No price change in 78% of actively used drugs post GST: NPPA

No price change in 78% of actively used drugs post GST: NPPA

Drug pricing regulator NPPA on Friday said prices of around 78 per cent of ‘actively used’ drugs will remain unaffected after the rollout of the Goods and Services Tax from midnight tonight.

The National Pharmaceutical Pricing Authority (NPPA) has already announced provisional ceiling prices of 761 medicines, including anti-cancer, HIV, diabetes and antibiotics, with a majority being reduced ahead of the GST implementation.

These prices will be notified as formal revised ceiling prices immediately after GST notification, NPPA had said in a memorandum earlier this week.

“Prices of approximately 78 per cent of all actively used and traded drugs in the country are going to remain unaffected post GST”, NPPA said in a tweet on Friday.

It had earlier indicated that the prices of majority of essential drugs would increase by up to 2.29 per cent when the GST regime kicks in. The government has fixed GST rate of 12 per cent on most of the essential drugs as against the current tax incidence of around 9 per cent.

“I am confident that GST implementation will be by and large smooth and will not cause any major disruption in the availability of drugs in the country,” NPPA Chairman Bhupendra Singh had earlier told.

Nod to drug brand names with rider

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Top government officials today clarified that doctors across India were free to prescribe medicines through brand names, but iterated that they should write the pharmacological, generic names alongside as part of efforts to promote inexpensive medicines.

Union chemicals and fertilisers minister Ananth Kumar, who is also in charge of the pharmaceuticals department, said the government would make it mandatory for doctors to write the generic names of medicines, but indicated that doctors and patients could pick brands.

Kumar said the government had taken steps to make it mandatory for pharmaceutical companies to display generic names on medicine packets in fonts much larger than those used to display brand names.

He said the health ministry had sent an advisory to all central government hospitals asking their in-house doctors to prescribe medicines in generic names. The ministry has also sent an advisory to all states asking them to follow suit with state hospitals.

He said the government was taking steps to amend rules to make it mandatory for doctors to write down generic names and allow retail chemists to substitute one brand with another.

The Narendra Modi government’s renewed push to promote generic medicines and prescriptions with generic names had given rise to speculation among sections of doctors whether they would be prohibited from writing brand names on prescriptions.

But Kumar indicated that the drive to promote generics would not prohibit brand names. “We are not into banning anything – no one can withhold the choice of a brand, people are free to use brands of their choice,” he said, responding to a query on whether the government intended to ban brand names on medical prescriptions.

A senior official in the pharmaceuticals department also said that while the government would promote generic medicines, there was no specific ban on the writing of brand names. A Medical Council of India official too had last month said doctors could continue to write brand names.

Kumar said the Modi government had expanded access to inexpensive generic medicines by accelerating the so-called Janaushadi programme that seeks to provide inexpensive generic versions of medicines at 2 to 15 times lower cost than what they would cost in standard retail pharmacies.

The Janaushadi scheme launched by the UPA government in 2008 had established 104 outlets offering relatively inexpensive generic versions of 361 medicines by 2014. “We have now accelerated and expanded the scheme – we now have 1,320 Janaushadi outlets with a wider basket of over 600 medicines,” Kumar said.

The Janaushadi outlets provide generic versions of antibiotics and medicines to treat cardiovascular disorders, diabetes, respiratory illness and kidney diseases among other therapeutic areas at lower costs than standard retail pharmacies.

A pack of 10 tablets of a drug called amlodipine, used to treat high blood pressure, for instance, costs about Rs 36 from retail pharmacies but is available for Rs 3.54 at Janaushadi centres. The cost of the generic version of the anti-diabetes drug metformin in a Janaushadi centre is five-fold lower than what it costs in retail shops.

Kumar said the Janaushadi stores would, in an effort to ensure supply of only high quality medicines, procure medicines only from manufacturers who meet the “good manufacturing practices” standards endorsed by the World Health Organisation.

IMA gets into semantics to beat code on generic drugs

Image result for IMA gets into semantics to beat code on generic drugs

Prime Minister Narendra Modi’s resolve to ensure that doctors prescribe only generic medicines is being undone by some creative interpretation of the Medical Council of India’s (MCI’s) “code” for doctors, which ostensibly makes it mandatory to prescribe using generic names. Reacting to the MCI injunction that doctors should prescribe generic drugs, the Indian Medical Association (IMA) said “should means may and may means optional or preferable”.

Meanwhile, doctors demanded that the PM ban companies from manufacturing any generic medicine with a trade name and ensure they produced only high-quality generics. Though the PM said he would bring a legal framework to prescribe generics, there is as yet no new law, either for the pharma industry or for doctors and chemists.

All that has happened after his announcement is that MCI has issued a notification reiterating an existing clause in its code of ethics regulations. The clause, which had earlier stated that “every physician should, as far as possible, prescribe drugs with generic names” was amended in October 2016 to “every physician should prescribe drugs with generic names”, indicating the intention to make it mandatory. However, the IMA has pounced on the fact that the letter of the clause uses “should” instead of “shall” to argue that it is not mandatory. IMA president K K Aggarwal’s statement on the issue further pointed out that the clause did not say doctors can prescribe “only” with generic names. So, IMA has advised doctors that they can write the generic name and add the name of the company that manufactures the drug.

“Nobody can stop you choosing the company for quality assurance,” said the IMA statement. IMA advised doctors to choose drugs from the National List of Essential Medicines (NLEM) as they are cheaper and of assured quality. “When writing non-NLEM, take consent. When prescribing, write the cheapest available medicine and that will always be the generic version of that company,” advised IMA.

 The All India Drug Action Network (AIDAN), a civil society group working on drug pricing and accessibility, issued a statement pointing out that the proposal to make prescribing generics mandatory for doctors would be a useless, counterproductive step as a standalone measure. “This is because in India no manufacturer markets medicines in the retail market under generic names and hence medicines are not available under generic names in the Indian retail pharmacy shops,” it pointed out.

AIDAN said that unless manufacturers (except those who are marketing medicines still under patent protection) are made to market medicines under generic names for the retail market, consumers would not get the benefit of “generic medicines”.

Many drugs using active Viagra ingredient: Govt

Many drugs using active Viagra ingredient: Govt

After registering a case against a pharma company based in Bihar, the health department suspects that there are other ayurveda and homeopathy drugs using sildenafil citrate, an active ingredient in Viagra.

Sildenafil citrate can only be sold on the prescription of an authorised doctor but the action of health department officials against such drugs shows that it was easily available as over-the-counter drug in the form of ayurveda and homeopathy medicine.

The drug is prescribed for erectile dysfunction but it can cause cardiac arrest and other severe complications.

Around four days ago, ayurveda department and health department jointly conducted a raid and collected medicines of ayurveda and homeopathy suspecting them having sildenafil citrate in Jaipur and Bihar.

“We are awaiting the report of seven samples collected. After receiving the report of laboratory test, we will take further action,” Ajay Phatak, drug controller, health department, said.

He said that use of sildenafil is allowed in allopathic medicines only as it is an allopathic content. No other alternative medicine like ayurveda or homeopathy can use it. It makes drugs spurious.

The health department officials had conducted raids in Bihar, where the manufacturer’s unit was situated.

Phatak said that they would take action against ayurveda and homeopathic medicines which are using allopathic contents. “We are taking it as a campaign against spurious drugs,” Phatak said.

After the raids, the drug controller imposed prohibition on sale of seven such drugs which were suspected to be using allopathic content- sildenafil. The cost of the drugs was over Rs 2 lakh.