Doctors are a soft target of politicians, Press and public. Yes, we agree some of the doctors are corrupt like other professional of the society but not all. When a MP, a MlA, a film star, a model or a player endorses a particular product, no one objects. We should not forget the 21st century is moved by brands from soft drinks to skin whitener.
Coming to our generic product, let’s analyse this simple situation. Ravi goes to a bar and asks for a peg of whiskey. He can’t ask for his favourite brand (100 Pipers) because it has been banned by the Government. The bar boy only gives him whiskey of his choice from which the bar owner will get maximum profit. Similarly you go to a super market and ask for a shaving blade and you get some blade without a brand name but written over the packet-blade.
My learned friends, you must remember when a doctor prescribes a particular brand of medicine, there are certain factors for which he or she has written the name of the medicine (like your choice of hard drinks)--his experience with that product, research product of certain firm mentioned in textbook of medicine, price factor, patients’ status, little bit of commission if he is having his own clinic or hospital and bioavailability of the product.
When we swallow a tablet or capsule, some are supposed to be released in stomach, some in duodenum and some inside intestine. The release of contents from the drug depends on the coating and capsule technology. Certain inferior quality medicines of certain firms get released in large gut or not at all instead of stomach! The patient would come back to doctor and blame him for not getting a cure with his prescribed medicines; will the CM or PM come to his rescue thenIJ
I will narrate one simple example. In SAIl hospitals we were almost forced to write Government run drug company’s medicines because that company was in red and certain Minister got some kickbacks for revival of that company. So the medicines were procured but the people get the substandard medicine indented as P1 product. The director and the store in charge doctor were harassed by the consumers and branded products were indented once again. It is not because doctors are building house after house or going on foreign trips or staying in star hotels abroad, which is not the lookout of political party. There is income tax department, vigilance or other department to check the corrupt practice of all professionals. Around 30 per cent of apartments and house at Bhubaneswar belong to persons attached to education system or chartered accountants but very few are doctors. I am a retired SAIl doctor but I doubt whether some Hindi film actors’ driver would stay in my house, even if given freeIJ
With present directives of the Government, instead of doctor, the unqualified pharmacists would get the option of dispensing medicine of his or her choice. After sometimes instead of doctors, pharmacists will go for foreign visits, thenIJ A drug quality depends on its bioavailability and quality control which are deficient in millions of small pharmaceutical companies of India. A particular antibiotic of these unknown companies are very cheap but no doctor is sure about its efficacy. Say a tablet of ciprofloxacilin from a branded company is costlier than another branded company because the other company is a copy master and a particular medicine is not its research product. If only cost factor is the concern of the Government then, let all the Central and State Government doctors prescribe products in generic name. Regarding hand writing of doctors, the MCI must look into it before giving the registration number.
like wearing helmet and changing of car, number plates from white with black digits to black with white digits or yellow digits, the wave of generic versus brand names debate will continue in India as long as we allow MPs and MlAs to advertise products in news papers,
TV channels and hoardings on the high ways. A time may come when our politicians and courts would prescribe a particular directive for doctors, when they can go to washrooms or temples or go to bed. We must remember the whole world moves on different branded product, or sponsors from Haldiram mixture to Bofors gun, you accept it or perish.
Postscript: Remember, not all branded medicines are costly; some are even cheaper than generic drugs. What the doctor should do when the patient requests for a branded medicine which he has been using for last ten yearsIJ
(Dr Satpathy is Joint Director, Health Services, Rourkela Steel Plant)