How has the medical community reacted to forced prescription of generic medication over brand names?
The recent intentions of Prime Minister Narendra Modi’s government to force doctors to prescribe generics as a means to reduce costs to patients — as previously covered by Health Issues India — has been met with mixed opinions.
It was already assumed that the decision would not be taken well by those pharmaceutical companies whose medications would, as a result, be sold less frequently, driving down profits. Recently many doctors have also opposed the decision.
A key concern amongst doctors is repeat prescriptions. Under the proposed new law a patient may end up on entirely different medication than the one they had been receiving for years. While in theory this medication may be cheaper, doctors worry that it may have slight chemical alterations compared to the brand name medication that could cause unpredictable effects. This, however, would suggest a weakness in regulation: generic products should be exactly equivalent to the originator product in the human body.
Some doctors argue that the generics that would replace the branded medications often have not had the same level of testing performed on them. As a result the bioavailability of the medicinal compound may differ, as well as the levels of impurities, the potency and the efficacy of the medication. All of these factors could contribute to side effects in the patient if suddenly altered.
Pharmaceutical executives have added to this discussion, putting forward the need that any drugs received by patients in India be ensured to meet a set standard. Cipla’s CEO Umang Vohra says “I think the quality aspect is very important for the government to address … to make sure that all companies in India are on the same quality footing,”
A survey of doctors revealed that 73 percent of those asked believe the law would be a bad idea claims the Times of India. The reason most cited as opposing the legislation is due to the potential for an influx of poor quality generic medications that have not gone through the same quality testing as their branded counterparts. Both doctors and the pharmaceutical companies argue from the same standpoint on the matter.
Others view the matter in broader terms, focusing more on the potential to improve access to medications for those in extreme poverty. The law undeniably has great potential to ensure that even poorest in society can afford healthcare, though some argue this low cost may come at the expense of quality.
Doctors and patients may trust brand-names more because of well-reported problems in regulation of India’s generic industry.