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Doctors in all Delhi government-owned
hospitals and clinics will have to prescribe medicines by their generic
name (chemical name) and
“The officers of the drugs control department have been instructed to monitor the prescriptions issued by doctors in hospitals and dispensaries under Delhi government,” a directive of the state government issued earlier this month said. According to the Delhi government’s website, it runs about 30 hospitals in the city state.
Prices of generic drugs which have the same therapeutic qualities are significantly lower than their branded versions. For example, popular brands of paracetamol, used to treat headache, cost Rs 10 for a strip of 10 tablets (500 mg). Its non-branded generic equivalent cost as less as Rs 2.45 for the same batch of tablets.
Unlike other consumer products, patients cannot choose from different brands or do not know their generic equivalent. They buy only the particular brand their doctor prescribes. Drug companies spend huge amount of money to promote their brands and convince doctors to prescribe their product over others.
In return, doctors are given lucrative gifts and incentives, an unethical practice the government is trying to address separately.
The Delhi government move follows similar steps by the union health ministry and the Rajasthan government. Last month, the union health ministry asked all central government hospitals and autonomous institutions to mandatorily mention the generic name of a drug when they prescribe a medicine.
“This will curb the often observed practice of prescribing specific brands of medicine with a rider that no substitute should be supplied,” a union health ministry statement said.
The Delhi government directive has also asked state-run hospitals and dispensaries to open more generic drug stores under the union government’s Jan Aushadhi programme. Under the initiative, launched last year, medicine outlets in the hospitals will sell lowcost version of drugs.
The move is a step towards the government’s plan to reduce the cost of healthcare. At present, about Rs 8,000 crore worth of medicines are sold in hospitals and institutes in India compared with Rs 42,000 crore in retail outlets through chemists. Of these institutional sales, a large chunk are in private hospitals.
Common medical exam on the cards
The board of governors of the Medical Council have set the ball rolling for doing away with multiple entrance examination for undergraduate and graduate medical programmes, reports Our Political Bureau from New Delhi. The board has already approached CBSE and asked it to begin work on the common entrance exams. The new system is expected to be launched in 2011.
Generic drug industry
tries desperately to protect an indefensible business model in Quebec
"By requiring the generic drug industry to reduce its excessive prices, the government is doing its job to ensure the sustainability of Quebec's Prescription Drug Insurance Plan," stated Rx&D president Russell Williams, noting that the generic drugs sold in Canada are among the most expensive in the world. The Fraser Institute and the Competition Bureau of Canada corroborate this, while the Bureau goes even further by maintaining that if generic drugs were sold at a competitive price in Canada, patients and drug insurance plans would save over $800 million a year.
Brand-name medicine prices, which are controlled by the Patented Medicine Prices Review Board (PMPRB), are below the international median. "We shouldn't let ourselves be distracted from the real issue here - that generic drugs cost too much. Quebec is exercising its right to reimburse the lowest price in the country and as such is aligning its reimbursement policy with that of other provinces, like Ontario," added Mr. Williams.
The 15 Year Rule - heavily criticized by the CGPA - is a provision specific to Quebec that acknowledges the risk tied to innovation by providing reimbursement for new medicines for a period of 15 years from their listing on Quebec's drug formulary, regardless if the patent expires or a generic equivalent exists. While this measure carries costs for Quebec's Prescription Drug Insurance Plan, a study by Quebec Ministry of Finance(1) indicates that the benefits largely outweigh the costs: abolishing the rule would lead to a recurring loss of $340 million per year in Quebec's gross domestic product (GDP) due to reduced investments and job losses in the life sciences sector.
The research-based pharmaceutical industry has a special relationship with Quebec thanks to its historic decision to develop a strong knowledge-based economy that will create wealth and usher in a bright future. This societal choice has been a profitable one, as Quebec garners 45% of all pharmaceutical research investment in Canada, even though it represents less than 25% of Canada's population, is home to 28 international pharmaceutical companies, and boasts the largest concentration of pharmaceutical headquarters in Canada, as well as the production and research activities of 12 of the 15 largest pharmaceutical groups in the world.
Over the years Rx&D member companies have forged partnerships with many Quebec universities and hospitals with a view to promoting pharmaceutical research. This has led to a variety of clinical trials, new research chairs like those on obesity at Université Laval and cardiovascular disease at McGill University, and a nurse practitioners program at the latter institution.
"In addition, since the Drug Policy came into effect in 2007, these same companies have invested several hundred million dollars in the construction, expansion, and renovation of various research facilities. These funds would probably have been channeled elsewhere if not for the long tradition of partnership between the research-based pharmaceutical industry and the Quebec government, and the importance of Quebec for our industry," said Mr. Williams. He concluded by stating that "all the partnerships we have formed with healthcare stakeholders - including physicians, nurses, and pharmacists - are aimed at ensuring an efficient healthcare system that benefits patients, who must remain a priority for all."
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