[india-drug] Re: Drug prices (10)

["Pranav Gupta" <pranavgupta@hotmail.com>]

Drug prices (10)
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Dear Dr. Manjula,

I see no reason to disagree with your advice of adding information about
different brands of drugs in the curriculum.......but...the brands as well
as their prices keep on changing. Nevertheless, if informed about cheaper
brands, at least some will stick to prescribing them. We teach/are
taught/asked each and every drug, whether it is obsolete/available in India (sorry to say, AIIMS people are extremely fond of asking such things in PG entrance exams, especially the drugs that are yet to be made available in India....I wonder what they want to test...bookish knowledge???) though never is taught 'rational use' of medicines.

It isn't that cheaper versions of drugs aren't available, doctors are either unaware or unwilling to prescribe them. We regularly get here, what WHO and everybody else are doing world over, but are we doing any thing except discussing their achievements? We definitely can improve the grim situation. 

Let me take the liberty of explaining it with a few examples:

(1) A physician falls ill...either he'll get the free samples of the drugs or he'll buy them. In the second case, he'll study the prices of various brands of the drugs extensively before buying. This study of his, if posted here, will definitely help others to learn at least one inexpensive brand of an important drug.

(2) During my small clinical experience, I have learnt that inexpensive brands are defamed by rival companies by promoting false beliefs. For example, few days ago, I came to know that Amoxycillin+Clavulinate produced by 'Mankind' under the brand name of "MOXIKIND-CV' is most economical because it doesn't contain the appropriate amount of Clavulinate, the expensive ingredient in the said combination. I, and probably many who prescribe it, have no means to testify it, but at least some people here do.

Coming to you question, "But why do doctor's listen to Medical Reps?" The
answer is simple....

(1) man is greedy by nature....greedy for small gifts (mind you, gifts can
be as big as Maruti-Zen...one of my professors got)
(2) nothing can be done even if these kind of malpraxis are proved.
Also, it is not the physician who has to foot the bills of chemists, and it
takes equal strokes of pen to write either the cheaper or the expensive
version of the same drug.

I see many 'big-guns' writing in here. If they practice what they preach,
the drug companies will have to bring down the prices of drugs manufactured
by them.

Pranav
Medical Graduate
Delhi
Email: "Pranav Gupta" <pranavgupta@hotmail.com>