CGHS doctors come under scanner for prescribing expensive meds

New Delhi, 25 Nov 2016: Despite government's stringent directions for doctors to prescribe cheaper generic medicines, the Union Health Ministry has failed to trace and take any action against errant doctors. An audit conducted under a parliamentary committee, found that from the list of doctors which have been indenting maximum amount of medicines in all the Central Government Health Scheme (CGHS) cities, during the two years i.e. from 1st January 2014 to 31st March,2016, top ten doctors had prescribed medicines of more than Rs 100 crores each in 23 cities.

Pulling up Union Health Ministry on this facet, the parliamentary committee in its report named 'Procurement of Allopathic Drugs in CGHS', tabled in Lok Sabha this week, said, "It is tip of the iceberg and the figure could have been much larger for all the doctors in all the cities. The committee had observed that the doctors continue to prescribe drugs outside the formulary despite the adverse recommendations of the parliamentary committee. Expensive medicines are being prescribed without any check."

"In order to keep a tab on the prescription pattern of doctors, the mechanism should be strengthened and exemplary action taken against the errant doctors," the committee said. In response to the haul over the coals by the committee, Union Health Ministry has shown its inability in controlling the practice. "It is not possible to restrict prescription only to the generic formulary because of the constant evolution of new drugs, and their prescription by concerned specialists. It is also true that revision of formulary cannot be done so frequently so as to keep pace with the development of new drugs," officials of the Health Ministry stated in their reply.

"CGHS doesn't have a formal system to know which doctors are prescribing drugs outside the formulary. This exercise would have to be done on manual basis and would be very time consuming even if resources for the same could be spared. The National Informatics Centre (NIC) has been approached to see whether such information could be retrieved from their database, but they have replied in the negative," the reply added. In a bid to manage the problem the Union Health Ministry has given a list of doctors to NIC who have been indenting maximum amount of medicines in all CGHS cities. The Union Health Ministry has also proposed to analyse the prescriptions and indents on a sample basis to assess whether any wrong doing has taken place and draw lessons for the future.

"It is always in the interest of the patients that doctors should always prescribe generic drugs. But checking prescriptions of all the doctors is a difficult task. As far as online sale and purchase of medicines is concerned, Central Drug Standards Control Organization (CDSCO) is planning to launch a centralised online system which will help make use of new technologies to deliver medicines effectively in a regulated and feasible manner. With this prescriptions can also be checked," said Dr G N Singh, Drug Controller General of India. Previous parliamentary committees had also asked the Union Health Ministry to direct doctors to prescribe generic medicines.

Earlier, In July, 2016, Ministry of Chemicals and Fertilizers requested the Health Ministry to make it mandatory for doctors to prescribe generic medicines and to allow pharmacists to sell generic medicines, if available, in place of branded medicines prescribed by doctors.

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