Prescription audit a boost to generic medicines

If all goes well, Baroda Medical College & SSG Hospital in Vadodara may soon become the first hospital in Gujarat to have a prescription audit, which will ensure that its doctors prescribe generic medicines and not branded one.

The pharmacology department of the medical college is already working on a plan to implement the same. The health department of Gujarat Government had, in the first week of August this year, issued a notification asking all government hospitals to ensure that prescription audit is undertaken in the hospital. It should be noted that so far prescription audits did not happen in government hospitals.

Speaking about the initiative, Dr AT Leuva, dean, Baroda Medical College said that such an audit will ensure that doctors in government hospitals prescribe generic drugs and not branded ones. “We are working out a plan for the same.

We will also be carrying out group talks and other such activities with doctors to let them know of how the procedure will work and why is it important to prescribe generic medicines,” said Dr Leuva.

He admitted that it will take time before the mindset changes. “But we are working towards it and we also have the government’s backing,” he added.

An associate professor with Baroda Medical College, Dr Shreya Shah, who too is working on the project, said ensuring generic medicines are prescribed is not the only benefit that a prescription audit will yield. “Prescription audit should be part of any practice.

It will help the hospital know if whatever the clinician is prescribing is rational or not as well as the quality of prescription. It will also let us know if costly medicines are being prescribed despite cheaper and effective ones being available,” said Dr Shah.

She said that prescription audit will be done as per the WHO standards, adding it will ensure that drugs on the national essential medicine list, which are easily and cheaply available, are prescribed. She too admitted that the move will not be a smooth sailing as there will be some resistance on the part of clinicians.

“The audit should ideally be random and there are some genuine concerns like the need for a duplicate copy of the prescription. On an average the hospital gets around 1,000 patients and duplicating the prescriptions and case files will entail some expense,” she added.

Chinu Srinivasan, managing trustee of Locost, a non-charitable trust that makes low-cost essential generic drugs said it was a step in the right direction. “But an audit alone will not solve the problem.

A prescription audit is done not just to see if generic medicines are being prescribed. It will also help the authorities get an idea if the prescription is rational and scientific as well as the efficacy of generic medicines,” said Srinivasan, who added that there are many misconceptions about generic medicines being of poor quality and ineffective.

He said that apart from audit, another important thing to do was to spread awareness about the fact that medicines are available for free for patients.

“The actual effect will be known if private pharmacy shops in and around a government hospital is forced to shut shop because doctors at the hospital have begun prescribing generic medicines and patients are getting the essential medicines for free at the hospital itself.

If private pharmacy shops around hospitals are thriving, it means branded medicines continue to be prescribed and few patients are getting the free medicine they are entitled to,” said Srinivasan.