Chemist Body AIOCD up against MCI Telemedicine Guidelines, writes to PM Modi

Medical Dialogues team had earlier reported that On March 25, 2020 telemedicine guidelines were notified by the Board of Governors in Supersession of the MCI by amending the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulation, 2002 with an intent to ease access to healthcare for patients. However, the amendment in not in accordance with the provisions of the Drugs and Cosmetics Act, 1940 Pharmacy Act, 1948, and rules and regulations, AIOCD has now stated.

Pointing out at the glaring irregularities in the Telemedicine Guidelines, AIOCD has moved a letter to the top government offices stressing that if it is not corrected immediately, would lead to misuse of telemedicine, and put public health to a great risk.

AIOCD, in its letter, elaborated that the Telemedicine Guidelines insofar as it seeks to validate photo, scanned, a digital copy of a prescription for buying prescription drugs is against the provisions of Drugs and Cosmetics Act, 1940, the Pharmacy Act, 1948 and Rules framed thereunder and warrants an urgent rethinking since it has the potential of affecting public health on a large scale.

It further mentioned that the Telemedicine Guidelines allow the doctors to issue prescriptions by sending a photograph of a scanned copy of the prescription to patients. The scanned copy of prescription or photograph of prescriptions not valid under applicable laws since it cannot be stamped to prevent multiple dispensations. Such a scenario gives rise to many risks.

The letter further added that the telemedicine guidelines classify medicines into 4 new categories namely List O, List A, and List B, whereas, the Drugs and Cosmetics Act, 1940 which medical practitioners and chemists are accustomed to has a different list namely Schedule H, Schedule H1, and Schedule X.

Moreover, the letter also highlighted the unethical prescribing and solicitation of patients while submitting that it is already a matter of concern that doctors receive compensation or incentives from pharmaceutical companies to prescribe medicines. "This has become a bigger problem with the advent of E pharmacies which are providing telemedicine consultation," the letter quoted.

AIOCD subsequently sought prompt action by the concerned authorities to safeguard the interest of the nation and public health while suggesting;

"To obviate this risk we suggest that the Central Government should establish a national portal on which the doctors can email prescription and the patients or the pharmacist can access the prescription by using a unique OTP. The Pharmacist can, after dispensing the prescription, either deface it or specify the quantity of medicine dispensed on the national portal itself so that once the medicines are dispensed the prescription cannot be reused. Until this portal is setup the doctors should not be allowed to issue scanned prescriptions in a telemedicine consultation," the letter added 

Expressing dismay over the guidelines, the body stated that it fails to understand the logic in having two separate lists and how can guidelines supersede the Drugs and Cosmetics Act, 1940 to make a new list.

"The medical practitioners and chemists are used to following the list under the Drugs and Cosmetics Act, 1940 and the new classification are likely to cause confusion that can lead to wrongful prescribing or wrongful dispensation," read the submission.

It recommended that telemedicine guidelines should adopt the Schedule provided in the Drugs and Cosmetics Act, 1940 for classifying the medicines into different categories instead of making a new list. And the List O, List A and List B in the Telemedicine Guidelines should be done away with.

Moreover, doctors should be allowed to do teleconsultation only in the same city of the town where they are practicing and in case a patient wants to consult a specialist doctor in another city or town, the same should be permitted through a three-way consultation between the patient, local medical practitioner and the specialist, they added.

In the context of E-Pharmacies, AIOCD stressed that E pharmacies or its affiliates should not be allowed to provide telemedicine consultation, directly or indirectly as it amounts to solicitation of patients by the Doctors and giving incentives to the Doctors to prescribe medicines.