Augmenting healthcare facility
It is high time for health department to augment health care facilities and bring accountability at all levels
HEALTH CARE REFORMS
It is only after more than five decades, a drug policy was approved by the State cabinet and already people who are related to this trade directly or indirectly have started making prophecies of its failure. I personally hope that this will be the beginning for the betterment of the health care facility in our state. It is hoped that, accountability will be introduced at all stages of R&D, manufacturing, sales, distribution, purchase, prescription, dispensing and post-marketing analysis. Strengthening, security, back up facilities and empowerment of enforcement authorities would ensure the fulfillment of the objective. It is my fervent appeal to common people to have a serious look over the very rapid growth of pharmaceutical trade in our state. A serious imbalance is apparent between prosperity and accountability. The prosperity must not come at the cost of human life; it would have otherwise serious repercussions, (we are virtually endangering our health and drug addiction has reached to alarming levels). Easy availability of the drugs is a huge contributing factor to addiction and due to the lucrative nature of drug peddling, locals hoard these medicines and sell them at higher prices to the addicts.
It may be a fact that a few unemployed youth get livelihood in pharmaceutical trade at various levels, and may get initially effected by proposed drug policy. Yet, the overall harm done by marketing of costly drugs usually over-weigh benefits, drastically. The cost difference of same drug (salt) varies many-folds (across various brands) available in the market. We have to introspect, whether it is boosting or ruining our economy (since public expenditure on drugs is very high). It is very unfortunate that majority of people are self medicating, drugs are abused and misused, every other person is sick here and all categories of drugs are freely available. This problem is being exploited by many unscrupulous persons involved in drug trade at all levels. It is an important responsibility of the government to provide quality and cheaper health care facility, (including dispensing of drugs either free or low cost generic or at subsidized rates) to patients. Government has put some rider on rates of drugs, prescription fee, rates of investigational diagnostic tests, lab tests, dental procedures (RCT, extractions, filling,) etc.
Unnecessarily highest range antibiotics, tonics, vitamins, calcium salts etc are prescribed and result is side effects, adverse reactions, development of resistance and toxicity (e.g. renal failure due to indiscriminate use of injectable vitamin D). In my opinion, our state must be ranking 1st , as far as per capita consumption of drugs is concerned. Self styled doctors, chemists, unregistered RMPs are illegally practicing and Government has to take prompt action to curb this menace. Irony is that this practice is flourishing very rapidly, thereby robbing patients and endangering their lives. As per law, they are not allowed and are not competent to prescribe any drug, except some over the counter (OTC) products, they usually lack requisite knowledge about (side effects, drug reactions etc.) The most common reason for illegal self-practicing is greed (profit), besides advertising creates a demand; chemists are apparently more interested in a sale than in the patient's welfare. As per the present status of drug policy, chemists will continue enjoying dispensing of generic drugs and thereby making maximum profits (up to 500%). In this regard, it is hoped, Government must allow only those manufacturers whose rates are highly subsidized, besides being efficacious (e.g. Tab Levotac i.e. Levocetirizine costs only rupees 5 per ten tabs and is being manufactured and marketed by a Reputed company). The sale of spurious and sub-standards drugs can be automatically checked once the authorities stop operation of thousands of companies in our state and let only reputed multi-national companies operate in our state; and they should be directed to market low cost generics having very less MRP as compared to counter brands.
As per medical ethics, a medico has to strictly prescribe only those drugs in which he is holding valid degree and a registration, (a BUMS doctor cannot prescribe allopathic drugs). Government must start, Jan Ausudhi drug stores (cheaper generic drug stores, but only those drugs should be kept available which are from reputed manufacturers and have undergone prior quality assurance check) at every Government health installation, (Inventory and dispensing must be inbuilt). There should be sufficient monitoring staff with specialized legal back up and discretionary powers at tehsil level, to check, whether good prescribing practices and good dispensing practices are followed.
Patients requiring antibiotics must be subjected to sensitivity tests, prior to prescription; this will help to stop the development of resistance. In Jammu and Kashmir, many important life saving antibiotics have become ineffective, since antibiotics here are used indiscriminately, and the same are readily available without any prescriptions. There must be pre-determined and pre-defined treatment protocols for antibiotic use (there must be pre-determined guideline on choice, dose and duration of their use). It is pertinent to mention here that, antibiotics are useless and usually not needed in common colds, upper respiratory tract infections, viral diseases, dysentery, mild fevers (since these are mostly self-limiting).
Drugs must be subjected to strict quality control and quality assurance tests prior to procurement and distribution (both for private as well as government run health institutions). The condition of license for sale/purchase of drugs should be strictly enforced, like mandatory issuance of cash memos against sale of drugs. Licenses should be only granted to well-qualified candidates and limited exclusively to diploma holders (pharmacy), since as per media reports, there is already mushrooming of premises (both retail chemists as well as wholesale pharmaceutical dealers). As of now, majority of drug license holders are matriculates, may not be well versed with drug salt names (generic name).
It is high time for health department to augment health care facilities and bring accountability at all levels in health sector.
Lastupdate on : Tue, 19 Jun 2012 21:30:00 Makkah time
Lastupdate on : Tue, 19 Jun 2012 18:30:00 GMT
Lastupdate on : Wed, 20 Jun 2012 00:00:00 IST
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