Generic drugs are being pushed in a big way by the West Bengal government to replace expensive branded medicines and bring down the prices of essential drugs.
The medical community, however, is cautious in its appreciation of the move - it's "laudable", they say, but sustaining this over the long term could be "challenging".
The government has initiated the process of introducing generic medicines in state-run hospitals by opening fair price shops through public-private partnership (PPP). These outlets are selling generic drugs at a whopping rebate on the maximum retail price (MRP), earning kudos from the people, but annoying a major section of drug sellers.
The government has announced that more fair price medicine shops would open.
Generic drugs cost less than branded ones, and the price difference is mainly due to the absence of marketing expenses incurred by pharmaceutical firms for their products.
"If the government can make the switchover, it would ensure cheap medicines for poor people," renowned orthopedic surgeon Sunil Thakur told IANS.
The fair price shop at the Seth Sukhlal Karnani Memorial Hospital (SSKM), the state's only government-run super-speciality hospital, is selling generic drugs at a 67.25 pecent rebate. It is the eighth such shop in the state. With plans to launch 35 fair price shops in the first phase, the health department has asked the shops to store 142 types of generic medicines.
"Quality control would be an issue, and the government has to be smart about sniffing out spurious medicines," Thakur warned.
Noted cardiologist Dipankar Mukherjee said: "It's a challenge mainly because it's very hard to change one's natural habits. For long, doctors have been prescribing branded drugs, while the people are also habituated to taking branded medicines."
The medicine outlets also lacked adequate trained pharmacists capable of giving the precise medicines to customers if physicians prescribe generic drugs, he said.
There is reason for caution, going by the experience in neighbouring Bangladesh.
A senior official at a drug makers' body in Bangladesh told IANS over the phone on condition of anonymity: "Our country had initiated the process about 30 years ago. But the quality of generic drugs was not up to the mark."
"When a doctor prescribes a branded medicine the onus is on him, but when he prescribes drugs with generic names, the onus of providing the right medicines shifts to the pharmacist, who is often a mere shopkeeper. Thus it compromises people's heath," the official said.
West Bengal, however, can draw encouragement from Rajasthan, which successfully implemented the policy of promoting cheap generic medicines.
The Mamata Banerjee government has got some success in lowering medicine prices. The state's druggists association, which was earlier up in arms, has now asked its members to sell generic medicines with a higher rebate than the discounted rates at fair price shops.
Claiming it was not against introducing cheaper drugs, the Bengal Chemists and Druggist Association (BCDA), which has more than 35,000 members across the state under its umbrella, said the government should make the programme more "practicable".
"First the doctors have to start prescribing generic names. Providing single-molecule generic drugs would not be difficult for a pharmacist, but difficulties would crop up in case of combined products," BCDA general secretary Tushar Chakraborty said.
Chakraborty said doctors of even government-run hospitals were prescribing medicines for critical patients which were currently not available in fair price outlets.
It was difficult to treat critical patients with these 142 specified drugs, while the fair price shops were also selling medicines at varying prices in Kolkata and the districts.
A pharmacist at the fair price shop at the SSKM however claimed they were meeting around 97 percent of the patients' requirements from the specified generic drugs.
Minister of State for Health Chandrima Bhattacharya parried questions. "I cannot reveal the government programmes in detail," Bhattacharya told IANS, adding that no government in the state earlier had tried to reduce the price of medicines.
On the flip side, the transition attempt could prove costly for a section of medical representatives, as sales of a few branded drugs have shrunk dramatically.
"I learnt that recently some drug companies, engaged mainly in manufacturing general pharmaceutical products, are reporting low sales of their branded products. They are even not being able to set sales targets due to a severe demand fall," said a medical representative working with Zydus Cadila.
He said there was ground to fear loss of jobs.