The grand brand coalition

Professor Geetha Fernando at her induction as President of the Sri Lanka Medical Association stressed the necessity to reduce the number of branded drugs and the excessive number of brands of the same generic, implying that the essential drug list should be revived and activated.

She predicted: “If there is no reduction of the ever increasing number of brands, quality failures, irrational prescribing and dispensing will increase.” She was courageous to declare that “tightening of quality control will eliminate 20% of drugs registered”.

Quality failures and recall of drugs from circulation are frequent. Parallel drug imports did not exist long. In Sri Lanka, a pharmaceutical tradition that prevails is that the contraband, unregistered brand drug is launched surreptitiously on doctor, patient, prescription demand, to be followed much later by the ceremonial launches of various registered brands of the same generic. Importer drug companies learn the prescription potential of a drug from the prescribed unregistered drug. State hospitals purchase and use these unregistered drugs to meet prescription requirements. The Drug Regulation Authority hesitant to come into conflict with doctors, tracks down the dispensers.

The potency drug, Sildenafil Citrate, has 15 brands; Atorvastatin has 20 brands; iron preparations have 35 brands; Gliclazide, 30 brands; diclofenac sodium, 35 brands; Cephalexin 30 brands; Ciprofloxacin, 30 brands; Omeprazole, 35 brands, and Clopidrigel, 20 brands, to name a few.

By Mervyn Burrows, Moratuwa.