Generic Medicine and Generic Prescribing in Nepal: An Implication for Policymakers

Abstract

Rajeev Shrestha,1,* Sunil Shrestha,2,3,* Binaya Sapkota,4,* Santosh Thapa,5 Mukhtar Ansari,6 Asmita Priyadarshini Khatiwada,2 Rohullah Roien,7 Akihiko Ozaki8 1Department of Pharmacy, District Hospital Lamjung, Lamjung, Nepal; 2Department of Pharmaceutical and Health Service Research, Nepal Health Research and Innovation Foundation, Lalitpur, Province Bagmati, Nepal; 3Department of Nursing, Nobel College, Sinamangal, Kathmandu, Nepal; 4Department of Pharmaceutical Sciences, Nobel College, Affiliated to Pokhara University, Kathmandu, Province Bagmati, Nepal; 5Jeevee Health, Kathmandu, Nepal; 6Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia; 7Medical Research Centre, Kateb University, Kabul, Afghanistan; 8Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan*These authors contributed equally to this workCorrespondence: Rajeev Shrestha; Rohullah Roien Email [email protected]; [email protected]: Generic medicines are being promoted in many countries for their added benefits over branded drugs, such as reduced price, therapeutic equivalence, and convenience to the patients. However, generic prescribing is still not up to the optimum level in Nepal to assure access to cost-effective, quality medicines to the public and to reduce the overall economic burden and practice-related errors of medications. This review aimed to discuss the current scenario of generic medicine, generic prescribing, hurdles on the one hand, and potentials ways in promoting generic medicine usage and generic prescribing in Nepal on the other. Extensive literature on generic medicine usage and generic prescribing practice in Nepal was reviewed. This review found some of the major challenges to be addressed for the proper implementation of generic medicine prescribing, and utilization. These challenges include lack of facilities and competency to assure therapeutic equivalence of different brand-name medicines, lack of understanding about generic medicines among health care providers (HCPs) and the public, and lack of stringent regulation towards promoting generic medicines. Rational pharmaceutical promotion and awareness about generic medication to the medical students are also inevitable towards promoting the practice of generic medicines. The practice of generic medicine and generic prescribing is not possible without the assurance of therapeutically equivalent generic alternatives. The study recommended the prompt effort of the regulatory authority to enforce the generic prescribing and generic substitution policy through strengthening policies, procedures and laboratory testing to assure citizens’ right to access to cost-effective, and affordable quality medicine, as the Nepal’s National Health and Drug Policy mandated.Keywords: branded generics, brand medicines, generic medicines, generic prescribing, generic substitution, Nepal

Keywords

• branded generics
• brand medicines
• generic medicines
• generic prescribing
• generic substitution
• nepal