THE provision of healthcare has traditionally been managed on the philosophy that where the patient is concerned, price should not be a hindrance. But in a real world situation, access to life-saving medicines is far from perfect.

It has been reported by the World Health Organisation (WHO) that more than a third of the world’s population has no access to essential drugs, and of this half live in the poorest regions of the developing worldin Africa and Asia.

Several factors determine the accessibility to drugs in developing countries. Cost of medicines is one of them.

For chronic medication users, one way to combat the escalating cost is by using generic medicines. Generic drugs are cost-saving as they may be substantially lower in price than the innovator brands.

Providing timely access to affordable, safe and effective products should be the central purpose on every government’s health agenda. Although the use of generic medicines in most developing countries is well mandated by the government agencies in their respective national health policy statements, the majority of healthcare practitioners and consumers are still sceptical about their efficacy, quality and safety.

This is further complicated by the lack of initiatives among the respective governments and non-government agencies in developing countries to promote generic medicines to consumers.

Developing new medicines is a long and expensive process. Before getting permission to be in the market, medicines have to be tested first on animals and then on humans to determine their safety and effectiveness in the condition for which they are to be used.

There is the ever-present danger of medicines failing different tests during the development process, causing huge losses to the company. So those that make it to the market have to cover the costs of medicines which “fell by the wayside”.

Considering the high costs, the commercial nature of drug companies and the need to stimulate research and development, a drug company which develops a new medicine is allowed a certain period of time during which only it can produce and market the medicines.

During this period, due to the lack of competition and to recover costs, companies usually sell the medicine at a high price. Once the patent period expires, then other companies can manufacture and sell the medicines often at lower prices.

These medicines are known as “generic medicines” or “generics”.

In Malaysia, branded generics are common where generic copies of medicines are manufactured and sold by different companies under their brand names. The national medicines regulator, as a gatekeeper to ensure the quality, safety and efficacy of medicines, requires scientific evidence to prove that generics must be shown to be bio-equivalent – delivering about the same amount of the drug to the site of action in a similar time frame – to the originator product manufactured by the innovator company.

International regulatory agencies such as the United States Food and Drug Administration (USFDA) and the European Medicines Agency (EMA) play a pivotal role in educating consumers on the benefit of choosing generic medicines through various educational channels.

Besides focusing on consumers, massive educational campaigns are also needed to educate healthcare professionals especially on the general concepts of bio-equivalence, as many of them might not understand this topic well.

To overcome this problem, educational seminars can be organised as part of compulsory continuous professional development (CPD) programmes by the respective professional bodies. Similarly, future healthcare professionals who will be directly involved in patient care, such as doctors, nurses and pharmacists, need to be well informed on every aspect of rational prescribing starting from their junior years.

This can be done by incorporating topics on rational prescribing in their standard therapeutics course or as problem-based modules in their tutorial.

In a nutshell, and particularly in the present economic climate, in order to achieve optimal outcomes, consumers must not only receive appropriate treatment but also have the knowledge and skill to use it to its best effect.

Health professionals and government agencies have a vital role to play in promoting quality use of medicines through good treatment choices, good communication with consumers, and collaboration with each other.

Source: The Star