'No brands, prescribe only generic drugs': India's diktat to doctors

The National Medical Commission (NMC), an Indian regulatory body, has introduced a fresh set of regulations that mandate doctors to stop prescribing branded drugs and instead, they should exclusively prescribe generic drugs. “Every RMP (registered medical practitioner) should prescribe drugs using generic names written legibly and prescribe drugs rationally, avoiding unnecessary medications and irrational fixed-dose combination tablets,” the regulation stated. What does that mean? If you were running fever and you visit your family doctor or any other doctor, he or she may have given you a Dolo or a Calpol, which are branded drugs. Now, NMC has asked doctors to stop doing this and instead prescribe the generic name of the drug. In this case, it would be paracetamol. So, doctors will now ask you to take paracetamol. What is the difference? Generic medicine is the same drug minus the brand. It is the branding. Most medicines are patented by pharma companies like Dolo is made by a company called Microlabs, Calpol is made by Johnson Johnson. What is worth knowing that these are not lifelong patents and when they expire, other companies are free to replicate these medicines. The colour, shape, taste may be different. Also, the cost may vary from what it is now, but the only thing that remains constant is the active ingredients used to make the drug.

Under the generic medicine and prescription guidelines of the regulations, the NMC defined generic medicines as a “drug product that is comparable to brand/reference listed product in dosage form, strength, route of administration, quality and performance characteristics, and intended use”. On the other hand, a branded generic drug is one which has come off patent and is manufactured by drug companies and sold under different companies’ brand names. Currently, the doctors have been prescribing generic drugs as per the regulations issued in 2022 by the Indian Medical Council (IMC), but the Council did not specify any punitive measures for non-compliance. The new regulations by NMC, officially notified on 2 August, emphasies the significant role of India’s out-of-pocket expenses on medicines with the broader context of healthcare expenditure. But why government is doing this? The government has been doing this because of the cost. Generic medicines are a lot cheaper compared to the branded ones. “Generic medicines are 30 to 80 per cent cheaper than branded drugs. Hence, prescribing generic medicines may overtly bring down healthcare costs and improve access to quality care,” NMC said. The move will help reduce your medical bill. Also, there is less regulatory control over the prices of branded generic drugs. Doctors to be penalised for not adhering to NMC regulation If doctors are found violating the order, he/she may be given a warning to be more careful about the regulations or instructed to attend a workshop or academic programme on ethics, personal and social relations and/or professional training. On repeated violations, the doctor’s license to practice may be suspended for a particular period, the regulations said. The NMC said prescriptions should be legible and preferably written in all caps to avoid misinterpretation. As far as possible, prescriptions should be typed and printed to avoid errors, it said. A template has also been provided by the NMC that may be used for writing prescriptions rationally. Medical practitioners should prescribe only those generic medicines available in the market and accessible to patients. They should also advocate for hospitals and local pharmacies to stock generic drugs, the NMC regulation stated. They should encourage patients to purchase drugs from Jan Aushadhi Kendras and other generic pharmacy outlets, educate medical students and the public about the equivalence of generic medicine with their branded counterparts and should actively participate in programs related to promotion and access to generic medicines, it added.