Even as the government has been pushing for, at least in its official rhetoric, doctors to prescribe only generic medicines, as opposed to the branded more expensive ones, a new study has some contradictory evidence to suggest that the government's plans might have hit a roadblock.
According to a commentary published in the Journal of Pharmacology and Pharmatherapeutics last month, the Prime Minister's Jan Aushadhi Pariyojana has hit a roadblock. Under the scheme stores selling affordable generic medicines can be run by NGOs, charitable institutes, private hospitals, registered professional organisations, or self-help groups.
Several factors such as issues with the supply chain of generic medicines, lack of awareness among consumers and doctors not prescribing generic medicines have been identified as the reason behind the scheme's failure.
The scheme is important because after the Prime Minister's announcement on a law to make doctors prescribe generic medicines in April 2017, a lot of emphasis was placed on the Jan Aushadhi stores that sell generic medicines.
In May 2017, Union Minister for Chemicals & Fertilizers and Parliamentary Affairs Ananth Kumar said that the country would have more than 3,000 Jan Aushadi Kendras by the end of the year, from the existing 1300 stores. The plan is ambitious and the authorities may well consider this study to understand the ground situation.
According to the authors of the study, one of the major constraints faced by these fair price stores for medicines is that the “public sector is unable to cater all of the 361 medicines identified as the most needed medicines in this scheme”, and so, the scheme covers only 130 medicines.
The article also quotes studies, that have proven that availability of generic medicines was only about 33 per cent due to the dependence on the public sector. The study also found that pharma companies replaced expired medicines, only if they were branded, in case of the generic medicines, replacing the expired ones was the responsibility of the pharmacist. Thus, stocking generics is not economically viable for pharmacists.
Branded medicines, on the other hand, come with high margins up to 200 per cent, experts say.
The article says that doctors don't prescribe generic medicines because of the “cozy connections” with pharmaceutical companies, who are also the sponsors for conferences and seminars organised by medical societies. However, doctors have often argued that the prime reason for avoiding generic medicines is the issue of poor quality.
To fix some of these problems, the article calls for more “real action”, instead of “lip sympathy” to generate awareness and make a well-intentioned scheme successful.