The Telegraph
Sunday , April 30 , 2017

Brand names can be added

New Delhi, April 29: Senior medical regulators today said that doctors could write the brand names of medicines on their prescriptions as long as they also mentioned the generic names, seeking to remove confusion after a regulatory directive issued earlier this month.

An April 21 notification from the Medical Council of India (MCI), the country's apex medical regulator, had said that "every physician should prescribe drugs with generic names legibly and preferably in capital letters", reaffirming its order of September 2016.

Generic names are the pharmacological names of drugs (such as paracetamol) that can be sold under various brand names (such as Crocin, Calpol or Pyrigesic). An official body gives a drug its pharmacological name while the manufacturer picks the proprietary brand name.

The notification had come after Prime Minister Narendra Modi had said earlier this month that the government would take legal steps to get doctors to write the generic names of medicines. The notification said that doctors violating the directive could be punished, leaving many doctors confused.

The move was intended to help patients buy the cheaper brands if they wanted, but some doctors said it would merely shift the choice of brand to the retail chemist.

They highlighted possible quality differences between medicine brands and said a chemist might struggle to identify the right medicine if a doctor wrote a combination of generic drugs and left out the brand name.

Two regulators, however, today independently told The Telegraph that the April 21 notification did not bar doctors from also writing the brand names.

"Our objective is that patients should receive the best treatment at the least cost," said C.V. Birmanandham, MCI vice-president and senior consultant cardiologist in Chennai. "Doctors could write generic names along with the names of low-cost brands."

Birmanandham and Girish Tyagi, secretary of the Delhi Medical Council, however, agreed that the best way to reduce drug costs was price control.

"Just as the government has imposed caps on coronary stents, it can consider imposing maximum prices on branded drugs," Birmanandham said.

The government's drug price control mechanism now covers only about 350 so-called essential medicines. "If the government wants to really reduce the cost of medicines, it can do so by setting prices on all medicines in the market," Tyagi said.

He added: "We want to clarify that writing brand names is not illegal, but doctors should write brand names along with the generic names of medicines ---- and legibly, preferably in capital letters."

The National Medical Forum, a New Delhi-based non-government organisation of doctors, welcomed the clarification from the regulators, saying this would help resolve "confusion across the medical community".

"We've had a dialogue with the council, and it is important to get across the message that writing brand names is not punishable," said Prem Aggarwal, forum founder and senior cardiologist.

"The focus should be on writing prescriptions the way they should be written - specifying generic names along with other requirements."

One feature of pharmacological names is that their prefixes, infixes and suffixes can indicate the nature and use of the drug. For example, the suffix "vir" in aciclovir implies it is an antiviral drug while the generic names ampicillin, amoxicillin and cloxacillin indicate they belong to a particular group of antibiotics.

Even some drug combinations have generic names: for instance, the 1:5 combination of the antibacterial drugs trimethoprim and sulfamethoxazole is called co-trimoxazole.

The pharmacological name is distinct from, and usually simpler than, the drug's chemical name, which is based on its molecular structure. For example, the chemical name of paracetamol is N-(4-hydroxyphenyl) acetamide.

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