India is called “Pharmacy of the world” because it is a major manufacturer and supplier of affordable generic drugs, biologicals and vaccines.
But along this, there exists a painful reality in India. While India is a hub of major multinational and big domestic pharmaceutical companies, we have also seen a huge proliferation of small ‘mom and pop’ pharma companies (better called shops), typically run by an individual or so over the last 2-3 decades.
How do these solo manufacturers operate and sustain?
Now, how do they sustain? Very simple. Typically, a small pharma company manufactures (or, gets manufactured from operators) anywhere from 10 to 20 molecules, which are not under the patent, assigns them brand names. Typically, their menu includes anti-pyretics, pain killers, cough syrups, ‘older’ antibiotic like ampicillin, amoxicillin, Quinolones (eg, ciprofloxacin), multi vitamins, general tonics, ant acids, etc
How to sell the menu?
And then they build up a network of about typically 5 to 15 doctors (including quacks - a low hanging fruit for them), offer them huge commission, even up to typically around 20 to 40%. The doctor writes the prescriptions with those brand names. The patients are ‘forced’ to buy them, and this is how these mom and pop shops make their money.
Now, you can imagine the efficacy and the potency of these medications. In the light of recent incidences of deaths due to cough syrup, one can conclude how much accountability the system holds.
Corruption begets corruption.
Generic drugs are supposed to work just as well as their brand-name counterparts.
Once a patent lifts, generic-drug companies find alternative ways to manufacture a drug that should work indistinguishably from the brand-name version. In a world of skyrocketing prescription drug prices, cheaper generics have acted as a crucial counterweight.
There must be strict regulations governing drug dispensing and distribution. Physicians have an ethical responsibility not to promote medications that could be harmful, and should prescribe transparently and responsibly.
I have observed instances where tablets are handed out in unlabelled, colourful packets with no prescription or packaging for reference, practices that endanger patients and should be punished. The government should also prioritise affordable, accessible healthcare so that the most vulnerable do not suffer because of unsafe or inappropriate prescribing.
This article really opens your eyes to the darker side of India’s pharma success story. It makes you wonder, when will profit stop outweighing people’s safety?
It’s unsettling how these small, unregulated pharma setups survive in the shadows of India’s massive drug industry. It really makes you wonder — if just a handful of unchecked brands can cause nationwide harm, how much hidden risk is still slipping through the cracks?