generic names by massive campaign as we do for many social projects. I have been doing so for long and some people have come back to me observing that there were duplication of same drug in other combination which they have been taking.
- Remember that these people were intelligent and educated
- Each month, local Medical associations should give advt in news papers which will give name of 5 generic medicines along with names of manufacturers name and their prices for the same. This will improve the image of doctors in association and hopefully narrow down the price differences .
Currently there is band wagon of ministers, MCI, sociologist etc to join the chorus.
Tail piece – medical practice is industry, insurance driven, and corporate hospitals ( for profit ) driven, nowhere the doctor (the popular whipping boy of everybody) or patient who is totally forgotten are considered.
By Dr Suresh Amin MD. IFCAP