Doctors divided over MCI directive on generic 

drugs

Pratiksha Ramkumar





`No Studies On Quality, Effects'

Do all prescription gener ic drugs work as well as their brand-name counterparts? The question is a subject of debate among doctors who have now been asked by the Medical Council of India to use generic names of prescriptions as far as possible. The apex medical regulator has put out a circular stating that an amendment to the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulation, 2002 has made it mandatory for doctors to prescribe drugs with generic names, legibly and preferably in capital letters, and should ensure there is rational prescription and use of drugs. Signed by MCI secretary Dr Reena Nayyar, the circular also says action will be taken against doctors who violate the rule.While almost all doctors' bodies and doctors welcome the rule for legible prescription, many did not agree on generic drugs. Most generic drugs are affordable and save crores of rupees each year for the Tamil Nadu government, which offers free medical care to the poor. The health department was one of the first to establish a body like Tamil Nadu Medical Services Corpn that purchases generic drugs for all state-run hospitals and health centres. “It's a move that can be implemented eas ily,“ said MCI council member Dr L P Thangavelu. “Generic medicines will increase competition and make medicines affordable.“
Some specialists, mostly paediatricians, cardiologists and neurologists, expressed concern about generic formulations of drugs in which slight variations could worsen a patient's health. There have not been detailed studies on the quality or effects of generic drugs, but stories are typically about patients who switched from a branded to a generic drug and had side effects or return of symptoms.
Consumers are told generics are identical to brand name drugs, but that is clearly not always the case, said Coimbatore pediatrician Dr A Jayavardhana of PSG Hospitals. “There are too many formulas and too many strengths. So if we just write a generic name, the pharmacist may make an error,“ he said.
It would be dangerous for the government to make generic drugs mandatory before it standardises formulas, he added. But the Union health ministry stands behind generic medications and its methods for approving them.“There are no studies that show generics do not hold up as well as brand name drugs.We believe the generic drugs we approve will work on everyone,“ said an MCI official.
Coimbatore Medical College and Hospital resident medical officer Dr A Soundaravel said if doctors want a specific combination, they might have to prescribe two tablets instead of one. “We have always prescribed only generic drugs. It did not make a difference as long as the quality is good,“ he said.