Times of India
20 July 2010
By Sumitra Deb Roy
Mumbai, India

The city’s chemists have alleged a nexus between a section of doctors and drug manufacturers that is not only threatening to throw them out of business but also bleeding patients who are paying through their nose for medicines. This “nexus”, they say, is largely confined to high–value drugs meant for cancer, kidney problems, neurology, antibiotics and life–savers where profit margins can go up to 700%.

Nearly 5,800 chemists in the city, under the banner of Retail and Dispensing Chemists’ Association (RDCA), have written to the state government and the income–tax department to step in and break the network. Their grouse, primarily, is that drug manufacturers now directly approach doctors to sell their products and offer lucrative discounts. In the bargain, chemists claim, they are left out of the chain and doctors–many of them without valid drug licences–evade taxes on medicines while making profits out of them.

Doctors’ associations, however, have begged to differ. “Doctors must be storing life–saving drugs in small quantities but they are meant for emergency situations,” said Dr Shivkumar Utture, president, Indian Medical Association, Mumbai. “Patients cannot be expected to scout for life–saving drugs in the middle of the night and Mumbai lacks adequate dayand–night chemists,” he added.

Dr Rajeev Walavalkar of the Association of Medical Consultants said that there was no law stopping doctors from dispensing drugs. “Moreover, doctors have to work with pharmaceutical companies when chemists are involved in unfair practices,” he said, adding that chemists, too, were known to keep high profit margins. “And, what about chemists dispensing drugs without prescriptions? That’s similarly unsafe,” he said.

The chemists’ association, however, claims that doctors purchase drugs at heavily discounted rates but sell them at much higher MRP to patients.

Picture this: cancer injection Oxaliplatin is made available to doctors at Rs 980 a vial when brought in bulk. The same injection costs Rs 5,000 a vial when a patient has to purchase it. Another example could be of an injectable drug named Paclitax that is provided to doctors at a cost of Rs 3,260. But the price for the same drug and quantity shoots up to Rs 10,850 when a patient buys it. “The list is endless and varies with the company and the doctor,” said Prasad Danave, general secretary, RDCA.

“Doctors are illegally selling drugs at unbelievable prices and there is a thriving grey area that the government needs to wake up to,” he added.

“The worst sufferers in the bargain are unsuspecting patients who are paying anything between three and seven times the actual price of drugs,” he said.

Apart from economics, ethical as well as safety issues are involved too. “Many doctors purchasing drugs do not have proper storage facility which a chemist would normally have,” said Damjibhai Palan, president of RDCA.