Will Indian Medical Association also come out against medicine pharma companies?

On April 23, during the hearing of Patanjali’s misleading advertisement case, along with writing an apology to Patanjali, the Supreme Court had also given some advice to the Indian Medical Association. The court had said that along with raising questions on Ayurvedic medicines, the Indian Medical Association should also consider its doctors, who often prescribe expensive and unnecessary medicines to the patients. Apart from this, the Supreme Court had also told the Indian Medical Association that if you point one finger towards someone, then four fingers also point towards you. On which the Indian Medical Association got angry and now the Supreme Court has directed the President of Indian Medical Association (IMA) R.V. A notice was issued on Tuesday on Ashokan’s controversial statement and his reply was sought by May 14.

After this, scrutiny of English medicines started or should we say, fingers were raised on the prices of English medicines. The report of TV 9 came out which had exposed the companies and doctors of English medicines. It was written that the treatment and medicines of English medicines were But due to the expenditure, every year 3 crore 8 lakh people in the country go below the poverty line. People get this pain from those pills, which on one hand are used to cure their disease. But on the other hand, it hits their pockets like a bomb and makes them financially ill. Moreover, during the Corona period, these companies had committed huge loot.

Dr. Arun Gadre, senior scientist and author of ‘Dissenting Diagnosis’, once claimed that he had a prescription for a cancer medicine. Got it from the retailer for Rs 100. In this, the profit of the pharmaceutical company making the medicine has been given. Margin of wholesalers or distributors has been given. Rs 100 MRP of the pill is Rs 900. Is written. Retailers are selling it for Rs 200 to Rs 900.

If we go back a bit, in September 2020, Dr. Anirudh Malpani’s post on social media went viral in which he had shown pictures of the leaflet of Ivermectin 12 mg tablet and showed that the price of one tablet with the manufacturing date is Rs 19 50 paise. Which increases to Rs 35 per pill in packs with manufacturing date of October 2020. But you will be shocked that the MRP of the same Ivermectin 12 mg tablet manufactured by different companies ranges from Rs 1 70 paise to Rs 58 fifty paise.

This is not the story of just one medicine, but of hundreds of medicines, which are manufactured and sold in India. There is NPPA i.e. National Pharmaceutical Pricing Authority to control the prices of medicines in the country. More than 10 thousand medicines are manufactured and sold in the country. But out of these, the government controls the prices of only 874 essential drugs.

This means that except 874, the rest of the medicines are being sold at MRP by the pharma companies. But in reality they are charging the desired price. But now understand how this MRP is decided. Pharma companies manufacture medicines, out of which the government decides the MRP of some medicines and not of others. Companies add their costs and profits and give it to the distributor. Distributors sell to retailers at 16 percent margin and retailers sell at 8 percent margin.

Close to the country. More than 90 percent of these are private companies. The tactics of these private companies are so powerful and the laws of the government are so weak that even after getting rid of the disease, the patients in India continue to suffer from expensive medicines for years.

So now the question is, how can people escape from the trap of expensive medicines? So the answer is, by using generic medicines instead of branded medicines, now the question may arise that what are these generic medicines. Are they as effective as branded medicines and why finding a generic medicine is as difficult as picking a pearl in the ocean.

In fact, while treating a patient, doctors advise to take various precautions. But many doctors themselves are avoiding one thing and that is generic medicines. Generic medicine means the chemical name of any medicine, which is also called salt. Suppose you have fever, you took a medicine called Paracetamol, then it is a generic medicine. The name of its chemical is also paracetamol, but when the pills made from paracetamol salt have wrappers with the names of big companies, they become branded. Which are sold at expensive prices. In generic form, one 500mg tablet of Paracetamol costs Rs.2. But if it is branded, the price of one pill increases to Rs 11 to Rs 17.

This difference between generic and branded medicines can be seen in other medicines also. Understand this with the example of some other commonly used medicines. Like ciprofloxacin which is usually given in bacterial infections. Its 500mg tablet costs 1 rupee 85 paise in generic form. Which becomes worth Rs 4 as soon as it is branded. Diclofenac is used in the treatment of joint pain and swelling, which costs up to Rs 20 in branded form, but in generic form it costs 3 rupees 30 paise. Nimesulide which is used in fever and pain. The cost of one pill is Rs 2 in generic form, which increases to Rs 5.5 in branded form.

The salt is the same, the medicine is the same, the technology is the same. Now you must be wondering why there is this difference in the prices of medicines made from the same salt. Let us now understand that to make medicines, the work of converting chemicals into medicine is done. The same company manufactures both generic and branded medicines, but to sell the branded medicines manufactured under the banner of its company, the company puts full emphasis on packaging, supply and marketing. Lakhs of rupees are spent. From doctors to chemists, they are asked to promote the medicine by giving direct and indirect inducements. This work is done by the company’s MR i.e. Medical Representative who deals with the doctors that if you prescribe our branded medicine for the patient then we will give you a car or get so many fans or ACs installed in the hospital. Many types of inducements are given. Now many doctors charge up to 40 percent commission for prescribing medicines of a particular company. Doctors prescribe medicines not based on their studies and the disease of the patient, but based on which company will give more commission. Nowadays, pharma companies are sending doctors on foreign trips, why?

The result is that when patients approach doctors who are favored by pharmaceutical companies. So those doctors pay off the debt of the pharmaceutical companies by prescribing branded medicines instead of generic medicines and on the other hand, if someone goes to an ordinary chemist shop and asks for a generic medicine, they refuse it.

There are 6 to 8 lakh medical stores in our country, out of which there are only 4-5 thousand Janaushadhi shops. That means less than 1 percent, if you go to an ordinary medical store, you will not get medicine with generic name. Describing generic medicines as less effective, they hand over the medicines of that company on which they get huge margins. Whereas the truth is that generic medicines are as effective as branded medicines and provide the same treatment as branded medicines. But in India, the disease of illusion and the mentality of considering only expensive things as good, is a major reason for the unabated profiteering in the name of medicines not ending.

The second reason is the nexus between some doctors, chemists and pharmaceutical companies, which people can break by adopting generic medicines if they wish. This can save you from losing your pocket due to the cost of medicines. But this mafia has become so big that the common man can be saved not by the action of one or two but only when a large number of people come out against these drug mafias. If generics win this battle, then crores of people in the country who are becoming poor every year due to paying the price of medicines, will be saved from sinking into the quagmire of poverty. The government has also appealed to the doctors to prescribe generic medicines but still many doctors are still avoiding prescribing generic medicines. Here we want to make one thing clear that not all doctors in the country do this. I myself remember an incident, once I went to Meerut Medical College, there I saw a doctor scolding the medical representative of a pharmaceutical company and saying that why should I put the burden of one rupee on the poor people for your and my own benefit. Why should I write a tablet worth Rs 10 instead of a tablet, take up my offer of giving a car and then disappear…this game was discovered that day. Therefore, we want to appeal to all the doctors of the country that they should also come forward to break the cycle of expensive medicines for profit and you should also be aware about generic medicines. As far as the Indian Medical Association is concerned, they should leave Ayurveda and focus on English pharmaceutical companies as the Supreme Court has also advised them.

BY-Rajeev Choudhary