Doctors will now have to prescribe generic drugs mandatorily, says the new regulations from the National Medical Commission (NMC). At the same time, the NMC has cracked down on registered medical practitioners (RMPs) receiving freebies from healthcare establishments or pharma companies. Moreover, for the first time ever NMC guidelines restricted doctors from speaking on subjects beyond their area of expertise on any public platform including social media.
NMC in its regulations said that all doctors ‘must’ prescribe generic drugs, and failing which they will be penalised. Even their licence to practice may be suspended for a period. The NMC issued the ‘Regulations Relating to Professional Conduct of Registered Medical Practitioners’ recently on August 2.
It says, “Every RMP should prescribe drugs using generic names written legibly and prescribe drugs rationally, avoiding unnecessary medications and irrational fixed-dose combination tablets.”
Industry insiders feel this is a step towards implementing and codifying the Uniform Code of Pharmaceutical Marketing Practices (UCPMP).
“At the moment the UCPMP is a voluntary set of guidelines preventing pharma companies from giving freebies to doctors, but it falls upon pharma associations to enforce the code,” said a senior executive of a pharma firm.
Another person who is also a member of a pharma lobby group said that the firms self-regulate themselves.
“We want unethical practices to stop. But since the code is not legally implemented, we don’t have any power to take action against any firm that violates the UCPMP. The NMC regulations had to be in tandem with the UCPMP, and this a step in the right direction,” the person said on grounds of anonymity.
Doctors tend to write brands for drug molecules in prescriptions. India is a branded generic market where companies make generic or copy-cat versions of a drug which has lost its patent, and sell it under several brand names. For example, the analgesic medication paracetamol can have hundreds of brand names. The NMC has now asked doctors not to prescribe branded generic drugs.
If a doctor prescribes the generic name of the molecule, the patient and the chemist have the option to go for any brand, or even trade generic medicines. Trade generics are those medicines which are not pushed by pharma firms through doctor prescriptions but are sold directly through trade channels.
The new set of guidelines issued by the NMC has also spoken about ‘conflict of interest’ between doctors and commercial healthcare establishments, and pharma or medical devices companies.
It has stated clearly that RMPs and their families must not receive any “gifts, travel facilities, hospitality, cash or monetary grants, consultancy fee or honorariums, or access to entertainment or recreation from pharmaceutical companies or their representatives, commercial healthcare establishments, medical device companies, or corporate hospitals under any pretext.”
“However, this does not include salaries and benefits that RMPs may receive as employees of these organisations,” it clarified.
Also, RMPs should not be involved in any third-party educational activity like seminars, workshops, symposia, conferences, etc., which involves direct or indirect sponsorships from pharmaceutical companies or the allied health sector, it adds.
“RMP should be aware of the conflict-of-interest situations that may arise,” it says.
The NMC regulations related to professional conduct have also laid down directives around the use of social media by RMPs.
For example, it states that “RMP is allowed to share educational material for the information of the general public. However, communication should be limited to the expertise of the RMP.”
RMPs should avoid discussing the treatment of patients on public social media or prescribing medicine to patients on the public social media platform, it has added.
If a patient approaches doctors through public social media, the doctor should guide the patient toward a telemedicine consultation or in-person consultation as the situation warrants.
The regulations further state that RMPs should not directly or indirectly indulge in the practice of purchasing “likes”, “followers”, or paying money so that search algorithms lead to their name being listed at the top or registering on software programs (apps) that charge fees for higher ratings or soliciting patients.
– Doctors cannot speak on subjects beyond their area of expertise on social media
– Doctors cannot attend seminars, workshops with direct or indirect funding from Pharma cos