On the last episode of Satyamev Jayate, the topic raised was healthcare in India. I felt that in this episode many facets related to healthcare in India were aptly handled. One of the issues raised was of the exorbitant cost of medicines and the need to make generic medicines available within the reach of all. I admire Dr. Samit Sharma who has helped in setting up many of these generic medicine shops with the help of Rajasthan government in Rajasthan. I do hope that this initiative can be taken to other states as well.
Many of us are aware of the difference between generic drugs and branded drugs. For those who are not, generic is the chemical ingredient of the drug and brand name is the particular name by which the drug is sold by individual pharmaceutical companies. Just like other branded goods, branded drugs are expensive, sometimes manifold. But unlike clothes, cars, jewellery, drugs do not really offer a show-off value or possession quotient. All one cares for is the drug to alleviate the symptoms it is meant to alleviate and be pure and safe. Hence, paying for the branding of the drug versus a generic is a wasteful expense.
To give an example paracetamol (a common painkiller and fever reducer) is very commonly sold as Crocin or dolo in India. In this case, there might not be too much price differential between the brand and the generic. But those who take Tylenol in the US will agree that there is quite a price gap between it and its generic available.
I’ve known and noticed that doctors regularly prescribe branded drugs (often very costly), offering no perceivable additional benefits as compared to their generic that are priced at a fraction of cost. My dog was prescribed Augmentin 625mg recently as an antibiotic by a vet in Bangalore. The cost of 10 tabs is approximately Rs 440. Augmentin is regularly prescribed for both kids and adults. Its generic counterpart having the same chemical composition (amoxicillin and clavulanate) costs Rs 108. You see the difference of three times, yet two doctors prescribed this, and I had to specifically ask the pharmacy to give me the generic.
A month back, my dog was prescribed Nizoral tabs for a fungal infection. I was told to give it for six weeks and just three days’ supply costs Rs 250 (no exaggeration)! On calling up the vet and cajoling her, she prescribed an alternative grisovin by Glaxo that costed Rs 15 for a week’s dose. This is a huge price difference! You will find this happening for many drugs. Do compare the costs of various OTC (over-the-counter) vitamin supplements available at your pharmacist and see for yourself. You are being fleeced and end up paying pharma companies because they are telling your doctor (giving commissions) to prescribe you expensive drugs.
For OTC and commonly used drugs, it would help to check for the generic alternatives. Your pharmacy person can easily guide you, and you can compare the chemical composition along with potency. You can even call up your Doctor, and I’ve done that many times, and they have told me the generic name when I said that the drug they prescribed is too expensive and the pharmacy person is suggesting an alternative and cross-checking with the doctor if it is fine.
So, demand information, use information, browse the net and don’t get fleeced. There is a huge scam going on in vaccinations too. Doctors often ask for useless vaccines or expensive ones of the same variety to be given. Their cut can be as high as 50%. A simple example is the DTP vaccine given to children. This vaccine costs less than Rs 100, but its expensive equivalents DTaP costs Rs 1000. The difference is that DTaP has less chances of causing fever in children than DTP. Doctors will not even tell you the difference and ask you to take the expensive one. Do ask in detail about vaccination. I have personally been fleeced here.
Footnote: Please be careful when buying generic substitutes from unknown pharmaceutical companies due to so many fakes available in the market. But many times good generic substitutes from reputed pharmaceutical companies are available at a lesser cost as in the examples given above. At least try asking your doctor, most good doctors do give you a substitute. Even good vets give. I have experienced this umpteen times. Many of them are not willing to risk their reputation when their patient insists upon asking for a perfectly acceptable cheaper substitute (if available).⊕
As Sriram said, Pharmacies also have a hand in pushing the branded drugs across. They simply say, the generic ones are not available, the branded ones are.
Sickness is one business people get exploited very fast.
Nice write up. Some pharamcies simply don’t stock generics as the margins are low. I have experienced this with amoxycilin.