Generic prescriptions under review, says Drap

ISLAMABAD: Pakistan’s Drug Regulatory Authority (Drap) is preparing to study whether physicians should be legally required to prescribe medicines by their generic names rather than brand names, in what could become one of the most major reforms in the country’s healthcare system.

Officials said the move is being seriously considered to break the conflict of interest and entrenched nexus between pharmaceutical companies and prescribers that fuels undue prescriptions, rising costs, and corruption in medical practice.

“At the moment we are conducting a study on effects of price deregulation on people, and its report is expected within next 10 days. After that, we are going to conduct a study on possibility of introducing generic prescriptions by physicians. But, we will have to listen to all stakeholders, including pharmaceutical companies operating in the country,” Drap CEO Dr Obaidullah told Senate Standing Committee on National Health Services on Monday.

The disclosure came during a charged meeting of the committee, chaired by Senator Amir Waliuddin Chishti, where members grilled Drap and health ministry on what they called, “A culture of conflict of interest”, spanning across drug pricing, physician practices and regulatory enforcement.

Senators accused doctors of writing unnecessary prescriptions and diagnostic procedures, pushing C-sections without medical justification, and accepting lavish perks from pharmaceutical companies - from foreign trips to five-star hotel stays - in exchange for prescribing their brands.

Federal Health Minister Mustafa Kamal defended pharmaceutical price hikes, saying companies were business ventures working for profit. “At a time when prices of everything are increasing, why can’t prices of medicines increase as well?” he remarked. Multinationals were already exiting Pakistan due to poor ease of doing business, he added.

He said the latest price issues involved fixation of 35 new essential medicines and hardship-based increases for 58 other essential drugs.

The minister disclosed government had abolished a law under which pharmaceutical CEOs could be booked for supplying substandard medicines. “We want to encourage investment, not drive investors out”, he argued. He also pointed to digitisation reforms at Drap that have allowed 180 device registrations to be processed in weeks, with timelines reduced to as little as 20 days.

But senators showed little patience for reassurances. Senator Sarmad Ali directly accused Drap of corruption, claiming, “It is commonly believed when Drap officials retire, they become billionaires”. The regulator’s reputation was undermining trust in the entire health ministry, he added.

The minister admitted he too had been congratulated on assuming office, as if he had joined, “The most corrupt ministry”, but insisted transparency measures were being put in place at Drap, Nursing Council and PMDC.

The committee’s discussion stretched well beyond medicine pricing. Senator Danesh Kumar raised alarm over soaring rate of cesarean deliveries in Pakistan, claiming, “Nowadays every pregnancy is going through C-section”, regardless of medical need, while also accusing doctors of prescribing excessive tests for commissions.

Chairman Chishti formed a sub-committee led by Senator Fawzia Arshad to probe practice of unnecessary C-sections, directing the ministry to collect detailed data from federal and provincial hospitals. Senator Sarmad Ali called for a complete ban on foreign trips funded by pharmaceutical companies for doctors.

Senator Dr Zarqa Suharwardy Taimur, while presenting her amendment bill, highlighted prices of medicines were continuously climbing and had become unaffordable for ordinary people, particularly after floods. She warned of counterfeit medicines being sold at exorbitant rates, and the committee directed the ministry to submit a detailed report on medicine pricing in the next sitting.

The other issues, which came under review, included rising number of dengue cases in Islamabad, health challenges in flood-affected districts and upcoming MDCAT examination. Senator Mirza Muhammad Afridi urged the test be postponed for flood-hit students, stressing fairness.

Senator Rubina Khalid called for urgent measures to address medical needs in flood-devastated regions like Qambar. The senators also criticised closure of PMDC portal, which they said had provided transparency and convenience for students.

By the end of the session, spotlight returned to the root problem: a healthcare system compromised by financial interests. Senators warned as long as doctors continue prescribing by brand names, patients will pay the price of a physician-pharma nexus greased with perks and profits. Drap’s upcoming study on generic prescribing, they said, could mark a turning point - if the regulator has the will and independence to push through reform against powerful lobbies.