This story of Mulla Nusrudin best illustrates the Govt’s move to Break Pharma-Doctor nexus by asking doctors prescribe only generics.
A man is walking home late one night when he sees an anxious Mulla Nasrudin down on all fours, crawling on his hands and knees on the road, searching frantically under a street light for something on the ground.
“Mulla, what have you lost ?” the passer-by asks.
“I am searching for the key to my house,” Nasrudin says worriedly.
“I’ll help you look,” the man says and joins Mulla Nasrudin in the search.
Soon both men are down on their knees under the streetlight, looking for the lost key.
After some time, the man asks Nasrudin, “Tell me Mulla, do you remember where exactly did you drop the key ?”
Mulla waves his arm back toward the darkness and says, “Over there, in my house. I lost the key inside my house…”
Shocked and exasperated, the passer-by jumps up and shouts at Mulla Nasrudin, “Then why are you searching for the key out here in the street ?”
“Because there is more light here than inside my house,” Mulla Nasrudin answers nonchalantly.
The govt diktat asking doctors to prescribe only generics is like Mulla Nusrudin searching for his key under the streetlight. The diktat will definitely not solve the problem but it will give a false satisfaction that some action was taken. Now the nexus will shift to unscrupulous manufacturers and retailers.
If the Govt wants to break the pharma-doctor nexus, then the right thing would be to make the much-talked-about UCPMP into law and enforce it. UCPMP like the Sunshine Act in the US would’ve ensured that unethical practices of all stakeholders come under scrutiny and action. Indian Pharma would’ve been free of those companies who had no other means of promoting their drugs but by giving freebies to doctors.
Now, in one fell swoop, the Govt has put all doctors and pharma companies in the same bracket – unethical practitioners, who need to be policed with the generics-only stick. Wouldn’t UCPMP been a better stick? Yes, but like Mulla Nusrudin, the Govt in its wisdom considered it prudent to search where the light was. The patient is now more confused than before with generic names that are hard to pronounce and even harder to remember.
Indian Pharma leaders are equally to blame for not having taken any concrete steps to stop unethical practices by adopting UCPMP, knowing well that Govt was seized of the matter and it was only a question of time before the Govt acted. But they too like the by-passer who got down to searching for lost key under the street light, wasted precious years and are now angry at Mulla Nusrudin.
The lesson for pharma leaders in this is – it is best to self-regulate because regulation makers are not fully aware of the situation at ground level and will use a heavy stick in their belief that it will cover all aspects of the problem.
PS: I would also add – Bring down the middlemen’s margins (Retailers, Wholesalers from 32-40% to just 2-3% as in our neighboring country – Bangladesh.
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