Doctors, drugmakers divided over SC's prescribe-only-generics remark

The SC's suggestion to mandate generic-only prescriptions has drawn mixed reactions from the medical and pharma community, highlighting concerns over quality and feasibility

Experts in the medical and pharmaceutical industry appeared divided over the Supreme Court’s observation suggesting that doctors should be “legally required” to prescribe generic medicines rather than brands, oral remarks which came about 21 months after the Centre withdrew a fiat issued by the National Medical Commission (NMC) asking doctors to prescribe generic medicines only.

 

The apex court’s Thursday observation came during the hearing of a petition filed by the Federation of Medical and Sales Representatives Associations of India (FMRAI) and others, over money being spent on sales and promotional activities aimed at influencing doctors to increase prescription volumes.

 

Welcoming the SC’s remarks, Mandeep Singh Basu, director of Uttar Pradesh-based Jagat Pharma, said that generic prescriptions (if it is made legally binding) could be a strong step towards transparency and lead to reduction in undue commercial influences on a medical professional. 

 

“Ordaining that generics be prescribed should be a helpful step towards achieving affordability and accountability in India’s healthcare system,” he added.

 

In August of 2023, the Union health ministry intervened and withdrew a directive issued by regulator NMC asking registered practitioners to prescribe only generic medicines.

 

The Indian Medical Association (IMA) had opposed the guidelines over patient safety issues, with the body questioning quality controls and lack of genuine generics in the market as a hurdle.

 

Currently, only Rajasthan has an executive instruction that registered medical practitioners can prescribe just generic medications. 

 

However, several experts have raised concerns over the practicality of such a “rule”, with questions being raised over public awareness and availability of generics in the market. 

 

Shabnam Sheikh, legal associate at Arogya Legal, said that mandating doctors to prescribe only generic drugs may not be the most effective way to protect patient interests as such a mandate could shift the decision making power from doctors to pharmacists, who can then choose which brand of the generic drug to dispense. 

 

“Even with generic prescriptions on paper, it is worth noting that doctors can still influence patients verbally, recommending specific brands during consultations,” she added.

 

According to Sheetal Sapale, vice president (commercial) at market research firm Pharmarack, generics contribute around 10 to 15 per cent of the Indian Pharma Market (IPM) in terms of market value.

 

A medical practitioner from a Delhi-based hospital, on the condition of anonymity, said that India is a branded generic drugs market where pharmaceutical companies sell copy-cat drugs (those that are off patent) under different brands. 

 

“This means the same molecule can be sold under different brand names,” he added. 

 

Meanwhile, Jagat Pharma’s Basu said that only 25 per cent of India’s Tier-2 and Tier-3 population have easy access to modern healthcare, and therefore generics have to be promoted so that medical care reaches to such areas.

 

“Stringent monitoring and regulatory support have to be there to close any loopholes and ensure the benefits reach the masses,” Basu said.