concluding remarks on quality issues

[Guest guest]

Dear Netrumians,

Thanks you for a lovely debate on quality issues. I hope you enjoyed the posts as much as I did.

Five years ago I took over running the pharmacy of JIPMER hospital telling myself I would give it a try for six months. I am still running it!

What have I learnt? It has been the most satisfying, humbling experience of my life. I believe that being able to supply medicines which are of good quality to those in need and who cannot afford it due to their poor socio economic status is one of the best things we could do in life.

To check quality we need to start with simple things - check the packaging, the cardboard cartons. Companies use such poor quality cartons that by the time they come to Jipmer they are in tatters exposing IV fluids and injectables to the elements. I reject them or make them repack the whole stock. Check the strips. We often get drugs with empty strips. We have found stapler pins inside a tablet of metformin. We found strips of another tablet among strips of one type. The list is endless.

We need to train pharmacists who manage the stores on this aspect. In govt. hospitals the basic qualification for pharmacists is a diploma in pharmacy. This is not enough nowadays - looking into the number of drugs, the issues surrounding quality. They must also be trained to use computers and we must go in for computerization of stores.

On the procurement issue, we can insist on things like a valid drug license, certificate as per schedule M issued by the state drug controller, continuous marketing for three years or more, non-conviction certificate, an annual turnover of above 10 or any number of crores etc., However, as I said we can only take the certificates that they show or send us at face value. There are any number of modifications being done using photoshop. The companies know that we don't have the time, money and manpower to look into and pursue these things.

My only request will be that we share our information of companies supplying poor quality drugs on websites, through blogs, netrum or any other manner, so that another governmental organization can avoid them. If we are able to share our problems companies will be careful.

We also need to set up labs for analysis. We can easily test solubility, hardness, packaging without very expensive equipment. Lastly, we must have the inner strength and seek inspiration from within to do a job which may not be appreciated by others and certainly not by the companies. If we could do this even a little bit, perhaps we can feel proud to call ourselves pharmacologists who peeped out of their ivory towers.

Thanking each one of you for sharing your knowledge, experience, and expertise with me as well as with each other. Thank you Vijay for giving me the opportunity to moderate.

Best of luck

Sincerely

Gitanjali-- Dr.Gitanjali Batmanabane MD PhDProfessor of Pharmacology & Officer-in-charge,Dept. of PharmacyJawaharlal Institute of Postgraduate Medical Education & ResearchPondicherry 605 006

India