ISLAMABAD: Transparency International Pakistan (TIP), a leading watchdog organization, has raised serious concerns about the stark price differences between branded and non-branded (generic) medicines in the country, stating that this disparity is causing enormous financial losses to both the general public and the national treasury. In light of this, TIP has called on the federal government, particularly the Ministry of National Health Services, to urgently implement and enforce the generic medicines prescription policy across public and private healthcare sectors.

In a formal letter addressed to Federal Minister for National Health Services, Regulations and Coordination, Syed Mustafa Kamal, TIP emphasized that the lack of adherence to the Drug Regulatory Authority of Pakistan (DRAP)’s 2021 directive—which instructed doctors to prescribe medicines by their generic names instead of brand names—has created a deeply flawed and profit-driven pharmaceutical system that prioritizes corporate interests over public welfare.

Alarming Price Disparities: A Costly Reality

The letter highlights extreme pricing inconsistencies within the Pakistani pharmaceutical market. TIP’s comparative data reveals that branded medicines are being sold at prices up to 4,000% higher than their generic counterparts. For instance:

• A 300mg Aspirin tablet can be purchased for as low as Rs. 47 under a generic label, but the same dosage is being sold by some branded pharmaceutical companies for Rs. 300 or more—a price increase of over 500%.
• A 10mg generic tablet, priced at Rs. 3.07 as per Punjab government’s official rate list, is being sold by branded companies for Rs. 93, reflecting a staggering 3,029% markup.
• A 20mg version of another commonly prescribed drug, available as a generic for Rs. 1.70, is found on the market with a branded label at Rs. 67.85—a shocking 3,991% increase.

Such disparities, TIP noted, are not only unethical but economically devastating for lower-income groups who already struggle to afford basic healthcare services.

Billions Wasted: Public and National Losses

According to estimates presented by TIP, the annual cost burden on the healthcare system and the general population due to overpriced branded medicines runs into billions of rupees. This not only inflates out-of-pocket health expenses for households but also severely strains the national budget allocated for the procurement of medicines in public sector hospitals and clinics.

TIP pointed out that if a comprehensive generic medicines policy were properly enforced across the country, medical expenses for patients could drop by as much as 90%, making healthcare more accessible and equitable for all, particularly the underprivileged segments of society.

Societal Benefits of Generic Prescription Policy

Beyond the financial implications, TIP stressed that the implementation of a generic drug policy would yield numerous social and systemic benefits, such as:

• Affordable treatment options for low-income populations.
• Equal access to medicines across different socio-economic groups.
• Reduction in healthcare inequalities.
• Promotion of competition and innovation within the local pharmaceutical industry.
• Encouragement of cost-effective procurement practices in public hospitals.

Furthermore, generic drugs contain the same active ingredients as branded ones and are subject to stringent quality controls by regulatory bodies. They are considered just as effective in treating illnesses and managing chronic conditions. Hence, promoting generics does not compromise patient safety or treatment efficacy.

TIP’s Demands from the Ministry of Health

In its letter, Transparency International Pakistan has outlined a series of key recommendations and demands for the Ministry of Health and the Drug Regulatory Authority of Pakistan:

1. Immediate enforcement of DRAP’s 2021 Generic Prescription Policy across both government and private hospitals and clinics.
2. Strict action against non-compliance, including the initiation of inquiries into institutions and individuals that fail to follow generic prescribing guidelines.
3. Overhaul of public procurement practices to ensure essential medicines are purchased at the lowest possible rates through generic options.
4. Public awareness campaigns to educate citizens about the benefits and effectiveness of generic medicines, empowering them to demand lower-cost alternatives.
5. Training and sensitization of doctors to shift their prescribing habits from brand names to generic drugs in the best interest of patients.

Resistance and Challenges

One of the key reasons cited for the failure to implement the generic prescription policy is resistance from pharmaceutical companies and a portion of the medical community, who benefit financially from promoting and prescribing branded drugs. These companies often offer incentives, commissions, and benefits to doctors for recommending their products over generics. This practice, commonly referred to as “incentivized prescribing,” contributes to the inflated drug prices and poses a significant ethical challenge.

Transparency International has called for transparent oversight mechanisms to eliminate such practices and ensure doctors are prescribing based solely on patient needs and clinical effectiveness rather than personal gains.