Alliance of Doctors calls for modifications in the National Medical Commission’s (NMC) directive

The Alliance of Doctors for Ethical Healthcare (ADEH) has called for modifications in the National Medical Commission’s (NMC) directive making it compulsory for registered medical practitioners (RMP) to prescribe drugs using generic names, which has now been kept in abeyance.

In a statement, ADEH, a network of doctors spread across India advocating healthcare reforms, urged the NMC to reverse its decision to put the directive in abeyance and to issue a “fresh, improved directive mandating doctors to write prescriptions in generic name only with the company name in the bracket if any RMP desires to”. The directive, as a standalone measure, will not achieve the objective of promoting lower cost rational prescribing practices.

Elaborating on the justification for their demand, the ADEH said considering that medical college training of doctors in pharmacology and all clinical subjects are done in generic names, they want to continue to write prescriptions in generic names. However, they said that till the government assured through concrete evidence that all medicines available in the market are of standard quality, doctors should be allowed to use in their generic prescription the name of the company in brackets, in which respective doctors believe as regards the quality of the medicine. In the absence of such reliable assurance, doctors have to rely on the company’s reputation, his/her individual experiences as well as of fellow doctors.

Within five years, there should be a move towards a situation in which all medicines in India are of standard quality, whatever may be the manufacturing company. To monitor the progress towards this end, National Drug Surveys should be carried out based on representative samples of medicines in the retail market. Once this goal is achieved, all brand names should be gradually done away with.

The doctors noted that if their demand to allow doctors to write the name of the company in bracket is not accepted, the control of choosing the brand would pass to the chemist, who they fear would decide the brand primarily on the basis of the margin to be gained.

They also urged the government to ban all irrational Fixed Dose Combinations (FDC) that constitute around 40% of the retail market in India as against seven percent in World Health Organisation’s Essential Medicine List. Generic prescription, the network said, becomes a huge challenge if irrational FDCs with multiple ingredients are to be prescribed in generic name, the ADEH stated.

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