07 June, 2012

THE CASE OF GENERIC MEDICINES

THE CASE OF GENERIC MEDICINES
June 7, 2012
The case of the generic medicine seems clearly to have been rather over-simplified. Medicines are not just about raw materials; a whole lot of additives, preservatives, packaging etc determine the ultimate potency of the drug, affecting their sustainability, digestibility, shelf-life etc. 
GMP [Good Manufacturing Practices] certification is subjective and differs regionally in its application. It may even tilt in favour of the small local players scouting political favours.
Label equivalence need not amount to therapeutic equivalence. That is, say, paracetamol of two manufacturers need not deliver identical results.
Branded medicines [ethical formulations] strive to ensure their end-user quality and thus add some value. Then there are a whole lot of expenses on brand-promotion, incentives to intervening players etc. Priced higher they attract even higher excise duty [being advalorum] and thus the price differential.
It is obvious that the generic medicine produced by the major players would be qualitatively superior to that dished out by local players. Yet the smaller players can give them dirty competition with their generic medicines, selling them far cheaper due to smaller overheads. Thus the generic medicine market is open to manipulation leaving the consumer in a lurch anyway.
I am personally seeking definitive answers to the following questions and will be grateful for any useful inputs:
1. Isn’t it true that there is a substantial price difference between the generic medicine and branded medicines of the same quality?
2. May it be said that the quality of the generic medicine and the branded medicine for the same formulation, both produced by the same major player, would be identical? If yes, would the consumer not be better off buying this generic medicine?
3. Can anyone say that every price is truly representative of its quality? In other words can’t some products be unfairly priced against the consumers? [For instance, we know how competition brought them down.]
4. Restricting this to the major players, what percentage of medicinal requirements of, say, Ahmedabadi consumers can be served by the generic medicine? In other words, what percentage of branded products are also available as generic medicine? Just a guess will do.
5. If consumers of, say Ahmedabad, were all to have equal access to the generic and branded medicines of major /reliable players, how many would opt for generic medicines today?
6. Again restricting this to the major players, if the Ahmedabadi consumer were to buy only generic medicines, in preference to the branded ones, to the extent they are available, what would be their saving, in percentile terms?
7. If we were to offer all the generic medicines of ONLY the reliable producers to the poor of Ahmedabad what would be the percentile saving for an average buyer? On a wild goose chase, what might be the sales of first such store in the first month after proper promotion, if located near the V S Hospital?
8. What would it cost to stock one month’s sales of all the running generic medicines of major players to begin with? Or with what capital outlay [on medicines alone] can such a store be viably started?
9. What are some of the reliable standards classifying / grading pharma companies in terms of their quality and reliability? Would their sales revenues be a good enough indicator? Do Indian apex bodies like AIOCD or international regulators like USFDA rank them otherwise?
10. In the end, should SPRAT actually launch a generic medicine store confining its purchases to the produce of only the recognized players?
If you care about the health of the poor please do contribute to our knowledge.

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