Drug row: Piecemeal solution worse than disease

The Peoples Movement for the Rights of Patients and other health action groups are appealing to the Health Ministry to introduce the legislation for a compressive National Medicinal Drugs Policy instead of piecemeal directives which have caused concern and controversy among doctors and patients.

On December 28, Health Services Director General Dr. Ajith Mendis issued a short directive to all government hospitals and other state medical institutions saying the Minister of Health has decided to promote generic prescription of drugs to reduce the burden of cost to patients when purchasing drugs.

Dr. Mendis said as a preliminary step, visiting of Medical/Sales representatives to Government Health institutions to promote their products would be prohibited from this month.“Please note that if any Medical/Sales Representative is found by the investigation team of the Ministry of Health in a medical institution, the relevant head of the Institution is liable for disciplinary action,” Dr. Mendis said.

The PMRP and other health action groups see this as a piecemeal regulation which is likely to produce more questions than answers. They say that the Ministry should instead push ahead by bringing in comprehensive legislation for the National Medicinal Drugs Policy. The first step in this policy will be the setting up of a new National Medicinal Drugs Regulatory Authority which will re-evaluate some 8,000 drugs now registered and slash the figure to less than 1,000.

In its evaluation the new law will provide for the NMDRA to consider quality, efficacy, safety, the cost and the need for the drug. Through this it is hoped that quality drugs could be made available to all the people at affordable prices through more effective quality control and post marketing surveillance. In addition the country could save billions of dollars in foreign exchange annually by stopping the import of thousands of non essential drugs imported under highly expensive brand names.

The controversy took a more drastic turn when Health Minister Nimal Siripala de Silva warned in a television interview that doctors who did not prescribe drugs under their generic names could be sent to jail in terms 1992 regulations under the Cosmetics, Devices and Drugs Act.

The Sri Lanka Medical Council – the country’s premier medical body reacted strongly to the Minister’s warning. In a letter to him the SLMC said it was appalled by his threat to imprison doctors who prescribe drugs under generic names. The SLMC said this castigation of doctors was uncivilized.

“Before drastic changes to the present policy of drug prescribing, opinions of a broader section of the medical professionals including professional organizations and practicing doctors should have been obtained. We are of the opinion that it is quite in order for the brand name of a drug to be included along with the generic name as stated in the Regulations under the Cosmetics, Devices and Drugs Act published in 1992,” it said.

The patients movement say the whole controversy could be resolved if the Health Ministry introduces the long-delayed legislation for the implementation of a National Medicinal Drugs Policy. They say they have learnt that powerful vested interests with influence in the Ministry are blocking the introduction of the NMDP legislation and the Ministry is trying to divert attention by issuing piecemeal directives which are worsening the sickness.