[UD17]

Originally Posted by Turbanator

Problem is much worst in smaller towns and rural areas. We all must have seen some of the most significant buildings in otherwise small towns. I occasionally go to Kashipur for work or pass when going to the hills, and a small town like this, if you notice, will have Hospitals that will put any Hotels to shame.

+1. My father in law is a Govt. doctor in Kashipur and i know which building you are talking about and fully agree with the statements. I was speaking with him yesterday, most of the generics suddenly disappeared from the Govt. drug centers and in normal days there is always acute shortage.

The nexus is too big to counter. But i like the idea of prescribing just the salt and options for people to choose from. The biggest issue in generic drug adoption is the trust deficit as the quality control is highly doubtful.

[100Kmphormore]

I believe that this is to avoid confusion about similar drug but many names or complex medicine names being erroneously interpreted for another. Example, Calpol 500, dolo 650 are familiar names for paracetamol compared to apazine, zanmef etc. not only are they costly, but not familiar names especially if they’re Schedule H drugs. I use Naproxen 250 gm prescribed by my doctor for migraine headaches and unless I say Naxdom 250/500 (the Dolo of migraine tablets), most pharmacists have no idea of them, not even Naprosyn.

[tsk1979]

Originally Posted by Hayek

I am sorry but you are mistaken here. Even the best Indian Pharma companies have different standards for plants that export products to regulated markets such as the US, UK and EU, plants that supply to other export markets where WHO norms apply, and plants that serve the Indian market.

Not just drug firms. Even the Haldiram Aloo Bhujia packet I buy in the USA is of much better quality and comes from a different plant and has a label (for export only).

No drug company will try to exceed the standards required by a large margin. If "meeting" the standards works, they will do that.

[Straight6_N54]

As a practicing Physician what the general
Public doesnt know is that, The minute we write Generic name the pharmacy will dispense a medicine that is significantly costlier or has a higher margin for pharmacy (less quality). I personally prescribe standard pharmacy brands that has proven track record of efficiency which comes from their robust R&D and API.

There are doctors who write low tier pharma drugs for their margins, that is problematic. At the same time we cannot just write the generic name and give the option to Pharmacist. I write the cheapest alternative from a reputable list of the pharma brands, which is proven. In that way I know my patients are getting the right drug for the best price possible among competitors.

[Fx14]

Originally Posted by Gansan

We all hear about pharma companies sponsoring overseas visit of doctors, giving them expensive gifts etc. Essentially, in kind instead of cash. I don't want to use the word kickback. We don't know whether to believe or not, but they seem very plausible. I don't see doctors staunchly denying it. Some friends who worked in big pharma companies say not all stories are false.

They've heard you.

https://www.bqprime.com/business/doc...ical-companies

[RGCST]

Originally Posted by Fx14

The local scenario is quite different.

Many times I have noticed that the pharmacist stocks only some brands (probably offering them better margins) and blatantly try to push the substitute to unsuspecting patients despite the Doctor prescribing a certain brand.

Sadly even hospital pharmacies are now doing the same. They will keep only selected brands for in-patient which are often times unknown to the doctors. Even when the doctors prescribe reputed brands it is the hospital pharmacy that decides which drug to give. There may even be cases where the reputed brand costs less than what the hospital is providing. (Learnt this from a Pharma grad friend of mine).

[Deep Blue]

If the government is so concerned, why doesn't it simply ban all branded medicines and mandate all pharma companies to only manufacture generic medicines and even decide at what price they are going to be sold. Why put all the onus on the docs and pharmacists? All the accusations of hefty commissions, junkets etc., will all go poof and all of us can live in our perfect utopias. The politicians can garner a lot of brownie points at the next hustings too.

[rrsteer]

…and the govt. pulls back the regulations!!

Typical of governments….formulate harebrained ideas in haste, understand implications later and then pull back.

[alpha1]

To be frank, even though the drug molecule nomenclature may be same, I have seen different effects from different names. I have no experience with un-named generics (perhaps I might be too scared to take, if I chance upon them)

So, the concern of doctors that chemist will dump the stuff that brings him the highest margin and not care about efficacy is true.

What the Gobermint must first of all do it to have extreme tight control over the quality of drugs being made and distributed. Once you are sure of the quality then only you may debate whether to let doctor chose the medicine based on his commission vs whether to let the pharmacy choose the medicine based on his profit margin vs whether to let public choose their medicine based on misrepresentative claims (media advertisements) by the manufacturers (oh that means allowing general marketing of non-OTC drugs!).

[dragonfire]

Originally Posted by alpha1

What the Gobermint must first of all do it to have extreme tight control over the quality of drugs being made and distributed.

Govt should focus on infrastructure, law and order, border, foreign relations etc and quit meddling in the free market.

[tsk1979]

Interestingly there is no law on what the pharmacist gives. So the chemist can take the generic salt name and give the user the medicine which has the highest margin.

[WorkingGuru]

Ofcourse doctors can also suggest/recommend their preferred brand, but IMO there's no reason they would find it hard to prescribe the composition of salts.

Originally Posted by tsk1979

Interestingly there is no law on what the pharmacist gives. So the chemist can take the generic salt name and give the user the medicine which has the highest margin.

That's what we expect them to do, but this way people will see it as the business that it really is, & seek out their options.