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Old 6th September 2012, 12:03   #16
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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Originally Posted by amitk26 View Post
Exactly as you can see in the opening post Abbott, Cipla, Ranbaxy are all generic manufacturers but still their drugs are priced higher sometimes for same formulations.

A lots of cost is towards the promotions and educational conferences.
And doctoes generally write the brand for which med. representatve visited last or constantly pestered them,

In urban areas with higher paying capacity like Bangalore doctors do not put lot of mind share to minor deviations in price because it does not matter much to the target customer.

In Rural areas / Semi urban places where paying capacity is less and patients have heart wrenching stories doctors are more sensitive and prescribe the cheaper alternatives.
The Websites which show comparative costs - this isn't new information.The information always used to exist in book form. Every pharmacy has a copy of one of these books which shows all medicines sorted by chemical constituents. 15 years back, one family member was prescribed an expensive medicine. The doctor prescribed the famous brand name coz that was the only name she remembered. But she told me to make the pharmacy check for cheaper equivalents before buying. This almost saved me 50% on the cost.
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Old 6th September 2012, 12:12   #17
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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A lots of cost is towards the promotions and educational conferences.
True. Pharma companies spend millions in research to develop a drug. Educational conferences are a necessity to educate the doctors about the newly developed drugs.

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And doctoes generally write the brand for which med. representatve visited last or constantly pestered them,
Absolutely not.
However much a medical rep pesters, the doctor would prescribe a particular brand only if its effective. Else the doctor loses the patient and his own reputation. A good reputation is hard to build up and no doctor would sacrifice it just because a rep pesters him. Plain, simple and logical.


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Originally Posted by amitk26 View Post
In urban areas with higher paying capacity like Bangalore doctors do not put lot of mind share to minor deviations in price because it does not matter much to the target customer.

In Rural areas / Semi urban places where paying capacity is less and patients have heart wrenching stories doctors are more sensitive and prescribe the cheaper alternatives.
True. I myself have prescribed cheaper medications to poor patients. How else would they be able to afford the costlier (but better?) medications?

Last edited by revintup : 6th September 2012 at 12:21.
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Old 6th September 2012, 12:18   #18
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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Absolutely not.
However much a medical rep pesters, the doctor would prescribe the medication only if its effective. Else the doctor loses the patient and his own reputation. A good reputation is hard to build up and no doctor would sacrifice it just because a rep pesters him. Plain, simple and logical.
I don't think he was saying that doctors decide on medication based on which rep pesters them. However once the doctor decides on the medication, its very likely that the doctor would chose the brand based on whichever brand name has stuck to his mind - which is probably the one whose rep has pestered him the most.
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Old 6th September 2012, 12:51   #19
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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I don't think he was saying that doctors decide on medication based on which rep pesters them. However once the doctor decides on the medication, its very likely that the doctor would chose the brand based on whichever brand name has stuck to his mind - which is probably the one whose rep has pestered him the most.
Yes that is what I meant , It is human to remember the brand name which is constantly bombarded at you and that is why pharma companies employe representative and take pains to track them.
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Old 6th September 2012, 14:24   #20
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

There are only 20-25 drug manufacturers in India ( bulk drug)

More than few hundred firms are there which make prescription stuff ( tablets, injections, syrup's). These guys buy it from the first category and make tablets/syrups/injections.

Corruption exists in terms of quantity of medicine actually present in tablet. To check it one has to spent a lot.

Paracetomol tablet may cost Rs 1 or 2 for 500 mg. To test its quality it costs upwards of 1000/-

It is govt duty to check. Periodically they do it and release press advertisement. But invariably these appear in some corners of news papers.

If there is a lower price variant from a reputed firm it is definitely OK but not from over night operators

Last edited by rkg : 6th September 2012 at 14:27.
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Old 6th September 2012, 14:35   #21
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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If there is a lower price variant from a reputed firm it is definitely OK but not from over night operators
Agree 100%.

My late father always inquired about the pricing esp. for drugs taken for a long time. If a drug is used long term like for Diabetes, Hypertension, etc. then even a difference of a few paise per tablet make a big difference. On the other hand things which are taken only over a very short term, say under a week, then a minor price difference does no matter that much.
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Old 6th September 2012, 16:19   #22
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

I will not go into the subject of certain segment of doctors constantly prescribing costlier medicines while some prescribe extremely reasonable and effect or resolution being the same.

If lot of medicines needs to be bought.I generally buy from a wholesale market in Hyderabad which gives medicines at 20%-30% cheaper than MRP while most medical stores give a flat 10% on MRP rates and a few known stores give zero discount.

Just to give you a few hypothetical examples of the difference in cost when purchased from a normal medical store and wholesale dealer

MRP of 1 Injection : Rs.1450

What I pay at wholesale dealer : Rs.10XX

MRP of a strip of 10 tablets : Rs.410

What I pay at wholesale dealer : Rs. 300

Thats a whopping 30-40% difference in the pricing. So there is a huge margin in the medicines and i urge people who regularly buy medicines to locate a wholesale dealer in their city and purchase from them.
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Old 6th September 2012, 16:20   #23
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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There are only 20-25 drug manufacturers in India ( bulk drug)

More than few hundred firms are there which make prescription stuff ( tablets, injections, syrup's). These guys buy it from the first category and make tablets/syrups/injections.

Corruption exists in terms of quantity of medicine actually present in tablet. To check it one has to spent a lot.

Paracetomol tablet may cost Rs 1 or 2 for 500 mg. To test its quality it costs upwards of 1000/-
Since generic medicines hit big time into the business of the big pharma companies - I am sure they would be willing to chose 3 of the worst fly-by-night operators medicines, do a periodic testing (costing Rs. 3000) and release reports periodically. The fact that we don't see this happening makes me feel that this is FUD spread by big pharma.

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It is govt duty to check. Periodically they do it and release press advertisement. But invariably these appear in some corners of news papers.
I have seen such releases about fake medicines (mostly fakes of big brand name medicines), but I never seen one about generic medicines.
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Old 6th September 2012, 21:04   #24
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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Since generic medicines hit big time into the business of the big pharma companies - I am sure they would be willing to chose 3 of the worst fly-by-night operators medicines, do a periodic testing (costing Rs. 3000) and release reports periodically. The fact that we don't see this happening makes me feel that this is FUD spread by big pharma.

I have seen such releases about fake medicines (mostly fakes of big brand name medicines), but I never seen one about generic medicines.
Generics are those which are out of patent regime. It has nothing to do branding.Any one can manufacture if he has the capacity.

Example: paracetomol, penicillins, sulfa group, quinolines etc, statins, malaria drugs.

Fake/inferior quality stuff comes from all the brands. I have seen it several times. it mentions clearly the batch numbers of so & so of XYZ manufacturer is to be withdrawn etc etc.

Small over night operators do not manufacture drugs. they buy it in bulk from biggies (reddy, ranbaxy etc) and just make tablets/syrups.

these are the one which are available very cheap. they do not have any QC, as it is a small scale operation. their portfolio is not constant and keeps on changing depending upon the market price of a particular drug. Further they do not have pan india presence.

They operate only in generics because none can make patented stuff including biggies

No firm can make its own formulations. they have to go by some pharmacopia (IP- Indian paharmacopia, BP- british pharmacopia, USP-USA Pharma)

What one sees next to active ingredient on a tablet strip is either IP/BP/USP. So particular formulation is as per so and so pharmacopia.
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Old 6th September 2012, 21:30   #25
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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Generics are those which are out of patent regime.
Yeah, I know.
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Originally Posted by rkg View Post
It has nothing to do branding.
Yes. Sure. I am not sure what we are debating here.


Anyway, the rest of your reply doesn't really address the questions I raised.

Here are my questions again.

Quote:
Since generic medicines hit big time into the business of the big pharma companies - I am sure they would be willing to chose 3 of the worst fly-by-night operators medicines, do a periodic testing (costing Rs. 3000) and release reports periodically. The fact that we don't see this happening makes me feel that this is FUD spread by big pharma.

I have seen such releases about fake medicines (mostly fakes of big brand name medicines), but I never seen one about generic medicines.

Last edited by carboy : 6th September 2012 at 21:48.
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Old 6th September 2012, 22:04   #26
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

Ok. When it comes to medication - ofcourse quality matters. I agree. You should also remember that for the common medicines (cold, fever, and some other generic issues) govt provides subsidy to make sure the cost is controlled. Not just cost subsidy, but also the raw materials provided to the company are got at subsidized price. So, I do not see the reason for 100% difference in some of the common drugs.

About the quality, I think these medicines are all same compositions, and they should be equally safe on humans. Else i dont think they can have their license to keep producing the tablets.

This industry is not like a food or beverage industry where you can see many different brands and most are over-night ones. This is a much organized sector, and all manufacturing are done with the body monitoring it constantly. Remember it involves human life.
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Old 6th September 2012, 23:45   #27
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

There are huge profit margins in a drug even after accounting for R&D, sponsoring medical conferences,docs goodies etc, for the pharma companies to play around with resulting in such price variations. That is why as somebody here said, it is cheaper to buy it from wholesale agencies. But then, I am sure every branded product has huge margins on the MRP, it is just that drugs save lives and we feel that pharma companies should exercise some responsibiity while pricing their products. Pharma companies dont think so and all they are bothered about is how fat is their bottomline.
As regards to quality, the MNCs surely have better QC and standardised processes, but most of the big Indian companies are very much there. The smaller ones obviously have doubtful QC as they operate on a much tighter margins. Whether such quality transgressions if minor(e.g., 490g instead of 500g or 95% Vs 99% purity) would result in marked variations in patient outcome is matter which nobody would bother to spend their money to study and prove. Of course,there are government regulating agencies to do that, but how much to trust the government agencies in our country where life is cheap is another debate in itself.
The doc might prescribe you an expensive brand(for whatever reason), but it is very very very unlikely that he will prescribe you an ineffective drug. If you are concerned about the cost, you could always ask the doc for cheaper alternatives.
This country has sold itself to a profit driven private health care system rather than a need based government health care system, so you can only expect costs to go up.

Last edited by Deep Blue : 6th September 2012 at 23:48.
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Old 7th September 2012, 11:03   #28
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

My distance cousin is medical representative. His company's courier comes to my house. Courier contains gifts to doctors. Looking at the gifts I could say that pretty much costly affair. He said most of doctors ask for different favors, one senior doctor in my town asked for a trip to foreign country with his family. He said every month end he needs to calculate how much of drugs are sold due to doctors prescription. He collects data from nearby medical stores and goes to doctor to give his commission which ranges from 10%-20%. So straightaway price of drugs is increased by this percentage.

This happens to all medical services as well like MRI, X-Ray etc. Once I had to do MRI scan for my mother. Our family doctor saved our money which they got as a commission from MRI center. MRI cost was Rs.4000 but we paid only Rs.2700. Rs.1300 was doctors commission which our family doctors returned us.

There are good doctors as well. But ratio between good and bad really worrisome. Bad doctors make so much money which is mostly tax free(Black) from consultation and still they are hungry for money which they get as a commission.
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Old 7th September 2012, 12:01   #29
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

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He collects data from nearby medical stores and goes to doctor to give his commission which ranges from 10%-20%. So straightaway price of drugs is increased by this percentage
I dont think cash commissions exist for drugs barring maybe a few MBBS general practitioners that too from small companies. It is highly unlikely that any of the standard companies offer direct cash to the docs in return for prescription. How do they show it in their account books?
Drugs however are sold to hospital pharmacies at considerable margins. The bigger the hospital or a corporate chain, the bigger the margins. The hospitals, however will retail to the patients only at MRP, thus pocketing a neat sum. But I have never seen or heard companies offering unaccounted cash to the docs directly. All manners of gifts ( inexpensive to expensive), travel junkets etc, etc all do exist.
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Old 7th September 2012, 13:06   #30
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Default Re: Medicinal Drugs: How much (more) we pay for the SAME?

Check this out. Launched recently. Give it the name of the drug and it will show the other generics under production and also tell you have more expensive or cheaper they are.

http://healthkartplus.com/
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