Why we need an audit on Doctors’ prescriptions


It is really surprising that FAROBACT- 200mg, an allopathic drug sold by CIPLA in a 6 tablet strip and a 10 tablet strip costs the same in both the cases. Though the MRP is Rs.332.50 for both the strips, the price per tablet is shown as Rs. 33.25 and Rs.55.42. What is more surprising is that most of the chemists sell only the 6 tablet strip and not the 10 tablet strip. 
Our government, like its predecessors is still reluctant to carry forward certain public interests schemes like Jan Aushadi Store 2008 despite the fact that most of the allopathic medicines that were included in the National List of Essential Medicines (NELM), were seen to be marked with unfair MRPs. Even then, in our state, most of these medicines are being sold comfortably under a brand name with the support of prescriptions dispensed by some motivated doctors. The patients despite being aware of the malpractices most of these big drug manufacturing companies resort to, are forced to stick with them as most of the alternative medicines available on the market are of poor quality and least efficacy. May be this is why most chemists and even some government doctors profess that the generic medicines identified as essential drugs  are of poor quality whereas this is far from the truth. Such opinions are totally unfounded and only aimed at misleading the common masses.
Despite being fully aware about this, the government is yet to take any effective steps to undo such false propaganda. Even the doctors, who claim to serve humanity, don’t seem to be interested in taking any steps in this regard. Had they, on their own, started writing prescriptions by chemical /generic name (at least for the medicines included in NELM), they would have helped in curbing these malpractices in the commercialised private sector. This may be one of the reasons that the Jan Aushadi Store Program, 2008 has been almost a nonstarter even after 8 years. It will not be an over statement to say that it has been so more due to the pressures of practicing doctors, manufacturers and sellers than due to the government’s inefficiency. 
It is very disappointing that in an era of professed professionalism when high cost investigations and clinical tests are being prescribed routinely by the doctors under the plea that proper diagnosis is essential, our drug control department, medicine procurement departments and other similar departments don’t have a Pharmacologist appointed among their key positions. Had the Mehbooba Mufti Government really been interested in streamlining drug procurement, effective use of drugs and proper drug rationalisation, the services of a qualified Pharmacologist would be put in place by now. 
There is an utmost need of starting a practice of prescription audit so that no unnecessary drugs are prescribed and also that the doctors share their opinions and reasons for prescribing a certain drug after a disease has been diagnosed. Presently in J&K there is no specific prescription audit cell or unit functional, even in our top medical colleges. Since  some doctors, including the ones employed in government run hospitals have taken to near total commercial enterprising under the cover of permission given by the government for private practice (in relaxation of  conduct rules for the public servants), fair programmes and considerations are being discouraged. 
These days even some commonly used drugs are sold at exorbitant profit margins because certain doctors prescribe a particular brand of medicine at the insistence of the manufacturer or a particular retailer. This forces the patient to go for a much expensive brand of medicine rather than its counter genuinely priced brand. Prescription audit, if enforced in government hospitals, will surely check such unfair prescriptions as well as inclusion of unfairly priced drugs.
The medical profession is considered as a very pious profession. Our elders advise that a doctor be considered next to God only. Had thus the doctors put pressure on the government for promoting the Jan Aushadi Store like programmes started by GOI in 2008, they would have done a real service to humanity. 
There has also been no effective campaign sponsored or launched by the government to undo the false propaganda that generic medicines bearing same composition as that of a brand name medicine, are of low quality. CIPLA marketed the same drug as Amlip-5  (MRP Rs 27.70 per strip of 10 tablets) and Amlopress-5  (MRP Rs 44.80 per strip of 15 tablets) but the prices at which Amlip-5  was supplied to the retailers was not even one fourth of the price at which Amlopress-5 was supplied to them. Yet, the retailers bought and sold the exact same drugs under different names. The prices and policies prevailing in 2016 for such dual brand names are not any different from what they were in 2010. Had there been a system of Prescription Audit in place, such practices would have been eliminated once and for all. Why has no authority questioned such practices so far? Are they accomplices to such misleading practices or are they merely disinterested in policies of public interest? Will the present PDP- BJP Government rise above the cliched norms of the governments and really work for the benefit of the common man? Only time will tell.



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