THE letter “Is there a right price for medicine?” (The Star, Aug 1), by Emeritus Professor Dr P.T. Thomas, was informative and raised important questions about the cost of medicine, the safety and efficacy of generic drugs, and the correlation to the quality of life. In general, the use of generic drugs reduces the cost of medication.
If you walk into any pharmacy in government hospitals, the chances are you will see a poster comparing the generic medicine with the innovator (original) medicine. Accordingly, “all generic medicines approved by the Drug Control Authority undergo a stringent approval process, from specialisation and quality to manufacturing and labelling”.
The learned Professor has presented the expert view on the subject matter.
From the consumer’s point of view, there are other issues that need to be highlighted as well.
As the Professor rightly pointed out, when a patient is not able to afford treatment due to the high cost of the prescribed drug, it is really disheartening and demoralising to the patient and the family. Many would agree that the drugs dispensed at the private clinics and private hospitals are sold at higher prices, almost double or triple of those available at private pharmacies. That is why the debate emerged as to whether there should be a separate system for prescribing and dispensing medicine, and whether clinic doctors should dispense drugs or leave it to the pharmacists to do so.
The debate gets repeated ad nauseam and with not much input from the general public.
The recent move by the government to register the prices of medicine in a database and to inform the public on the recommended retail price would help consumers make informed decisions when buying medicine over the counter or from pharmacies, and to counter-check if the prices are marked up and if the consumers are being overcharged. Apart from price control, the shortage of essential generic drugs for various ailments, including HIV drugs, needs to be addressed.
Another aspect that requires attention is the role and responsibility of a pharmacist when dispensing medicine to the public. More often than not, the hospital pharmacists or the clinic assistants would just read out the instructions on the medicine label, like how many times in a day the medicine needs to be taken.
The dispensers should take more initiative to explain clearly in a language that is best understood by the patient on the purpose of the medicine and how it helps to relieve symptoms, drug-food interaction and other safety precautions that the patient needs to adhere to.
Other than giving information on dosage and frequency, it is the responsibility of the dispenser to ensure that patients understand how to take their medicine, how to store it, and are warned of possible side-effects or adverse reactions. Patients should also be educated on the difference between the chemical name for the drug, the generic name and the brand name.
In today’s digital world, the dispensers should let the patients know the name of the medicine given to them, regardless of its form, whether it is a tablet, capsule, ointment, cream, spray, inhaler, or solution drops. However, there are private clinics which do not provide the name of the medicine issued to the patient, especially those in the form of creams and ointments, and charge the patients excessively. This is a denial of the patient’s right to the information.
Patients obtain information about the prescribed drug from the container label, or leaflet and package insert. The lack of written drug information may pose risks to the patients, who might have a history of multi-drug interactions. Hence, it is the mutual responsibility of the doctor, pharmacist and dispenser to create awareness and to educate the patients on the potential risks and benefits of the prescribed drugs. That is why there should be continuous monitoring by the local regulatory bodies to ensure good dispensing practices.
Taking a cue from the World Health Organization report The Role Of Education In The Rational Use Of Medicines (2006), “the rational use of medicines means patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community.”
DR S. MATHANA AMARIS FIONA, PhD