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Saturday, 30 April 2016

Should doctors write Generic Prescriptions?

            If an amateur asks, it’s a ‘doubt’… but, experience creates a dictum of ‘disbelief’… While having a discussion with experienced professionals, an amateur in me was drawn into a debate, “Should doctors write generic prescriptions?”
            To begin with let’s get introduced to concept of Generic Medicines- According to WHO, “It’s a Pharmaceutical product usually intended to be interchangeable with an innovator product, from the innovator company and marketed after the expiry date of the patent or other exclusive rights.” Generic products by law are meant to be marketed by their generic name. However, as a marketing strategy there evolved a concept of “branded generics” where generic products are marketed with unregistered brand names & exorbitantly printed MRPs. As a result, there is a huge confusion regarding generics amongst doctors as well as patients. (Not pharmacists)
            In current scenario, if you ask, how many doctors write prescriptions in generic form? You may hardly get a few. But, if you ask, how many pharmacists dispense generic medicines? You will hardly exclude few. This is true, as exorbitantly printed MRPs on branded generics offer a high profit margin to pharmacist. A question that arises amongst doctors is a “doubt” or “disbelief”, doesn’t matter. What matters is, “Should doctors write generic prescriptions?”
            Well, if a doctor is concerned about well-being of a poor patient, he would prefer an affordable treatment. But, same doctor also doubts over the quality control regulations of generics. Irony is such that, his beliefs and disbeliefs are manipulated by pharmaceutical companies. In fact, they recruit a special task force for such manipulation. While discussing with a FDA inspector, his trust over generics reflected through the fact that he used them for personal use. He added, “Doctors are so dumb! They complain about ineffectiveness of generics, just on basis of its price tag. But, they have no problem with exorbitantly priced branded generics. In fact they can’t even differentiate between branded and generic products.” Calling a doctor dumb hurts his ego. So, he had a silly excuse, “It is easy to write brand name, as it is concise.” And his laziness, got a solution through computers, what now?
            “Even If I write a generic prescription, I don’t trust pharmacist dispensing the same”, added another Registered Medical Practioner. A doctor doubts pharmacist, so he writes branded prescription and gets gift packages for same. Wow! What a solution. The irony is he is unaware of his prescriptions being flooded by exorbitantly priced branded generics that are instilled by his team mate he doesn’t trust. It’s so annoying, when you know that price of distrust among health team is the patients’ health. Question arises, “Should doctors write branded prescriptions?”
Shahbaz Khanda, shahkhanda@gmail.com
1.      Shahbaz (NIRMAN 6) has completed D.Pharma and is pursuing MBBS from Government Medical College, Nanded. He holds special interest in the topic of generic medicines.
2.      An awareness campaign was conducted in Nanded by Shahbaz and team, to clarify doubts regarding generic products on 21st to 23rd Feb, covering about 5000 people. Feedback reviews were taken for same.

3.      Under ICMR, (Indian Council of Medical Research) a short term studentship (STS) is given every year to undergraduate medical students. Simple short term study to be completed within 2 months is conducted through it, with a stipend of 10,000 INR. STS has been given to Shahbaz for the study  “To Study Doctors' Beliefs, Barriers, Awareness and Actual Practices regarding Use of Generic Medicines.”

4.      A panel discussion was held on 21st April, 2016 to finalize the questionnaire for the above study. Panel included 2 members from pharmacy faculty and 2 from medical college. About 25 Medical students were also part of this discussion. (Most of the comments in above article were part of this panel discussion.)

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