Drug mafias and fake medicines..

Recently, I had reasons to go to a medical shop at Trivandrum. I gave them the prescription for Dexona injection(Dexamethasone) intended for my daughter n law. (It  contains cortisone,and is a life saving medicine)  Luckily,after reaching home, I was looking at the vial and noticed the Dexona "Vet" label on it. The drug they gave me was intended  for veterinary use and NOT for human!!.I went back and asked the young boy behind the counter.He said,Sir,your driver usually buys medicines for your dog,and so..... Wonderful answer..isnt it. He probably was trying to impress me with personalised service...like they offer in bars,when a regular drunkard walks in,and the bar attendant welcomes him with his regular brand of drink.... I have often wondered whether the person behind the pharmacy counter himself is really qualified, as in whether he is a trained pharmacist or has simply ‘learnt’ the trade through an apprenticeship, many of these so called pharmacists look suspiciously young, unkempt and I have seen some, who  even passes comments,and make "better" suggestions, when requests for  medicines are made,as if they knew better than the doctor who prescribed.. Thinking about it, I would not be far from the truth if I said the entire ‘drug’ industry in the country is rather unregulated, thus giving way to huge amounts of fake drugs, quacks who operate as doctors and fraud pharmacists, to mention  few among many problems.


We in Kerala ,always boast of our literacy and health awareness.A recent survey showed that Kerala is the largest consumer of medications in India. The average consumption of medicines here is three times the national average!!.India has a twenty thousand crore fake drug market!And 30% of medicines sold in Kerala are fake medicines. And most of these fake medicines have been found to be made in slums,under unhygenic conditions,by people who have no idea about what they are making.

If you are not careful,the next time you buy Paracetamol for fever,the chances are that you will be taking tapioca powder than Paracetamol itself..Imagine what would happen if it is a life saving drug ! Common counterfeits include expensive medicines like Plavix( a blood thinning agent given after heart attack) and Lipitor( medicine to lower cholesterol).
This is not an isolated phenomenon happening here.The World Health Organisation estimates that up to 10% of medicines available globally are counterfeits.The sale of fake drugs from China and other countries is expected to reach £38 billion by 2010. Fake drugs industries are thriving in China and exports medicines all over the world,including India, often with " Made in India" label. A fake consignment of Zyprexa, an anti-psychotic treatment prescribed for schizophrenia( mental illness), infiltrated Britain's national healthcare system last year. Following this, more than £3million of fake LIFE SAVING MEDICINES for ailments such as heart disease and cancer were intercepted by customs officials and  security agencies. Frightening...isnt it?. They took immediate steps like banning the repackaging of medicines and the mandatory use of special seals to stop counterfeiters,and bar codes to determine whether a drug is genuine or not.


Medicines are life saving,it is not just any other commercial commodity,and has its own sanctity.

Coming back to us,there are some other interesting observations.When my daughter was sick ,I had to frequent pharmacies at Trivandrum..and these are lessons I learned,and hadn't known earlier. If you look at the drug label,you will notice an  MRP ( Maximum Retail Price) printed ,either at the side or back of the strip or affixed on the bottle..For a medicine,on which was written  Rs1220, I had to pay only Rs780 at the Neethi Store in front of SAT Hospital. Had I bought it  from any other pharmacy,I would have paid the whole 1220 printed on the strip plus taxes!! Such is the profit margine on medicines. MRP only means that the medicine can be sold up to that price,but can be sold for a much lesser price.There are no clear cut regulations on drug prices..I had seen an article in a Local news paper comparing drug prices at various medical shops,and it was unbelievable. Most of the medicines can be sold at half the prices of what is written as MRP.For a little  bit of effort, and a bit of extra time,make sure you go to a reliable medical store( I believe the safest are the Neethi medical stores,or like those) and buy  your medicines,if you dont have money to throw around.

And also make sure that your medicines are not substituted by the pharmacist,to another brand,than what was prescribed by the doctor.


 Kerala’s medical distribution system is also one of the most abused and exploited, controlled by thousands of unscrupulous distributors and retailers who often practise the profession of pharmacy without following the basic norms set by the  Pharmacy Council or Drug controller authorities.Pharmacies are mushrooming everywhere,for the simple reason that it is easy money and profit.In the greed for money,man stoops down to any level, even selling medicines ,knowing they are fake,and can kill sometimes. It is an open secret that most of the pharmacies function with the Pharmacist licence of those who are not actually working there, are employed elsewhere, are very old and sick or even dead persons! Health care is the responsibility of the State. It has to impose strict regulations on issue of licences to new pharmacies and enforce the registration norms prudently. The quality of drugs has to be ensured by the Pharmacy Council and they have  to stipulate stringent conditions for issuing licences and renewal of registrations ,and implement them. Drug inspectors should periodically inspect pharmacies,and violators must be closed down.
Government institutions also use the system of tenders while purchasing medicines,where the lowest tender wins the deal.This process can lead to unhealthy relations between the authorities and the pharmaceuticals. So the cheapest,and therefore,  medicines of the lowest quality reach the poor people who depend on them.

  Rigorous punishment of those who deal with fake medicines,on same terms as illegal drug traffickers,must be formulated. A Chinese man was sentenced for 11 years of imprisonment for selling fake drugs on the Internet last month, which has been the heaviest sentence for such crime given by a Chinese court.We need to follow the steps as well.

As long as criminals can harvest enormous profits, patients will remain vulnerable. The counterfeiters target the weakest members of our societies - the young, the sick, the economically disadvantaged, and it is our obligation to take action.In a state,where everyone knows everything about everything,I am surprised the public turns a blind eye towards such a grave issue.