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For 26-year-old Lakshmi, a construction worker from north Karnataka currently residing in Uttarahalli in Bengaluru, finding medication for her three-year-old who had a viral infection became Herculean task. The reason was that a brand of medicine prescribed by a general physician in the area was not available in any of the neighbourhood medical stores. “My daughter had a fever and cold for which the doctor prescribed syrup and injections.
While we got most of the medicines, one syrup was very hard to find. My husband went to at least eight medical stores in the area and it was not available. After three days we went back to the doctor saying it was not available, and he changed the name of the medicine.
We got it immediately,” Lakshmi said. What rules say Doctors prescribing branded medication instead of general medicine to patients has been a persistent issue. Clause 1.
5 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, prescribes that every physician should, as far as possible, prescribe drugs with generic names. It is to be written legibly and preferably in capital letters and he/she shall ensure that there is rational prescription and use of drug. Similarly, as per the Medical Council of India (MCI) guidelines (2016) and National Medical Commission (NMC) advisory (2022), doctors must prescribe medicines by their generic names rather than brand names.
To tackle the issue, the NMC, India’s regulatory body guiding medical professionals, has been constantly issuing guidelines to doctors. A notice by the NMC in 2023 said that doctors must prescribe drugs with generic, non-proprietary, pharmacological names only, but in the case of drugs with a narrow therapeutic index, biosimilars, and similar other exceptional cases, this practice can be relaxed. The notice also advised hospitals and local pharmacies to stock generic drugs, prescribe only those generic medicines that are available in the market and accessible to the patient.
It also advised encouraging patients to purchase drugs from Jan Aushadhi Kendras and other generic pharmacy outlets. However, despite multiple guidelines and notifications doctors and clinics are continuing to prescribe branded medications, said many patients and attenders from across the city that The Hindu spoke to. The long hunt Anil B.
, a resident of Sarakki, said that he found his mother struggling to find medicine prescribed by a general physician and the issue was resolved only when he intervened. “My mother had fallen sick recently and went to the doctor herself as all of us at home were busy with a family event. A week after the event, she continued to be sick, and when I asked her what happened she said she was not able to find a tablet the doctor had prescribed.
She mentioned that she went to two of our regular pharmacists and was not able to find it,” he said. He looked up the medicine on the internet and found out that it was a regular antibiotic for cold. “I got the combination of the tablet and went to a pharmacy and immediately got it for her.
It is very difficult for older or uneducated patients to find medicines that are new or do not have a generic name. Sometimes, I am away from family, travelling for months, and it is worrying to know that medicines are not easily accessible for my parents,” he added. Anusha Karthik, a resident of Yeshwantpur, said that her doctor had prescribed a specific branded medicine that she could not find at three different stores.
“The pharmacists kept suggesting generic alternatives, but I was not sure if they would work the same way. I was hesitant because my doctor had specifically mentioned the brand, and I did not want to take any risks with my treatment. I even called a few more pharmacies, but they either did not stock the brand or asked me to check back after a few days.
It was frustrating and stressful, especially since I needed the medicine urgently. In the end, I had to go back to my doctor and ask whether I could take the generic version instead.” It made her wonder if generics are just as effective, why do doctors still prescribe specific brands? “And if brands are better in some cases, why are they not easily available?“ she added.
Not available easily Another resident on Basavanagudi, Surabhi Rao, was prescribed a particular medicine for her auto-immune condition which she has to take on a regular basis. “I decided to check at a Jan Aushadhi Kendra first, hoping to get it at a lower price. But the pharmacist told me they only stocked generic alternatives.
I was confused because my doctor had specifically mentioned the brand, and I was not sure if the generic version would work the same way. The pharmacist assured me that the generic medicine had the same composition, but I was hesitant.” Eventually Surabhi bought the branded drug from a private pharmacy at a much higher price.
“It made me wonder if branded medicines are necessary in some cases.” A general physician from a clinic in Subramanyapura, who preferred to stay anonymous claimed, “While generic medicines are supposed to have the same active ingredients as branded ones, there can be variations in quality, bioavailability, and effectiveness. I have seen cases where patients did not respond well to a generic substitute, especially in chronic conditions like diabetes and hypertension.
Some branded medicines have undergone more rigorous testing, and I trust their consistency. I do prescribe generics when I am confident about their quality, but in cases where I have doubts, I prefer to recommend a brand I trust. At the end of the day, it is about ensuring the best possible outcome for my patient.
” A pharmacist in the same area, who also preferred to stay anonymous, said that for his business to run within the clinic complex, he had to agree to only sell medicines prescribed by the doctor. “Many doctors have an understanding to prescribe medicines of a particular brand. From my experience I have seen that these doctors get commissions, regular gift hampers, and some even get sponsored vacations for their entire family from these brands.
When the doctors are gaining so much, why would they say no? They are prescribing the right medication, it is just a matter of the brand name,” he said. He added that since the clinic has given him space to run his business, he has no other option but to agree to their demands. Dr.
Dabade said that implementation of guidelines should involve regulating the private health care sector more rigorously. | Photo Credit: Getty Images Need to regulate On asked if the NMC’s mandate on generic prescriptions has had an impact on doctors and patients, medical activist, founder member of Jagruti and Drug Action Forum - Karnataka, Dr. Gopal Dabade, said that the situation has worsened lately.
“Doctors in private health care are impressed by drug industries promotion and also are coopted by the drug industry. The drug industry has evolved several strategies to impress upon doctors. This is a global issue but the worst affected are poor people in developing countries.
Most patients are not aware, and doctors also make no effort to educate their patients. Many doctors discourage patients from using generic medicine,” he said. Dr.
Dabade added that Jan Aushadhi Kendras have made some impact, but their number is still not enough. Explaining how the State government or local bodies could get involved in implementing stricter rules, Dr. Dabade said that implementation of guidelines should involve regulating the private health care sector more rigorously.
“But in reality, the private sector is dictating terms because the private sector is 80% while public sector is just 20%,” he added. Published - April 03, 2025 09:00 am IST Copy link Email Facebook Twitter Telegram LinkedIn WhatsApp Reddit medicine / public health/community medicine / medicine (education) / health / private health care / health treatment.
