In spite of various social welfare and healthcare schemes of government, the affordability of good health services is beyond the reach of the common populace in the state of Meghalaya, where private hospitals and clinics are charging the patients as per their own tariff as there is no uniform rate either for room-rent or treatment in the state. Above that, the cost of medicine, particularly the lifesaving drugs are beyond the capacity of the common people to pay. Such situation has prompted the A’chik Youth Council (AYC) to demand for generic medicine store to be set up at all PHC, CHC and Civil Hospitals in Garo Hills.
The AYC provided the example of Glimepiride (2 mg tablets for of diabetes) available for Rs 50 while the generic version is available for Rs 5.05. Similarly, blood cancer medicines are available at Rs 1.2 lakh while the generic medicines cost Rs 10,000. In the antibiotic segment, the leading brands of Ofloxacin 200 mg tablets are priced at Rs 52.60 for 10 while the generic meds are available at Rs 14.80.
It may be reminded that the Chemical and Fertiliser Minister, Ananth Kumar on July 28, 2016, in response to a Call Attention Motion in the Rajya Sabha, informed the August House that the government is planning to modify the rules of the Medical Council of India to make it compulsory for all physicians to prescribe medicines with generic names.
Ananth Kumar clarified that under the amended regulation, every physician should prescribe drugs with generic names legibly and preferably in capital letters and he/she shall ensure that there is a rational prescription and use of drugs. The issue has been taken up with the Health Ministry to make it mandatory for doctors to prescribe generic medicines and to allow pharmacists to substitute generic medicines for branded medicines.
Also, on March 10, 2016 the Central Drugs Standard Control Organisation (CDSCO) — an Indian drug regulator — banned 344 drugs in the country. The notification said that these drugs cannot be made, sold or distributed in India. CDSCO gave two main reasons for the ban: the drugs were likely to involve risk to human beings while safer alternatives were available, and they were found to have no therapeutic justification.
The list of the banned drugs included some widely used products such as the Vicks Action 500 tablet, made by Procter & Gamble, and Pfizer’s Corex cough syrup.
In view of the high cost of medication, most of the middle class citizens, after indulging in a trial and effect strategy, entirely depend on self-prescription of medicines which are Fixed Dose Combinations (FDC), which means they are made by mixing two or more drugs, with full consciousness that all the drugs in the market have undergone rigorous testing before they are introduced in the market. Despite all precautions, some adverse effects of drugs appear only when the drug is used on the general population after its approval. These adverse effects are detected though a process of regular monitoring after the drug is released into the market called pharmacovigilance.
Meghalaya, known as the hub of various medicinal plants, has only banked on the Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), a part of the Ministry of Health and Family Welfare of the Government of India. Former President of India, late Dr A.P.J. Abdul Kalam who understood the potential of the medicinal plants of Meghalaya, invited the practitioners of traditional medicine to plant saplings in the Mughal Garden of the Parliament. In Meghalaya, till date only the individual or village base are preserving all the traditional plants, none of the government department or organizations attempted to promote the medicinal plants.
The traditional practitioners here in the state are unaware of the Intellectual Property rights assets and knowledge to generate economic wealth. In the fear of being duplicated, the findings and practices by the traditional practitioners have been kept close to their chest, not even letting the family members know of their findings, resulting in a loss of the invaluable knowledge after their demise.
The health care facilities in the rural areas are pathetic. All the government hospitals, PHC and CHC are always said to be running short of medicines, worst so, even the Civil Hospital in Shillong is facing the same problem, and on occasion expired-medicines are being administered to the patients.
The pharmacies in Meghalaya are mostly on hired licenses; hence on many occasions, NGOs had seized expired medicines from the pharmacy even in urban areas; so one can imagine the scene in rural sector.
Not to talk about the generic medicine, even expensive lifesaving drugs which need to be stored under refrigeration and be kept away from direct sunlight is being neglected as many pharmacies are functioning without refrigerators or proper storing facilities.
In the urban areas too, pharmacies are mushrooming in every nook and corner, which is good for the society, but when it is not up to the specifications, is going to harm the society more.
In a major push for the generic medicines, the health ministry on April 18, 2017, sent directions to all central hospitals making prescription of generics compulsory. The health ministry also sent the state governments an advisory on the same lines. Moreover, on March 30, 2017, the health ministry directed every company that every medicine must have a generic name in big and bold letters, along with the brand name of the drug. Following suit, that Medical Council of India (MCI) has also asked doctors to write generic names with brand names of medicines in prescriptions, or they should explain the reason for not doing so.
Any NGOs wanting to open a generic medical store can apply through the department of chemical and fertilizers, and the government provides aid of Rs 50,000 for the same. Strangely, there are very few applicants for the same.
Mizoram has already put up the proposal for generic medicine and Meghalaya too should take advantage of the latest regulation which will relieve many from the high cost of medication.