Thursday, 28 July 2016

Medicines and Stents, A loot in India.

During 1970's I remember buying C Vitamin tablets CELIN by Glaxo were Re. 1 each. After some years IDPL launched SUCKCEE C Vitamin tablets for under Rs.0.10 each. Such was the loot by MNC's in the name of patent and so called exploded R&D expenses recovery. Doctor's always prescribed CELIN never SUCKCEE because of perks offered by Glaxo through their dealers and medical representatives.

Before 1970, there was no patent protection in India. So production of generic medicine got a boost and it increased so much that India started being called the “pharmacy of the world”. But after 2004-05, with the advent of patent protection, the situation has changed rapidly.

But people have a Right to Life. Generic medicines should be produced in abundance by keeping peoples’ interest in mind. At the same time, the quality and standards of generic drugs must be maintained. It is the duty of the government to regulate the quality control mechanism of generic drugs so that its credibility never gets questioned. Adulteration in medicine is a serious offence and it must be dealt through a stringent mechanism.

It is all because of multinational companies’ influence. They give a cut and perks to doctors. Doctors are given the licence to practise by the government of India. Can’t we issue them the licence on the condition that they will prescribe generic medicines to the extent possible? They will prescribe MNCs’ drugs only when no options are there among generics. As per MCI rules, doctors should prescribe cheaper drugs whenever possible. Violation of this rule should be made cognizable offence punishable including heavy penalties and cancellation of practice licence.

Prescription format should be standardized with columns of brand and generic name both written in adjacent columns and giving complete details of the doctor.

In a country like India, a lifesaving drug of Rs 9,000 is sold at over Rs 2 lakhs.

R&D must be taken care of. The burden of R&D expenses need not necessarily borne by the immediate drug users alone. It should be borne by the society as a whole. The government should refinance it. R&D should be there for the welfare of humankind and it must not be a licence to extort people. Even though companies have the right to charge high price until the patent expires, such higher prices should be justified and such higher price should be with a cap so that the drug is affordable by all. Any kind of manipulation of patent should be prevented and penalized.The government must cap sales and profit margins and provide good medicines at fair price.

Public sector drug companies like IDPL should be revived and rejuvenated to produce more and more generic drugs for benefit of common man.

A poor worker in my agriculture farm was all set to buy medicines worth Rs.750 from a medical shop in a small town. I happened to be around and asked the medical shop owner, to charge only cost to cost basis as a favor to me. Then the bill came down to Rs.200. Imagine the extent of loot. Mind boggling 300%. Half of the loot (150%) will go to the prescribing doctor since all these drugs are lesser known local brands.

In 2010, out of estimated 3,500 stent implants carried out every month in Andhra Pradesh, at least 30% were unnecessary as per experts. While China accounts for nearly 30% of the global value, India claims around 25% of the stents market.

Some doctors while explaining the extent of corruption said, if a patient does not require a stent, he is being implanted with one, while a patient needing one implant is instead implanted with two. At least 20-25 varieties of stents are available in India, including imported ones and the cost ranges from bare metal variety costing Rs 15,000 to the advanced bio-absorbable stents costing Rs 3 lakh.

In 2010, the CBI that probed the cardiac stent scam in the state found that a hospital was billing for a high quality stent, but actually implanting a low quality one during surgery. The CBI probe allegedly involved several corporate hospitals and staff of CGHS in Hyderabad.

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