Bitter Pills:Medicines & The Third World Poor | Page 64

Would you rather have your
doctor choose a medicine
for you-or somebody else ?

Somebody other than a doctor
may choose a medicine for you if
brand names for drugs are abolished and doctors are compelled to
prescribe by generic name only
A generic name is the common
name of a drug — usually a long
chemical name. When this drug is
made by several firms, each one
gives il an easy-to-remember brand
name, which is usually simpler than
the generic name
Simplicity or Confusion ?
"Bromodiphenhydramine Hydrochloride" is a generic name. It is
marketed by companies under (heir
own brand names. "Ambrodryl", for
example, is a brand name for this
drug. Similarly, "Dihydro-ergotamine Methanesulphonate" is the
generic name of a drug marketed as
"Dihydergot", a brand rvame.
"Otrivin" is a brand name of a drug
generically named "Xylometazoline
Hydrochlonde"
Brand names usually have no
similarity in spelling or pronunciation. Hence the chances of wrong
dispensing of a drug prescribed by a
brand name are negligible.
In contrast, several generic
names are similar in spelling and
pronunciation, although the drugs
concerned may be quite different in
their therapeutic action Example
Quinidme Sulphate is a cardiac
*drug. while similar-sounding Quinine Sulphate is an anti-malarial
If doctors are forced to prescribe
drugs by generic names, the chances of wrong dispensing by chemists can be very high, especially if
prescriptions are illegibly written as
they often are
Layman's View
Laymen think that all products
with the same chemical composition have the same degree of

Do you have these misconceptions ?
The move to abolish brand name is motivated by the erroneous belief
that if there are no brands, drugs will become cheap er.
This belief may have some limited validity in countries which permit
free competition. But in India the price of every drug is rigidly controlled
by the Government. The Government also lays down which company
should produce what drug and in what quantity. The profits that drug
companies can make are also controlled.
As price control applies squally to generic* and brands, there is no
question of drugs becoming cheaper if brand names are abolished.
Another misconception is that the brand system somehow favours
large firms against small manufacturers. All quality-conscious drug
manufacturers - both large as well as small - are in favour of the brand
system which wins them consumers on the basis of merit.
effectiveness. But chemical equivalence is not the same as therapeutic equivalence, as every good
doctor knows.
This is because drug quality and
effectiveness are not simply a matter of how a medicine is named or
marketed, but how and by whom it
is made Several critical factors,
which differ from company to company.'vitally affect the effectiveness
of a drug in patients.
These differences can. and often
do, result in variations in the degree
and speed of therapeutic response
-how much of the drug is absorbed,
where in the body and how rapidly it
is assimilated, allergic reactions or
other side-effects, tolerance by the
patient in specific conditions, etc.
Doctor Knows Best
Thts being so, the doctor, who
knows the patient's condition better
than anybody else and has previously observed the action of different brands of the medicine, chooses
a brand he knows to be effective and
is best for the patiem.
If brand names are abolished,
the doctor will have to prescribe by
generic name. When you take the
prescnptron to the drug store, the
chemist will decide which com-

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pany's product should be given to
the patient.
And the chemist, unlike the doctor, has no knowledge of the
patient's condition, nor has he any
experience of the therapeutic
effects of products made by different
companies.
Ensuring Quality
When a company markets a product under a brand name, it slakes
its reputation on the brand This is a
less, expensive way of ensuring
quality than administrative controls
The Soviet Union has retained
the brand system. When Pakistan
abolished brands, spurious and substandard drugs took over The country has gone back to brands
It is obvious that the abolition of
brand names will jeopardise the
interests of ihe consumer without
any corresponding benefit like lower
prices There is no justification for
taking this risk in such a vital field as
medical care