State Drug Policy: Is it the right prescription for curing our ailing healthcare system?

It is a million dollar question, or going by the magnitude of money pharmaceutical companies are minting in our state, it may well be worth a billion dollars. And when such a ridiculous amount of money is at stake, collective conscience, moral responsibility, integrity, sense of duty towards the society often gets short changed.

If we make an accurate prognosis of our healthcare system, it’s invalided by a bunch of deadly viruses, read under-qualified work force, selfish interests, profiteering, a lack of empathy, or devil-cares-a-damn-attitude that has left all of us vulnerable to sharks out there who make no bones about making big money at the cost of our poor healthcare system.

What we need to get us out of this mess is no less than a miracle drug. A vaccine that will not only take care of all the ailments our healthcare system is afflicted with but will eradicate these viruses forever.

Now, let us take an unbiased look at the newly-adopted Drug Policy and see whether it is really up to scratch or is it just placebo. Doing a paragraph by paragraph post-mortem of the Drug Policy may not be possible but I will try to put the most important highlights of the policy under the microscope and try to make you see the bigger picture.

Essential Drugs Concept: There are about 300 -350 drugs on the repertoire of the World Health Organization classified under the Essential Drugs , that clinically tackle almost all disease conditions, and these “essential drugs” are recognized and  prescribed by the best healthcare systems around the globe.

This EDL (Essential Drug List) will be revised after every two years taking into consideration therapeutic advances and changes in cost, resistance pattern and public health relevance.

In addition to that there are some drugs, though not listed on the EDL, required for specific diseases/ exceptional cases, a special Complementary Drug List (CDL) is drawn up and provisions made to procure such drugs for the masses under the controlled prescription policy.

The question is whether implementation of this concept as prescribed by the drug policy is good or bad. And the answer is both good as well as bad. It is good for you and me. It is good for the patient. It’s good for our healthcare system as this limited number of carefully selected drugs based on agreed clinical guidelines leads to a better supply of drugs, to more rational prescribing and to lower costs.

But it’s bad for business as there are about 20,000 and more medicines/ drug combinations available in the market when just “Essential Drugs” would do. Less number of drugs means lesser profits for these companies. Thus implementation of this concept is bitter medicine for them.

International Non-proprietary Name (INN) use: As per the international protocol, the drugs selected shall be identified, listed by their generic name or International Non-proprietary Name (INN) only and not by their brand names. How will this help “the masses”?

Going by the standard marketing practices employed by the pharmaceutical companies, they employ their representatives to influence medical practitioners to prescribe their brand name medicine over others.

This triggers ugly marketing wars between the pharmaceutical companies. Every dirty trick in the trade is put into practice to win majority market share. Marketing gimmicks like undue perks: foreign trips, expensive gifts are promised to unscrupulous medical practitioners that lead to irrational prescribing, high costs of medicine. To tackle these marketing strategies, other companies stoop down to cutting costs by compromising with efficacy of drugs thus leading to the menace of sub-standard, spurious drugs in the market. Whatever the strategy; we, the masses, become casualties of their profit wars.

To save us from such a nexus of pharmaceutical companies and medical practitioners, this Drug Policy is recommending “Generic Drugs” marketed under a nonproprietary or approved name rather than a proprietary or brand name. These generic drugs are as effective as, but much cheaper than, brand name drugs.

Regulated Drug Licenses: The healthcare industry is the domain for specially-skilled workforce, but the tragedy with the healthcare system in the state is that every Tom, Dick and Harry  have gotten into it for lack of a much coveted, government job.

In the past two decades, the drug licenses have been distributed in the state like tehri. Medical shops have come up across the state like acne on a poor teenager’s face: aplenty. And the job of reading a doctor’s prescription and dispensing the right drug to the patient is often done by teenagers employed in these shops rather than by qualified pharmacists.

Drug Licenses should have been issued to qualified pharmacists in the first place and not to any random person with a matriculation certificate.

This Drug Policy is righting that wrong without jeopardizing the livelihood of the people involved in the healthcare sector by endeavoring to conduct training of drug sellers, continuing education of health care providers, and by empowering consumers through educating them about drug usage.

The concepts of essential drugs, rational drug use and generic prescribing shall be an integral part of basic and in-service training of health professionals. As such, these shall be incorporated in the curricula of health education training institutions.

Controlled Prescription: Popping a pill at the smallest hint of a headache has become a trend in our state. People take medicine as carelessly as if they are popping a candy. Or if we go by the traditional norms, the advice of a mere compounder, who is not even a qualified pharmacist, is taken as seriously as one should take the advice of a qualified doctor.

To control this careless attitude prevalent in the society, the Drug Policy is making it mandatory to monitor sale, storage, use of drugs and record keeping under Schedule X of the Drugs and Cosmetics Act, 1940.

This will put an end to irrational dispensing of Schedule X and Schedule H drugs. We’ve already seen the ugly consequences of not following these norms in the form of drug addiction.

Without proper supervision and monitoring, our vulnerable youth fall prey to repeated use of certain narcotic/ sleep inducing drugs and put their future at the verge of destruction. Special checking squads comprising Deputy Controllers working under Drug and Food Control Organization will be constituted to undertake periodic inspections in this regard.

This Drug Policy makes Schedule-H drugs to be strictly dispensed on the prescription of Registered Medical Practitioners only.

Prescription for Progress: I’m not a medical doctor, but as an aware consumer, I strongly believe that for successful implementation of the policy and to promote the concepts of essential drugs and rational use of drugs while ensuring proper management of the limited resources to promote long term sustainability, it is necessary to develop expertise of the state’s pharmacists.

To ensure safety, quality and efficacy of products, the regulatory agency shall regulate manufacture of medicinal products and conduct periodic inspection of manufacturing premises within the State.

Pharmacists should be empowered to manage the Drug Management System at all levels. Necessary steps should be taken, in due course of time, for training of adequate number of pharmacy professionals in the State to manage the hospital pharmacies and drug supply system. Appropriate in-service training programmes shall be designed and implemented at different levels to enhance the skills of pharmacists to meet the emerging challenges.

With a lot of hullaballoo going around in the media circles about the Drug Policy, it is for you, my dear reader, to decide for yourself whether it’s healthy for you to let someone with selfish interests to make money at the expense of your health or take a healthy stand for the State Drug Policy that will inject some vigour and vitality in our convalescing healthcare sector.

(After running into a couple of hiccups initially Jammu & Kashmir Health Department finally succeeded in implementing the State Drug Policy in March 2012 , which was based on the National List of Essential Medicines of India, 2011.)

©Harf’e Zaraf 2016. Unauthorized use and /or duplication of the writings without express and written permission from this site’s author and owner is strictly prohibited.

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