More hospitals prescribing these medicines together with its low cost has increased the demand for these generic drugs.
When 52-year-old Mary came to a Pradhan Mantri Jan Aushadhi store in Bengaluru’s NR Colony at around 1.20 pm on a week day, she was welcome with a sign board that read there was a lunch break.
The lunch break extends from 1 pm to 2.30 pm, a span within which at least six customers had to return back on seeing the doors of this store shut.
A temporary board at the store reads that the store would remain open only between 10 am to 5 pm. Out of this, there is a lunch break between 1 pm to 2.30 pm as there is no pharmacist here. A board explaining the same welcomes visitors.
Mary, who is a diabetic is determined to purchase medicines, decides to wait for the pharmacy to open while KhabarLive has a quick chat with her. She says that she has switched to buying generic drugs from branded drugs for the past two months and her sugar levels have dropped from 400 mg/bl to around 100 mg/bl now. She smiles as she says she saw these results on taking generic drugs.
However, this patient was left waiting outside the generic drug store as the pharmacy remained shut for a long lunch break. Mary has another challenge to face.
Even as a few medications that the doctor has prescribed for her are available here, Mary has to make a visit to private pharmacies to get some other drugs that have been out of stock for two months now. “I have been coming here for the last two months to get this tablet. They say there is no stock,” she said, handing out one of the strips of Neurobion forte which she carries along with her.
Many others like her are forced to switch back to branded medicines when there is a shortage of stock. Sometimes, patients explain, the same medication is not available for over two months and pharmacists who have the Jan Aushadhi stores in south Bengaluru acknowledge the fact.
“One sheet of medicines cost me Rs 65 and the same is priced at Rs 15 in generic stores. Doctors prescribe branded medication. I come here with the prescription and take the equivalent generic drug.
“Not all medications we need is available here. Out of the 10 medications that I have been given for diabetes and cholesterol, I get two of them here. The combination medicines, that is available in a single tablet in branded drugs ought to be bought separately here.
Sometimes, one of them is available and the other is not. At such a time, we are forced to buy branded drugs only,” said Manjunath (name changed), a customer at the Jan Aushadhi stores.
The Pradhan Mantri Jan Aushadhi generic drug stores have been seeing a rush of people. Pharmacists in these stores, however, have been battling an issue. They run short of supplies of drugs often. This, many feel, is due to a sudden spurt in the demand and inadequate supplies.
It is mostly the drugs for blood pressure and diabetes that they run out of stock and pharmacists in Karnataka explain that they have to, as a result, face angry customers.
Pharmacists at the Jan Aushadhi stores in Bengaluru say the problem of running out of stock has been persisting for nearly a year now.
“The trend has picked up. We see a lot more demand for generic medicines now. A few government and corporate hospitals have started to give generic names of drugs instead of branded while the ones practicing in smaller establishment are yet to adopt these. The demand has certainly gone up,” said Ramesh (name changed).
He, however, voiced a concern. “There is a delay in the supply of stocks whenever we place an order. This is true with respect to drugs that are most commonly sought after. Drugs for diabetes and cancer are generally difficult to procure. There is a delay at the central warehouse itself,” he added.
Increase in demand
The quality of generic drugs has been a topic of debate for a long time now. Apprehensions have been raised about their efficacy in comparison to the branded ones available in market. There is lesser fear in the minds now, say pharmacists.
“We have been getting a positive response from those consuming these drugs. When we started off, there was always a comparison with the quality of branded medicines. Today, we see most major establishments prescribe generic drugs. Even those mentioning branded drugs have their generic names mentioned in the bracket. This is a positive move,” said Satish, one of the Jan Aushadhi stores pharmacists who added that smaller clinics are yet to adopt the practice.
Demand far more than supply?
Patients buying medicines in bulk together with an unforeseen spurt in the demand are the major reasons for the stock running out, explain experts.
R Revanna Aradhya, who is responsible for the establishment of several of the Jan Aushadhi stores in Karnataka explains that the demand is far more than what was anticipated and this, could have lead to a short supply of the generic drugs.
“When it was started, the union government had anticipated that by the end of December 2017, there would be 1,200 of them across the country. However, the numbers have gone up multi-fold. There are at least 3,200 Jan Aushadhi stores as on date,” he said. In Karnataka alone, as against 31 stores that they began functioning with at the end of 2016, there are presently 241 of them.
Aradhya, however, believes that this is a trend that one need not be worried about. For, it is a sign that people are accepting generic drugs on the same lines as that of branded.
While on one hand, there has been an increase in the demand with the number of stores going up, the warehouse, however, seems less equipped to meet the demands.
Consider this. While a diabetic patient would have to shell out Rs 50 to buy branded medicines for a week, the same amount would fetch him 100 tablets in Jan Aushadhi stores. The drug prescribed here, GB1 is the one these pharmacies are in short supply of more often.
Aradhya explained that in August 2017, the state had placed an indent for three lakh strips of GB1 medicines anticipating the demand. They received 1,86,000 strips of the medicine. “We had estimated these stocks to last us up to December. To our surprise, the stock was sold out by the end of September,” he added. By November, the city was staring at an acute shortage of the drug.
A similar challenge exists with the cancer drugs, explained Aradhya. “While branded drugs cost anywhere between Rs 2,500 to Rs 4,100 per strip, it would cost them a maximum of Rs 400 for generic medicines,” he said. While diabetic patients do a switch to branded medications when generic drugs are in short supply, the out of pocket expenditure for cancer patients is much higher to be able to afford branded medicines.
Buying in bulk
Pharmacies in Bengaluru said that they saw a trend where patients purchased diabetic medicines in bulk. The diclofenac gel (used for pain relief) is yet another product that is in great demand due to which pharmacies run out of stock, explained Aradhya.
“The pain relief gels here range between Rs 7 and Rs 17. We have customers placing order for about 20-30 in numbers. We had placed an order for 10,000 tubes, which was estimated to suffice for three months, but it was exhausted in 20 days,” he said.
He explained that the higher officials were briefed about the situation and that the Union Government is in the process of addressing the issue. “It has been resolved to a considerable extent,” he said speaking about the shortage of drugs. #KhabarLive