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| Are not patients being fleeced by drug manufacturers, prescription writers ? | | | Daya Sagar | 8/9/2011 10:18:55 PM |
| Like any other Indian State , J&K too has not been able to check the unfair practices in the trade of medicines and health services. These days with the improving and growing medical facilities, drugs and investigations the money required by common man for the treatment of the patients too has increased. The costs would not have been that pinching had the increase been only due to genuine costs of medicines and services. The costs are disturbing because (i) information level has increased (ii) more alternative medicines / appliances are available (iii) more alternative treatments have been researched (iv) better and more investigation techniques are available (v) the service delivery quality of the government hospitals has deteriorated inspite of better techniques/ training / finances / wages (vi ) where ever the government doctors are allowed private practice (Doctors in Indian Defence services are also paid non practicing allowance , how funny) the government hospitals / institutions do not enjoy that much confidence of the common man due to falling levels of truthfulness towards duty (vii ) number of private practitioners have increased (viii ) the drug manufacturers / sellers / practicing doctors do not encourage sale of drugs / writing of prescription by Generic name (ix) unfair pricing practices being adopted by manufacturers to attract sellers & doctors and (x) medical services having got more commercialized.
It will not be possible to discuss the total health sector economics, I would discuss only drug trade .
It may surprise many educated subjects that even the all India level companies / multinational companies adopt different pricing and marketing policies for a drug manufactured from the same technical / generic material but sold under two different trade names. The practice adopted is not to benefit the sick / suffering people but to extra benefit of the pharmacist selling the medicines and the doctor prescribing the medicine. To exemplify a specific drug could be referred here with out mentioning the " true " name of the manufacturer since there are number of manufacturers practicing similar methods. An Indian manufacturer of international repute manufactured (AMLODIPINE Besilate IP 5mg ) with Trade name "AAAA" in strips of 10 tablets and the MRP was kept as Rs27.70 per strip in Dec 2010. This drug was sold to the retailer @ Rs. 3.78 per Strip of 10Tablets. No logic could fit here except that the large difference between the dealer price ( just 37.8 paisa per tablet and the consumer price /MRP (Rs.2.77 per tab) was kept to benefit the seller and the doctor who would send the patient to the seller. The same manufacturer manufactured the same drug with Trade name "BBBB" in strips of 15 tablets and the MRP was kept as Rs 44.80 per strip. This drug was sold to the retailer @ Rs.37 ( where as if we go by the price of "AAAA" it should not be more than Rs.6 /=per strip ) Strip of 15.Tablets. No truthful logic could fit here for so large difference in the dealer prices of same medicine The answer that could be obtained was that the drug named "AAAA" was marketed through the retailer/ dealer by the company . Where as the drug labeled "BBBB" was marketed by the manufacturer through the Prescription writing Doctor. In the case of drug " AAAA" only logic could be that about 732 percent margin over the dealer price is shared by the seller and the doctor. Where as in the case of Drug " BBBB" about 520 percent extra billed on the dealer / seller is passed on to the prescribing doctor . In case it is not so , why should a dealer buy same medicine of same company at two different prices ? And why should any doctor prescribe a medicine so highly priced in case the same drug of same company is available at 12 to 15 % of the price but with a different label ? The said medicine is used by patients with Blood Pressure disorder on regular basis. Imagine how large amounts are being unfairly drained from the pockets of the patients. Questions could be raised not only on prescribing doctors but also on the taxes / price control authorities.
Many say that in US / UK medicines are not sold without prescription from a doctor .It is being advocated that the same should be ordered and strictly implemented in India also. Should it be implemented in India where the trade practices are so ill conceived ? Yes it could be implemented in case (i) truthful honesty is imposed in trade (ii) the drugs are ordered to be sold by all manufacturers under the GENERIC /Chemical NAME and not the trade name. More than 80 % of the ailments suffered by people and more than 80% of medicines required in general could well be named & marketed under generic name without any difficulty. Surely these might have been the circumstances and trade practices that attracted the attention of Mr. Ram Vilas Paswan in 2008 ( the then Chemicals and Petroleum Minister GOI ). Ram Vilas Paswan had then talked of Jan Aushadi ( Drug) Store and first such store was opened in Amritsar in November 2008. Oos samay yeh bhi kaha geya tha ki 100 se jeada Jan Aushadhi ( Drug) Store desh bhar mein ek dam kholae jaein ghe aur aam admi kee par anuchit bhaar kam ho jaega. The Jan Aushadi Stores were to sell the drugs labeled by GENERIC / CHEMICAL name without undue provision for the benefit of dealers / prescribing doctors. A large numer of drugs were identified that could be sold at 10 to 20 % of the MRP being printed on the branded strips. Yes medicines could be sold at so low prices without any subsidy. Imagine how much burden on the common man would have been reduced had the programme been carried by the government machinery truthfully. But this programme has failed to even take off effectively. Where as by this time atleast 1000 stores should have been opened in India.
Many policies and welfare schemes are launched by the governments. But unless the official machinery works seriously ( aaj ke smay mein yeh kahaa ja sakta hai ki agar sarkaari tantr deyanatdaari se kaam karae) no programme would perform effectively. In case the inspection and vigilance organizations of the State do not perform honestly the common man and state exchequer are adversely affected. The Jan Aushadi Stores Programme has also suffered due to lack of commitment at the level of implementing agencies..It appears that this programme has been pushed back at the instance of manufacturers of medicines, sellers of medicines and the prescribing doctors Omar Abdullah too has not succeeded to come out of the pressures of the drug manufacturing and drug prescribing units. No order has yet been issued for writing prescription by GENERIC name by even government doctors in J&K .Not even a single Drug Aushadi store has been opened in Medical College Complexes / districts hospitals what to talk of block and Tehsil levels ( where the poorest of the poor people are being looted ) . It is now 3 years since first store was opened in Amritsar in 2008..
To be brief I would say that after it was detected that a large quantum of the drug trade was under unfair pricing policies , the GOI on paper decided to promote Jan Aushadi Drug Stores where the drugs would be available at genuine and fair prices. To start with the Government decided to retain the Public Sector Companies ( Indian drugs and Pharmaceuticals, Hindustan Antibiotics, Rajasthan drugs and Pharmaceuticals, Bengal Chemicals and Pharmaceuticals ) for supply of drugs to Jan Aushadi Stores . No doubt the Jan Aushadi Stores were to buy from the private sector companies too in case they offered the rationalized price. JADS could be run by government, cooperatives, NGOs and even private parties. This was to offer a competition to even private sector joints so that they change their policies for pricing.
.( Daya Sagar is a social activist and leading coloumnist on J&K Affairs dayasagr45 @yahoo.com 9419796096)
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