Quality, not price key when prescribing drugs

The raging debate pitying generic drugs against branded medicine is healthy but should be discussed in context. Quality, not price, is the key issue when prescribing drugs.

The entire issue of cheaper generics is based on the premise of measurable and enforceable assurance about quality through bioequivalence tests and other globally mandated parameters. In the Kenyan context, quality of generic drugs is not assured.

It is therefore not fair to crusade for generic drugs at the expense of branded drugs. Instead all efforts should be geared towards addressing high cost of health care in Kenya.

For those of us in the pharmaceutical space, it behooves us to educate “Wanjiku” that “original” drug molecules are not expensive for no reason; contrary to what the insurance companies would want us to believe.

There are a number of things which contribute to price differentiation and it’s good for patients to know and be allowed to make informed decision without necessarily being restricted to generic drugs.

The insurance companies should be sincere and address other operational challenges like internal theft and fraud that are impacting their margins; before associating high cost of health care to expensive drugs more so branded molecules and doctor’s consultation fees.

I expect them to tell us how much their clients are charged for a simple typhoid test in some high-level hospitals (Sh20,000) while same test in a county hospital is Sh500. Simple dental procedure will be charged approximately Sh25,000 for those with covers while at the county hospitals is much less.

If any insurance company want to restrict her clients to generic prescription, they must be willing not only to shoot themselves on their foot but be ready for amputation. According to our statistics, a large percentage of clients do not take generics serious as compared to branded drugs. This fundamentally calls civic education before restricting clients to generic medicines only.

The practice of medicine allows for autonomy. No one should for whatever reason command doctors on the type of drugs to prescribe to her patients, particularly on commercial grounds.

Drugs whether branded or generic don’t make doctors but patient does. Professional judgment and patient’s right is what makes a prescription.

The remedy for high cost of healthcare is not and will not be achieved by embracing generic prescription, this is an acute model! Patient can be on generic drug but on 10 of those generic drugs!

Rather, there is need for development and sustainability of a chronic model of medication therapy management services, addressing patient education and empowerment on their disease conditions. It is also equally important for healthcare practitioners to recommend life style modification in relation to disease condition and medications, prescription reviews and cost-cut programs as well as comprehensive drug therapy reviews.

This in turn will empower patient to take control of their own health limiting visits to the hospital.

This will in turn lead to producing controlled patients, reduced congestion for patients in special clinics, less hospital readmissions, less disease complications, prolonged lifespan, improved quality of life and finally a reduction in insurance spending. This is what I call chronic model.

Engaging drugs experts and medication consulting service providers is one of the many options the insurance players may consider.

(Dr Kathare is a Medication Therapy Management Service provider at MTM Consulting

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