'Chemists Will Decide What Medicine Brand the Patient Gets?' Doctors Fume at Generic Prescription Rule

“Making chemists the king”, “stop making branded drugs”, “running train without tracks”. This is how doctors across India reacted to the move asking them to prescribe generic medicines instead of branded ones.

According to the latest notification by the National Medical Commission (NMC), the country’s top medical body, doctors need to avoid prescribing branded medicines and should prescribe generic drugs in majority of the cases. Repeated violations, the notification implies, will invite temporary suspension of licences.

The NMC notification basically means that instead of prescribing, for instance, the brand Crocin, doctors should prescribe the generic salt name “paracetamol”.

The move, however, has triggered concerns across the medical fraternity that the notification will shift the power of choosing brands into the hands of chemists or pharmacy outlets.

Paracetamol, for instance, is available in more than 10 top-selling brands and hundreds of generic brands. With the latest rule, the patient will go with a doctor’s prescription (with generic names) to a pharmacy outlet and the chemist will decide which brand they want to sell.

“In most cases, the buyer or patient won’t be able to take the decision to decide which pack they want to pick. Most likely, the buyer will seek a chemist’s advice. In turn, the chemist will dispense the brand that is more profitable or has more margin,” Dr Sumit Ray, medical director at Holy Family Hospital, New Delhi, told News18.

“While the doctor is writing the prescription and the patient’s health and recovery should be their responsibility, here the chemist is going to have the final word in dispensing brands of their choice or convenience. Hence, the move shifts the responsibility to a chemist from a doctor, eventually failing the government’s purpose of empowering patients,” Ray said.

Expressing resentment, several other doctors told News18 that going by the NMC’s move, the Union government must stop manufacturing branded drugs altogether.

Dr Sumeet Shah, Director and Head, Bariatric & Metabolic surgery at PSRI Hospital, New Delhi, believes that instead of asking doctors to not prescribe brands, the government should ask pharma companies to stop writing brand names on medicines and manufacture generics.

“That will strike at the root of the problem… Why are they putting the onus on doctors when one simple change in the rule can change the entire pharma industry?”

Doctors Creating a Buzz on Social Media

Many doctors have echoed their concerns on social media. Dr AK Singh, endocrinologist at Kolkata-based GD Hospital & Diabetes Institute, calls it a “retrogressive move”.

Singh, in a long post on microblogging platform X, formerly known as Twitter, said that if the government wants to promote generic medicines and its own Jan Aushadhi medicine outlets, it should remove trade names of all medicines sold in India and only qualified pharmacists should be allowed to dispense medicines at pharmacy shops.

Responding to Singh’s post, Ambrish Mittal, chairman of endocrinology and diabetes at Max Healthcare, raised an important question. “If a licensed doctor prescribes a government-approved, legally available, branded drug, how can it be an offence? Who else will prescribe these medicines? If no one can prescribe them, why are they in the market?”

Dr Vivek Pandey, unit head of sports medicine & arthroscopy unit, Kasturba Medical College in Manipal, also highlighted a similar point.

“I am all for generics,” he wrote. “However, if all modern med (medicine) doctors have to write generics only, why manufacture branded drugs? Who will decide to dispense branded drugs? When composition and quality of a drug is same, whats the point of generic and branded(sic)?”

NMC Running Trains Without Tracks: IMA

The promotion of generic drugs by the National Medical Commission seems like an attempt to “run trains without tracks”, the Indian Medical Association (IMA) said on Monday.

“The ill-advised steps taken by NMC on the issue of generic drugs is an emergency. The regulation is mandatory for doctors to prescribe only generic drugs. It is a matter of great concern for IMA since this directly impacts patients’ care and safety,” the lobby of more than 4 lakh doctors across India said.

Raising the concerns highlighted by several doctors on social media, the IMA said that if doctors are not allowed to prescribe branded drugs, then why license such drugs at all given that modern medicine drugs can be dispensed only on the prescription of doctors of this system?

“The government, if serious about implementing generic drugs should give licences only to generics and not to any branded drugs while ensuring the quality of generic drugs.”