The Power of Choice

Picture this: You are not feeling well. You go to a doctor who diagnoses your problem and hands you a prescription (that often looks like Greek and Latin). You go to the chemist shop and wait for him to hand over the medicines. During the whole process, one doesn’t even bother to ask the doctor or the chemist for the generic equivalent of the same drug or even a medicine that falls within one’s budget without compromising on the efficacy. Say for example, you have a headache and need a Crocin, a branded drug, with paracetamol as its active ingredient, you could request your physician to prescribe an equivalent and save on your costs.

There has been a proliferation in the number of websites and mobile apps in the US helping consumers choose generics over branded drugs and even choose equivalent cheap branded medicines, thus bringing down consumer spending on prescription drugs. Take for instance GoodRx, a website which also has a mobile app wherein one could type in the drug name and their location. A range of rates at which one could buy the same drug and the pharmacies where it is available appears pronto, along with coupons and discounts one can avail of. However, such apps are a rarity in the Indian scenario. Patients usually rely on the doctor or the neighbourhood chemist (in rural areas) to prescribe the drugs. There are several reasons why.

Ruchi Dass, Founder and Chief Executive Officer, Healthcursor Consulting offers a perspective, “Most such apps are made by people in the US and have a worldwide audience; very few exist in India. Absence of the right infrastructure to expand their reach to the masses does little to help the cause. More so, it makes little business sense when there are already apps and websites providing globally reliable information that is suitably accredited.” With out-of-pocket expenditures accounting for more than 70 per cent of health expenditure, empowering the consumer on how they could save costs by dispensing information on medicines could help them take these in consultation with their doctor. However, there are some small steps being taken in that direction. Take for instance healthkartplus, an application developed by online pharmacy and medical retail store, healthkart.com.

The website www.healthkartplus.com, which has built up a database of 100000 medicines till now, saw close to half a million people use its medicine product information and 50,000 people download its Android, iPhone and Windows 8 apps (which are free) in the past eight months since its launch. The service, currently available in the Delhi-NCR region, started out as a medicine information search engine and mobile app. After seeing traction, user feedback and requests, an inventory of authorised distributors and pharmacies were incorporated into the network.

“Information about medicine is the key challenge we set out to solve. We are trying to make publicly available unbiased information on : the constituents of medicines, their side effects, interactions etc. to patients; not only helping them understand the nature of prescription but also assuring fair prices, authenticity of medicines and products well within the expiry date,” informs Prashant Tandon, Founder, Healthkart.

The website and the app aims to make consumers more aware to help them manage their health by listing relevant clinical information on medicines and comprehensive set of substitute medicines. However, we are a long way from apps which help consumers choose their generic counterparts and the blame might lie less on technology and more on the situation on ground. Ours is a market which is primarily ruled by branded drugs, despite an increased push by the government towards generic drugs. Early this year, the Medical Council of India (MCI), in a circular addressed to the Dean/ Principals of all the Medical Colleges, Director of all the hospitals and Presidents of all the State Medical Councils, MCI; called upon the doctors practising medicine to prescribe drugs with generic names, as far as possible. Generic drugs are currently available at Jan Aushadhi stores, run on the premises of public hospitals (state and central) either by the hospital’s administration or some NGO. As of February, 147 such stores were in operation. However, their future looks lopsided with several of them having closed even as the government makes ambitious plans to increase their number.

Not only this, the Drug and Cosmetics Act 1945 has set certain rules according to which Schedule H and X drugs cannot be sold without a written prescription by medical practitioners. With 60 to 70 per cent of the drugs falling in this category, online pharmacies have also been slow to integrate such medicines into their network to ward off the risk.

Atul Ahuja, Vice President, Retail, Apollo Pharmacy adds, “As a last mile service provider in the chain, we see our role as limited, we go by demand and give the consumer what he wants.” Most of the online pharmacies in India thus sell, health, wellness and OTC products. Moreover, online pharmacies in the US have come in the line of fire for operating illegally and even selling drugs of poor quality, with little or no active ingredients listed therein.

It is estimated that more than 65 per cent of the population in India does not have access to medicines. Even amongst those who do, they do not have a choice over what they are prescribed, let alone choose the generic version over the branded one. Dispensing basic information is a start and would lead to greater awareness and consumer empowerment, but that would be nullified if appropriate steps aren’t taken to provide basic infrastructure which ensures that the patient, who is the end consumer in the chain, is an equal participant in the entire process and is treated fairly. Of course, consumer empowerment also needs to take into account that safe medicines are delivered and the system is not misused. Until then technology will have to wait.

shalini.g@expressindia.com