Mumbai-based Jaslok Hospital’s advisory to its doctors to stop prescribing drugs manufactured by Ranbaxy has raised some eyebrows within the healthcare community. Why did the hospital choose to go public with this advisory? Was it a reaction to patient perception on the quality of medicines from this company? Ranbaxy’s $500 million rap on the knuckles by the US Department of Justice was widely publicised, both by print and electronic media, for over a week and no doubt, Jaslok had to field queries from patients and their relatives.
This might explain the hospital’s decision to put on public display what should have been an internally circulated advisory to doctors on its staff. The pharmacies of all hospitals routinely receive alerts from local FDA authorities on which lots of drugs have been found sub-standard and these lots are required to be withdrawn from circulation. But these alerts are restricted to certain lots, with specified batch numbers. The Jaslok advisory seems to be a blanket ban on a company’s products and this is quite contrary to standard procedure. In fact, certain companies have a monopoly on certain drugs and in such cases, a blanket ban might adversely affect patient health.
The hospital did withdraw the advisory from its reception front desk, clarifying that it had put certain queries to Ranbaxy and was awaiting replies, and would roll back the advisory if it was satisfied with the responses. The concern is definitely justified and the Indian Medical Association (IMA) too had added its voice by asking the Drug Controller General of India (DCGI) to conduct its own investigation into the quality of drugs manufactured by Ranbaxy.
But by then the ‘damage’ had been done, with the Ranbaxy stock reportedly sliding a few percentage points on the Sensex and rumours that other hospitals might follow suit in order to be seen as serving patient interest. The pharma company is already in damage control mode and today finds itself under fire, from not just the regulators and lay public but also the doctor community.
Did the move serve the purpose of alleviating patient concerns? The jury is still out on that one, but it’s clear that not just Ranbaxy, but the Indian Pharma League, as a composite entity, seems to be headed for a crisis of confidence. This is unfortunately mirroring the misfortunes of the other IPL: the Indian Premier League. Just as the average cricket devotee today questions the integrity of each player, the average person buying medicines is bound to look with suspicion at all medicine brands.
To the lay person, it does not matter that most big pharma companies, MNC or Indian, may not actually make most medicines, but only market or promote them. It is possible that more incidents of falsification/manipulation of data may be unearthed at Ranbaxy or other companies. Jaslok’s move, premeditated or not, highlights the role of hospital managements as well as individual doctors, both in hospitals as well as in their private clinics, in either building on such perceptions or explaining the issue with some cool headed logic.
Many hospitals managements have since clarified that they would not be issuing such a blanket ban, because they saw no merit in the argument and in fact termed it as an ‘overkill’. The lots approved by the concerned local authorities would remain available, and alerts concerning specific batches would result in a recall. By the same logic, the US FDA may have issued an import alert on one of Wockhardt’s export-oriented units in Aurangabad but until hospital pharmacies receive specific alerts from local authorities concerning medicines being circulated in the India market, all approved Wockhardt’s medicines would be stocked and available.
Was this just an individual case of a well intentioned move backfiring? Will the so-called doctor-pharma company nexus kick back in or will the end-consumers, i.e. patients drive this discussion forward in another direction? Only time will tell.
Viveka Roychowdhury
Editor
