The Medical Confrontation in India: Branded Medications versus Generic Alternatives 

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In India, the term 'generic' refers to medicines that are marketed without a specific brand name. Another term used is 'branded generics,' which refers to off-patent medicines sold under a brand name. This category encompasses almost all drugs in the Indian pharmaceutical market.

The National Medical Commission (NMC) of India has issued a notice mandating doctors to prescribe medicines using generic names instead of brand names. The objective of this move is to promote affordable healthcare and prevent overpricing of medications. However, many doctors are concerned about potential confusion and lack of quality control that may arise from this change. The NMC's notice addresses a significant issue related to prescriptions, rather than merely focusing on handwriting.

The government has instructed doctors to cease prescribing branded drugs and instead prescribe generic alternatives, sparking a contentious debate. The high cost of branded drugs is a major concern, with many doctors arguing that they are unaffordable for patients. Some doctors also question the effectiveness and quality standards of generic drugs. This debate underscores the importance of adopting a balanced approach to healthcare, considering both the risks and benefits involved.

The regulator is urging doctors to use generic names when prescribing branded drugs, such as "paracetamol" instead of "dolo," as branded drugs are typically more expensive. This encourages patients to choose affordable options without compromising the effectiveness of their medication, as generic drugs must meet the same safety and efficacy standards.

Branding plays a crucial role in the pharmaceutical industry, as most medications are patented by companies like Microlabs or Johnson & Johnson. These patents are not lifelong, allowing other companies to produce identical versions of the drugs. Despite variations in color, shape, and taste, the active ingredients remain consistent, providing affordable options without compromising safety or efficacy.

The government's promotion of generic medicines stems from their lower cost compared to branded ones, aiming to reduce healthcare expenses for individuals and the healthcare system as a whole. By providing broader access to essential medications, generic medicines can benefit patients struggling with high medical costs. Consumers should carefully consider the advantages of generic medicines when making healthcare choices to ensure affordable healthcare for everyone.

The Indian Medical Association (IMA), representing 350,000 doctors, is protesting the government's decision to prioritize affordability, expressing concerns about potential compromises in healthcare quality and safety. The IMA argues that the price difference between medicines can range from 30 to 80%, and without proper regulations and infrastructure, the healthcare system could become chaotic if doctors are primarily recommending cheaper options.

The IMA raises three main concerns. Firstly, they question the quality of generic medications, citing a survey conducted by India's medicines regulator in 2018, which revealed that 4.5% of all generic medications were subpar. Secondly, they highlight issues of availability, as local pharmacists may prioritize selling branded medications due to financial incentives, limiting access to more affordable generic options. Lastly, they express concerns about the lack of knowledge among pharmacies regarding alternative medications when specific generic drugs are unavailable.

Generic medications are essential for cost savings and improved health outcomes. In the United States, generic medications have saved $2.2 trillion in healthcare costs over the past decade. The demand for these medications is expected to significantly increase, with the global market projected to reach $670 billion by 2030. However, it is important to note that the most expensive options may not necessarily provide the most effective and cost-efficient alternatives.

To gain support from doctors and break the doctor-pharmacy nexus while ensuring patient safety, stricter regulations and transparency measures are necessary. Promoting unbiased education among doctors can reduce the influence of pharmaceutical companies on prescription decisions. Blanket rules regarding drug prescriptions may overlook complexities and hinder personalized treatment options. It is crucial to acknowledge that not all doctors engage in unethical practices.

Promoting generic drugs is indeed important, but it should be done only after ensuring their top-notch quality. It is essential to prioritize tracking and testing, followed by appropriate training. Establishing more testing labs and implementing stricter quality control measures will foster trust in generic drugs among doctors and patients. The government is aware of this need and has allocated $79 million to strengthen drug regulation in India.

India's transition to generic prescriptions is likely to lead to improved quality control, pharmacist training, patient education, and ethical practices. It has the potential to drive medical innovation, reduce healthcare costs, and inspire global changes. Policy adjustments will be shaped by research and data collection, fostering a patient-centric, affordable, and transparent healthcare landscape.