Guest guest Posted September 15, 2008 Report Share Posted September 15, 2008 Dear Vijay sir, You are rigt in saying that availability of OTC drugs EMPOWERS the patients.But in country like India its not only the safe drugs but even prescription antibiotics are freely available over the counter.One only needs to know the brand name of the said drug.While it helps the patient to some extent but it may do a lot harm in the long run Dr.Santosh In netrum , " Vijay " <drvijaythawani@...> wrote: > > Hi, > I strongly feel that availability of OTC medicines improves access to > such medicines and in turn " empowers " the patients. So finally the > patient decides what to buy unlike when the doctor prescribes and > takes the decision on patient's behalf. > We must realize that it is patient's body which is dosed with medicine > and patient pays for such intake. So ethically patient should have > power over the purchase. > But then the OTC must be meant for only safe medicines. Moreover the > patient must get all the information about the OTC medicines. > Vijay > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 16, 2008 Report Share Posted September 16, 2008 Hello, 1. In India, non-prescription medicines do not have/carry any information leaflet. 2. What we need is that is must be mandatory that every OTC medicine should contain a PPI (Patient PAckage Insert) - with patient specific information about the medicine - its indications, cautions/spl precautions, ADRs, dosages, when to refer to doctor, maxmum dosages, maximum duration of self-medication, etc. This will have to be in local languages too. 3. Besides, this the labels must carry more information than they carry today - so that the patient can comprehend at least the most important things at once - and can refer to the PPI and understand more things about the product they are going to consume. 4. In most developed countries, the labelling is quite extnsive - patient oriented, and the PPIs also are compulsorily present, and give pateitn specific useful information about using the drug. Raj Vaidya Community Pharmacist GOA On Wed, Sep 17, 2008 at 8:50 AM, kunda gharpure <gharpurekunda@...> wrote: hello, such an interesting discussion is taking place that I cannot resist posting my view on this topic. In the first place why medicines are available OTC ? We should not have any objection to this, since we agree that an individual is responsible for his own health.and professionsal care for minor ailments is unnecessary. I do not say that there is no role of a doctor in health management but what we should realise is, that for every sneeze the patient should not and cannot seek a doctors help. When we talk of OTC medicines, our first assumption is that the patient is capable, mentally and intellectually , to take care of his health. It is here that the people fail and therefore all the other stakeholders make hay. To solve this situation, Industryshould conform to the labelling requirements. FDA should be strict in enforcing the rules. Doctors should educate the patient on following instructions religeously. Pharmacists when issuing OTC medicines must give complete information to the patient even if it is there on the label. And finally the patient should learn to ask questions about his medication. I know all this sounds too much to seek for. well, let us at least make an attempt. kunda Unlimited freedom, unlimited storage. Get it now Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 17, 2008 Report Share Posted September 17, 2008 Thanks Professor Rao. Keep blessing. Vijay > > From: Vijay <drvijaythawani@...> > Subject: OTC medicines > netrum > Date: Wednesday, 17 September, 2008, 6:03 AM > > > > > > > > Hi Smita > I could retrieve this MS, which the journal did not dare to publish. It answers my point made in previous post. It remains unpublished but is a factual information and we the authors stand by all that has been stated therein. > Vijay > ------------ --------- --------- --------- --------- --------- ---- ----- -- > The return of old wine to old bottle > Dr Vijay Thawani , Mrs K. J. Gharpure , Manasi Thawani > >  > > > > > > > > While old wines are precious and connoisseurs delight, >  giving new wine in old bottle is downright cheating. >  Pharmaceutical companies have been attempting the trick of replacing the formulation of their popular brands. >  This case history relates to one such popular brand, > where the changeover was resented, > resulting in negative impact on the sale of the new brand. > Finally the company returned the old formulation in old brand. > Old wine did return to old bottle. >  >  >  >  >  >  >  >  >  >  >  >  >  >  >  > Commenting on the marketing gimmickry in medicines, a medical activist anguishly expressed - " It is only in the poorly administered third world countries like ours, having outdated laws, inefficient drug authorities, callous population, ignorant medics, unorganized patients and impotent activists that trans national companies (TNCs) are able to exploit the prevailing situation in the drug industry to suit exclusively their interests " .1 > > The consumers of the third world continue to be at the receiving end, getting the third rate treatment at the hands of the industry. Lot of junk in the name of medicines is sold in the market under the garb of international formulations that have been banned in the parent country of these international giants 2. TNCs not contented with dumping their outdated, obsolete, bannable, dangerous and hazardous formulations have adopted the technique of packing new formulation in the name of old brand name, without bothering to timely inform the consumers of such changeovers. Such sickening acts cannot heal the sick. >  > Since the only motto of the industry is to amass wealth in all possible ways, its best efforts are concentrated towards financial gains at the cost of patient welfare. While attempting this goal, obviously ethics are relegated to back seat. Because of the havoc of the branded medicines, generic prescriptions have been advocated. Since not many support the generic move, the result is over popularization of the brand name, encashment on brand name and subsequent exploitation through the brand name. Due to brand fancy the patients are attached to a particular brand and faithfully continue to provide business to it. Little do patients realize that the manufacturers by changing the formulation in it, misuse their trust and faith reposed in the brand. > > It is mockery of the existing rules if bureaucracy is not willing to change its antiquated laws and ban the launch of new formulation in the name of old brand. Rules should enable able governance of capable administration, which must cherish life to thrive and not endanger it. Several brands like Suganril, Esgipyrin, Spasmindon, Baralgan, Relaxyl are known where the goodwill of the brand was encashed by the pharmaceutical companies by substituting the medicine in them 3. This recent case history relates to the unethical changeover of contents of Disprin manufactured by Reckitt Benckiser ( India ) Ltd. >  > Disprin, known for its aspirin content (acetyl salicylic acid along with calcium carbonate and citric acid) is a popular OTC product. Realizing the great potential of its brand  name the company launched " Disprin Plus " with fanfare. It was noticed that the new " Plus " was actually minus the aspirin. By prefixing Disprin, it wished to retain the old consumers aware of the brand and by suffixing it with " plus " (without adding anything) eyewash all. The semantic jugglery was attempted to escape the dictum to sale aspirin at cheaper price, replacing aspirin with paracetamol. To prop-up the market of the costlier alternative (paracetamol) it even claimed, " introducing new formula " and gave misleading advertisements that it (paracetamol) gives " fast relief from pain " . > > When these facts were brought out, the Disprin consumers were foxed. Cardiac patients taking half tablet for its platelet inhibitory effect were in for a shock. All of a sudden Disprin ran in short supply and was missing from the shelves of pharmacy shops. Disprin Plus neatly replaced it. Not aware of the difference, the loyal patients of Disprin changed to Disprin Plus, little knowing what this switchover could have done. Many of the prescribing doctors wereignorant about this substitution till the press blew the whistle 3. The manufacturer had taken all for a ride. The pharmaceutical giant was probably also involved in the arm-twisting to establish the new product, since it appeared in the press that in case the company pressurized the retailers to sell Disprin Plus, then the state body of Chemists and Druggists Association should be informed 4. > > The unsavory mechanics started as aspirin was brought under the Drug Price Control Order (DPCO). National Pharmaceutical Pricing Authority (NPPA) notified ceiling prices for aspirin and 20 other formulations. It was just another routine exercise for the price regulator agency after taking into consideration the prevailing manufacturing costs and market prices of the bulk drug involved 5. Well-known brands of aspirin like Disprin of > Reckitt, Aspro of Piramal, Aspirin of Cipla, Codopyrin of Glaxo, Dispersible Aspirin of Astra started disappearing from the retail outlets. It seemed more like a ganged response. It was collective irresponsible act of the pharma industry because they were not willing to provide aspirin at lower profit margin. Reckitt and thought they were smarter and utilized their brand advantage to introduce Disprin Plus and Aspro Plus respectively, with a different drug †" paracetamol 5. Disprin was sold at 2.25 per 10. The companies opted out from selling it at the dictated price of Rs 1.70, and instead changed over to paracetamol pricing Disprin Plus at 9.40 for 10 (taxes extra). The economic interest sacrificed the sanctity of medicine business, killed the patient interest, butchered the ethics and massacred the morality. > > While the doctors and patients were still trying to figure out what was happening, Monthly Index of Medical Specialties (MIMS India) carried the entry of Disprin Plus in September 2001, with update of 31 August 6, obviously with the feed from the company. Another timed release was a free booklet " How to combat pain " 7 sponsored by Reckitt which accompanied the 16 Sept 2001 issue of the magazine " The Week " . It carried three full pages of same copy of the advertisement of Disprin Plus and its vignette logo on all the 30 pages of booklet. That this contained paracetamol appeared in the smallest font size. The company concentrated more on popularizing the new brand rather than making effort to inform the patients with drug information. It matched the action of intoxicated drunkard taking support of the lamppost, which was more intended to keep it erect rather than for illumination. > > It was a rare case of solidarity, when the Druggists and Chemists Association of Nagpur boycotted the new product Disprin Plus. Their apex body All India Organization of Chemists and Druggists (AIOCD) took up the matter with the company about the confusion in the brand names. It brought to the notice of the company that the addition of the word " Plus " created the prima facie impression that the drug was basically aspirin with something in addition. The similarity of the design of the strip pack led the consumers believe it was the old medicine. The addition of the words in red colour- " new formula " made one believe that it was improved formulation. The AIOCD also drew the attention of the manufacturer towards the section 17 (a) and © and section 17-B (a) and ( of the Drugs and Cosmetics Act 1940, which relate to misbranded and spurious drug, to warn them of the penalties 4. > > India has lot many acts, rules and laws. The Indian Merchandise Marks Act of 1889 is concerned with the misbranding of goods in general and provides for penalizing any false mark upon the containers of the goods in a manner, which may deceive any person as to the kind, nature or quality of it. Consumer Protection Act 1986 defines unfair trade practice as one which for the purpose of promoting the sale, use or supply of any goods, adopts any unfair methods or deceptive practice. Section 36 of MRTP Act 1969 specifies that the consumer has a right to be informed about the quality, quantity, potency, purity, standard and price of the goods so as to protect the consumer against unfair trade practices. When a problem arises as to whether a particular act can be condemned as an unfair trade practice or not, the key to the solution would be to examine if it does lead a reasonable person in the position of a buyer to a wrong conclusion 8. In spite of such laws of > the land, how the industry gets away, indicates system performance. > > Shaken by the statewide boycott in Maharashtra , the adverse publicity hit the company where it hurt most - the sales. Loyal patients of Disprin switched over to other brands. Reacting to the continuing criticism, Reckitt Benckiser inserted advertisement " for public information " 9 half-heartedly informing about the difference between Disprin Plus and low dose aspirin. But the damage control exercise failed. The concern due to falling collections in cash registers was evident. Finally after about two years, around July 2003, the company showed its delayed professionalism by withdrawing Disprin Plus and making Disprin re-available in India for retail price of 2.70 for 10 (120 tablets for 31.56, taxes extra). The battle was won. Old wine was returned to the old bottle. May this sordid saga leave indelible mark so that others desist from such misadventures. >  > References: >  > 1.Medical Activist. Letter to Editor. The Hitavada, Nagpur , Sept 19, 2001 . > > 2.Vandana Shiva. In Banned and Bannable Drugs. Voluntary Health Association of India , New Delhi . > > 3.Diwe Rajendra. Disprin plus minus aspirin foxes patients. The Hitavada, Nagpur , Sept 6, 2001 . > > 4.Diwe Rajendra. Statewide boycott of Disprin Plus. The Hitavada, Nagpur , Sept 12,2001 . > > 5.Chronicle Pharmabiz. Aspirin Shortage: Industry at fault. Editorial. Chronicle Pharmabiz. Vol 1, No 46, Nov 1, 2001 ,P 8. > > 6.MIMS India . Vol 21, No 9,Sept 2001, Page 74, Col 3. > > 7.The Week. How to combat pain. Sept 16, 2001 , PP 1-32. > > 8. Avtar Singh. Law of Consumer Protection: Principles and Practice. 3rd edition, P 125. Eastern Book Company. > > > 9.Times of India , Mumbai. Sept 14, 2001 > > > > > > > > > > > > > > > Unlimited freedom, unlimited storage. Get it now, on http://help./l/in//mail/mail/tools/tools-08.html/ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 2008 Report Share Posted September 19, 2008 Hi, Please see left window on NetRUM > Left click on Files > see posters on RUM > see slide on OTC medicines. Vijay Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2011 Report Share Posted February 1, 2011 Dear Geer Ishaq sir, I completely agree with your opinion that pharma companies should take consumer centric approach in designing OTC products where priority should be given on consumer education and there by his empowerment. I think packaging of OTC medicines in multilingual and simple language will be better for Indian market since it can be more customized and is less costly. Regards, Dr. Mangesh Bankar Assistant Professor, Pharmacology, GMC, Nagpur. Quote Link to comment Share on other sites More sharing options...
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