THIS is with reference to the letter ‘Prescribing medicine equivalents’ by Farooq Bashir Butt (9 June). It has brought to our attention the issue of medicines being prescribed by their brand names and not by their generic names.
To avoid confusion, I would, however, like to point out that Mr Butt when referring to a ‘generic name’, actually means a medicine’s ‘active ingredient name’ which is different to its generic name as each and every medicine has a name based on its active ingredient but does not necessarily have a generic version available.
For example, a medicine still within its patent has no generics available; once its patent expires, typically 10 years after it is first marketed, other pharmaceutical companies can copy and market the same active ingredient as generic medicines.
If a doctor feels the need to prescribe a newly marketed medicine, he/she has no choice but to prescribe the sole brand available in the market. The doctor may prescribe this new medicine under marketing influence or may feel a genuine need for the patient to be on this particular drug.
The availability of resources, as hard and soft copies, listing all the medicines available in Pakistan should make it possible for pharmacists if not the consumer/carer to ascertain the particular medicine that has been prescribed.
If a doctor has prescribed a brand that is not freely available or is more expensive than other brands of the same medicine, the doctor should allow pharmacists for brand substitution in consultation with the consumer.
I agree that to minimise confusion for people on long-term therapy for any chronic condition, doctors should keep them on their usual brand and if brands are at all changed clear communication is needed between the doctor and patient to avoid confusion. Patients who do not realise that the brand of their medicine has changed may take both the new and the old brand, thus taking a double dose or avoid taking the new and unfamiliar tablet and miss out on a medicine.
I also agree that our government should ensure the presence of a trained pharmacist on duty all the time at each pharmacy to guide consumers in matters related to medicines.
DR NIGHAT FARUQI Lahore