Rational Use of ARV and ARV Regulation

[Guest guest]

Subject: Query: Rational Use of ARV and ARV Regulation.

Dear FORUM,

Over the period of time ARV access has increased and the costs reduced.

While Government is the major player to provide ARV, pharmaceutical

companies have also placed the same on the shelves of the private pharmacies and

people who do not want to access ARV from the government system are procuring

ARV from the private pharmacies and drug dispensing shops. Now in the market ARV

is available like any other drug.

One of the major challenges visible is the rational use of ARV. While ARV shall

be prescribed only by qualified medical doctors, the ARV is also now freely

prescribed by non qualified doctors. People have started sharing stories where

the ARV was prescribed even when it was not required by the positive person or

in one family only one person was HIV positive but all the other family members

will still prescribed ARV with their HIV negative status, ARV is also prescribed

without doing the needed investigations, viral load or CD4.

This raises few queries:-

a. What Medical Council has to say on this? How the Drug controller can be made

more responsible.

b. Has anyone heard of a prescription audit on ARV been conducted by some one or

by the national authorities?

c. What is the opinion of Pharmaceutical companies? Can there be a

mechanism/system that the drugs will be dispersed and regulated only through

selected pharmacies and it will be closely monitored. Many examples are present

world wide including India of Desferal / Kelfer disbursement for Thallasemics,

or factor VIII and IX for Hemophiliacs, or close monitoring in case of vaccines.

d. And if both the above things are not possible, what could be the

other strategies besides building the capacities of the medical for

appropriate and rational prescription and referrals and adherence counseling by

non medical doctors

Please help me in educating myself and find the possible solutions/

strategies before ARV reaches the masses marketed/ promoted as vitamins and

health tonics, or misused like Oxytocin or Depo-provera and other drugs.

Regards,

Sanjeev Jain

+91- 9415160430

e-mail: sanj1966@...