‘Branding’ the patient

When you go to your family physician or a consultant the next time, remember the prescription for your drugs must – by law – contain the generic name of the drug, even if a branded drug is prescribed.

Or your ‘friendly’ physician could be slapped a fine of Rs 50 000 to Rs 100 000 for violating the Cosmetics, Devices and Drugs Act. This provision in the law is openly violated and the health authorities and the law enforcement authorities appear to be powerless in the face of the powerful pharmaceuticals industry.

A comparison of the prices of generic products and branded products as at September 2006 by the State Pharmaceuticals Corporation of Sri Lanka (SPC) shows that the difference between the two is sometimes as much as 10 times or even more.

A doctor who declined to be named, said generic and branded medication are “therapeutically equivalent”, ... the only difference being that they originate from two manufacturers. A generic drug contains the same active ingredients as a brand name drug.

Dr. B. G. D. Bujawansa, former President of the Independent Medical Practitioners Association of Sri Lanka said there is no advantage in opting for branded products over generics as the medicinal properties of both are the same. “The manufacturers of the branded medication make people believe that they are better. They put it across as the original product.”

He said however the quality should be taken into account, stating that there are some generics that are bad. “In India, where we import some of our drugs from, the pharmaceutical industry is sort of like a cottage industry. Capsules are distributed to houses and the filling is done in these houses. But this is not so with regard to all drug companies. There are also manufacturers that are really good. The doctors know which medicines to prescribe and which to not.”

Quality is the critical issue and that is what the consumer needs to be wary about, said the unnamed doctor. “They could be duped by either a branded drug or a generic drug if it is of questionable quality,” he explained, adding that the consumer is not at a special advantage by opting for the more expensive branded drugs. All drugs manufactured or imported into the country need to be registered at the Drug Regulatory Authority, which checks the quality of all such entries into the market.

All government hospitals in the country use generic medicine in their daily operations and these are prescribed by consultants but when they revert to private practice in the evenings, they prescribe expensive branded drugs, says another industry professional who declined to be identified.

Listed below is the price comparison for a few common drugs. (The price mentioned for the branded drug is that of the highest branded drug in the market.)

According to a Health Ministry official, non-compliance of the law in relation to not entering the generic name in a prescription is a violation of the law where a first time offender can be fined up to Rs 50 000 and a person who commits the offence for 2nd time or more can be fined up to Rs 100 000, the official said.

The Sunday Times FT also learnt that all government doctors have been issued a circular by the Director General of Health instructing them to use generics instead of branded medication but this circular has been ignored. Doctors are still prescribing heavily priced branded drugs over the more economical generics raising the question as to whether the doctors have become a law onto themselves and why the government is not applying the law.