Other than the costlier alternative to Augmentin, Goyal brothers sell alternative brands for other generic medicines.
Despite a slew of complaints filed regarding the sale of costlier medicines of brands not prescribed by doctors, against several private chemists at Government Medical College and Hospital (GMCH) in Sector 32, patients allege that the pharmacies, namely Shiv Medicos and Goyal Brothers, continue to sell expensive medicines manufactured by obscure brands.
Munish, whose wife was being treated at the Gynecology department of GMCH after giving birth to their child, says that he had approached the Goyal Brothers shop to buy a strip of Augmentin 625 for his wife, but he was given six tablets of the brand name Altermox 625 lb. “Later, when I went to buy another prescription of Augmentin 625 mg from a chemist outside the hospital, I found it to be much cheaper than the alternative brand provided by Goyal Brothers,” says Munish.
After a discount of 15 per cent, which the pharmacies provide on branded medicines, six tablets of alternative drug, Altermox 625 lb, costs Rs 204. Whereas, ten tablets of the prescribed brand Augmentin 625 lb costs Rs 167, after a similar 15 per cent discount. Thus, each tablet of Augmentin 625 costs Rs 16.7, whereas each tablet of Altermox 625 lb costs Rs 34. Both the brands consist of the same generic salt, Amoxicillin 500 gm and Clavulanic Acid 125 gm. According to the ceiling price fixed for this salt combination by the National Pharmaceutical Pricing Authority (NPPA), which all pharmacies and chemists are mandated to follow, it should cost not more than Rs 17.58 a tablet each.
The proprietor of Shiv Medicos, Amit Goyal, who also claims to speak on behalf of Goyal Brothers since his family runs both the shops, states that the tablet does not violate NPPA pricing regulations since apart from the basic salt prescribed by the doctors, Altermox lb also contains 60 million spores of a probiotic called Lactic Acid Bacillus.
“This is just a method to exploit loopholes. Even if one is selling the medicine at MRP and even if the medicine contains extra salts, the chemists have to sell exactly the same medicine as prescribed by the doctors,” says an official at the hospital administration. Indeed, as a response to a complaint filed by a patient against the chemists, as early as 2008, the GMCH administration had said that “they should restrain from selling un-prescribed medicines” at the store.
Beyond the restrictions on the sale of “un-prescribed” medicines, the chemists were also mandated by the hospital to sell generic drugs, just as doctors were asked to prescribe only generic drugs to their patients. Generic drugs are pharmaceutical medicines that contain the same chemical composition as the drug which was originally patented, and can be sold after the patent expires. In 2016, the government circulated orders asking hospitals to ensure that their doctors prescribed “generic medicines as far as possible”. The order was circulated among doctors and chemist shops in GMCH as well.
“Sometimes, we are worried about the quality of the generic drugs, so we prescribe a few branded drugs that we trust more. It is only in the interest of the patients that we do so. However, the chemist stores here often provide alternative medicines manufactured by obscure local brands, so they are obviously influenced by a local lobby,” says a doctor from GMCH, who wishes to remain anonymous. The doctor also alleges that he does not trust the efficacy of the drugs provided by private chemist stores in the hospital, thus, he asks his patients to buy medicines from outside.
Other than the costlier alternative to Augmentin, Goyal brothers sell alternative brands for other generic medicines. A patient at the emergency ward, Ashu shows a receipt of an alternative drug for Azithromycin 500 mg, labelled as Azitis 500 mg, it costs Rs 23.34 per tablet. The price ceiling for Azithromycin 500 mg is Rs 16.22 per tablet otherwise. Another medicine in the receipt, Voxclave 1.2 mg, a branded version of the salt combination of Amoxicillin 1 gm and Clavulanic Acid 200 mg, costs Rs 137, while the price ceiling for the salt is Rs 122.90.
“We have received complaints before and have kept a check on the issue at regular intervals, but we are planning to take further measures as well. We will employ workers to keep a regular tab on what medicines are being sold at the chemist stores. We will also ask them to explicitly put a label outside their shop that will say, only generic medicines are sold here,” says the spokesperson of GMCH 32.
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