Doctor-Pharma Nexus? Ignoring Jan Aushadhi Scheme, PGIMER doctors allegedly prescribing Branded Medicines
Chandigarh: While the National Medical Commission (NMC) and the Central Government have been insisting on the usage of generic drugs for quite a long time, the doctors working at Postgraduate Institute of Medical Education and Research (PGIMER) are being accused of prescribing expensive branded medicines, which are not easily available at the Jan Aushadhi Kendras.
Although on September 1, five deaths occurred at the institute for alleged use of an anaesthetic bought from a private chemist, there is no halt in the practice of prescribing non-generic medicines. Resultantly, it is being speculated that the doctors are being influenced while prescribing drugs because of the alleged nexus between the doctors and the private pharmacies, reports The Tribune.
On the other hand, several doctors have claimed that the generic medicines are of poor quality and they lack regarding the required composition necessary for the effective treatment.
Amid all such confusions, it should be mentioned that NMC had earlier directed the doctors to write down the generic names of the medicines in the prescriptions. Medical Dialogues had earlier reported the Ethics and Medical Registration Board (EMRB) of NMC in the recently released draft Registered Medical Practitioner (Professional Conduct) Regulations, 2022, stated that the doctors should prescribe medicines with "generic"/"non-proprietary"/"pharmacological" names only.
The prescription guidelines that form an integral part of the Draft mentioned, "Prescribe only those generic medicines that are available in the market and accessible to the patient."
Besides noting that "generic"/"non-proprietary"/"pharmacological" names have to be prescribed, the guidelines reiterated the point by again stating that physicians should "Avoid prescribing "branded" generic drugs". The guidelines however lay down that In the case of drugs with a narrow therapeutic index, biosimilars, and similar other exceptional cases, this practice can be relaxed.
In fact, taking a step further, the Guidelines added that the doctors should "Encourage patients to purchase drugs from Jan Aushadhi kendras and other generic pharmacy outlets" and should "Advocate for hospitals and local pharmacies to stock generic drugs."
Supporting the NMC guidelines, several states including Telangana, Chhattisgarh, Uttar Pradesh and Punjab had warned their doctors against prescribing the branded names of drugs.
Central Government also has come forward in order to ensure affordable health or all. In this regard, the Union Health Minister had previously mentioned about the Government initiatives for promoting generic medicines in more than 8500 Jan Aushadhi Kendras across the country
PGI Chandigarh also has Amrit (Affordable Medicines and Reliable Implants for Treatment) Pharmacies and Jan Aushadhi stores, where the patients can buy medicines at a cheaper and subsidised rates.
However, as per the latest media report by The Tribune, the doctors at the institute are continuing their practice of prescribing non-generic drugs. In fact, they allegedly provide the families of the patients with a long list of items that are required to be procured from pharmacies. Since most of these items remain unavailable at the Amrit Pharmacies or Jan Aushadhi stores, the patients are left with no choice but to rush to the private pharmacies.
Speaking about this, a patient told the daily, "Last week, my mother underwent surgery to remove kidney. I had to purchase surgical items from a private chemist for Rs 3,000 as some of the items were not available at Amrit Pharmacy."
This is shocking since there are altogether seven Amrit Pharmacies, two Jan Aushadhi stores on the PGI Campus offering drugs, implants, surgical disposables and other consumables at average discounts of up to 60% of the MRP.
On the other hand, the Private pharmacies often charge MRP price and there are four such private chemist shops available at PGIMER, while six more such private chemist shops are vacant at present.
Long before the NMC guidelines, the Health Department of the UT had directed the doctors back in 2017 for prescribing only generic medicines in the prescriptions. In fact, back in 2008 the Department of Pharmaceuticals had launched the JAS initiated by the Centre in order to make generic medicines available at affordable prices.
Also Read: PGI Chandigarh Satellite Centre to be functional by January 2023: Union Health Minister
However, the practice of prescribing non-generic drugs is continuing at PGIMER and the sources have allegedly claimed that there is a "cozy nexus" between the medical practitioners and the private pharmacies. Similarly, the private chemists are existing inside the PGI campus by paying huge rents, which also indicates towards the role of such pharmacies in pushing branded medicines with higher profit margins, adds The Tribune.
Speaking about this, a senior PGI doctor told the daily, "A file was moved to replace a private chemist shop at the Emergency centre, paying Rs 1.57 crore rent, to get it replaced with Amrit Pharmacy, but no action was taken."
"There is no denying the fact that some doctors prescribe branded medicines available at a particular pharmacy only. A robust mechanism is need to ensure patients get drugs at affordable rates at Amrit Pharmacies itself," added the doctor.
While commenting on this, another doctor mentioned, "The PGI drug committee selects 6-7 brands of quality drugs and ensure these are stocked by pharmacies. The institute can ask Amrit Pharmacy to stock up these brands only."
The doctor further pointed out how private chemists stock up brands offering higher margin and therefore compromise with the quality of medicines, as seen in the case of Propofol. In this context, the doctor added, "Private chemists should be evicted from the PGI. Their touts even discourage patients from going to Amrit Pharmacy and suggest them to visit their shops,"
On the other hand, refuting these claims some doctors have pointed out how generic drugs are often found in poor quality and they lack the required composition necessary for effective treatment. While commenting on this a PGI doctor told the daily, "In order to benefit patients, the government needs to get involved and cap the price of essential drugs by including branded medicines as well in the list."
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