Generic drugs: Yet to gain public trust

Hameed Ashraf | NT

Though generic medicines are much lighter on the pocket than their branded counterparts, there are not many takers. While customers are reluctant to buy generic drugs because of lack of awareness, the pharmacists do not stock them as the margins offered are low. Even doctors have a low opinion of generic drugs and insist that patients should buy only branded ones. Though the city has 241 Janaushadhi Kendras that sell generic drugs at affordable prices, the footfalls are low. Hameed Ashraf reports 

Though generic drugs are cheaper than branded ones, there are not many takers. The Jan Aushadhi pharmacies, where generic medicines are sold anywhere between 20 and 80% lower than their branded counterparts, seem to have a low footfall in the city. Lack of awareness and a low profit margin is why customers and pharmacists stay away, some say.

After suffering a mild heart attack in 2019, 67-year-old Lourd Raj has been very cautious about his health as well as his finances. He was advised to buy some expensive drugs from a city-based private hospital. Even though he was short on funds and struggling to make ends meet, he set aside money to buy medication for a couple of months.

He feared that he might run out of money and tried speaking to a few doctors about alternatives and less expensive treatments. That was when he came to know about generic medicines.

With an objective of making quality generic medicines available at affordable prices to all, Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) was launched by the Department of Pharmaceuticals, Ministry of Chemicals & Fertilizers, Government of India in November, 2008. Under the scheme, dedicated outlets known as Janaushadhi Kendras are opened to provide generic medicines at affordable prices.

According to the Janaushadhi portal, 8012 Janaushadhi Kendras are functional across the country among which 241 are operating in Bengaluru city as on August 2021. Product basket of PMBJP comprises 1,451 drugs and 240 surgical items.

Generic drugs tend to cost less than their branded counterparts because generic drug applicants do not have to repeat animal and clinical (human) studies that were required for the branded medicines to demonstrate safety and effectiveness. However, they have to undergo a rigorous review and can be made only after a set period of time that the branded product has been on the market exclusively. This is because new drugs, like other new products, are usually protected by patents.

But in spite of their low cost, the public remains suspicious of the effectiveness of generic medicines. A team of researchers from Institute of Public Health (IPH), Bengaluru, conducted a threeyear study on access to generic medicines for non-communicable diseases. “There is a strong perception among the public, and to our surprise, even practitioners and pharmacists, that generic medicines are of sub-standard quality,” said Upendra Bhojani, Assistant Director, IPH.

“In some countries, like Belgium, doctors are obliged to prescribe generic drugs. The pharmacist is also expected to offer a generic drug first. Whereas in India, you have doctors who write at the bottom of prescriptions — please don’t change the brand,” she said. A survey conducted by IPH found that an average household spends up to Rs 600 per month on procuring drugs for hypertension and diabetes, which is more than a week’s wages for many people in rural Karnataka. Many such families have no knowledge about generic drugs, where to buy them, their quality, and how they can be helpful.

Pallavi, a pharmacist at Jan Aushadi pharmacy located on the Gangondanahalli Main Road told News Trail that all generic medicines prescribed by the doctors at the hospital are sold at cheaper rates through the Department of Pharmaceuticals of the Union government. “The initiative was introduced to ensure that the public does not refrain from taking medicines prescribed by the doctor on the sole pretext of being unable to afford it,” she said.

Most private sector pharmacists who interacted with News Trail had a poor opinion about generic drugs, and were emphatic that they were ineffective. They reasoned that most patients prefer good quality medicines (which in their opinion were synonymous with branded medicines) and that very few patients, according to them, obtained their medicines from generic drug stores or PHCs.

“A section of customers identify their medicines through the colour and size. We try to explain to them that generic medicines also have the same therapeutic outcomes, but at a much cheaper cost. Some accept it while some insist on getting brands prescribed by the doctors,” Pallavi added.