A bitter pill to swallow for pharmacists, patients

​Nellore: The Health Ministry has banned 344 fixed drug combinations through a gazette notification issued on March 10. These include several common cough syrup solutions, analgesics and antibiotic combinations, many of which are sold over the counter.

• The ban on certain fixed dose combination drugs has put pharmacists and patients in a quandary
• Pharmacists are working overtime to separate the banned drugs from the rest of the stock
• Customers say the ban is against the objective of reducing medical costs for the poor

The ban, which came into effect immediately, follows recommendations of an expert committee formed to examine the efficacy of these drug combinations.

The industry though may question the basis of the ban and seek judicial intervention. Fixed drug combinations have mushroomed in the market as companies in their quest for newer products — and often to beat price control — mix and match ingredients into a single molecule to market them as newer remedies.

Meanwhile, pharmacists in the city were reeling under the effects of the ban. “We have asked all of the pharmacies in our association to separate and keep aside the drugs on the banned list. Many pharmacies are run by just one person and this is becoming extremely difficult. We want the government to give us more time to do this,” said an employee of a medical store.

The Association, he said, had provided pharmacies with a booklet with a list of all the banned combinations and also held an awareness meeting on the implications of the ban. “We will return them to the wholesaler and he will return them to the manufacturer,” he added.

He said “Customers have been coming in and asking us what to do with the drugs they have bought previously that are on the banned list. We have been telling them to ask their doctors.” Customers are of the opinion that the fixed dose combinations were for the treatment of, among others, diabetes and anxiety/depression. This is against the objective of reducing medical costs for the poor, they added.

It may be recalled here that the Delhi High Court extended the interim stay on the Union government's decision to ban some Fixed Drug Combination (FDC) medicines till the next hearing on March 28. On March 30, the court refused to vacate stay on drug ban. The government said in an affidavit that lifting the ban would be against public interest.

Speaking to The Hans India, Dr C V Subrahmanyam, a leading physician in Nellore said that while this move might lead to increase in costs for patients as fixed dose combinations are cheaper, it was welcome, as there are many irrational drug combinations currently in the market.

He said the Health Ministry is of the view that irrational fixed-dose combinations (FDC) are causing anti-microbial resistance, and, in some cases, toxicity that can lead to organ failure even as drug manufacturers in connivance with unscrupulous medical practitioners are making huge profits. “One drug can alter the efficacy of another in combination and so, it is always better to use individual drugs,” he said.

Meanwhile, the Health Ministry launched a drive to crackdown on irrational use of antibiotics and also notified a special schedule of drugs for which chemists will not only need to check the prescription before selling them but also maintain records with themselves or face government action. Government officials familiar with this ban were unavailable for comment.