The local generics pharmaceutical industry
Pakistan was a pioneering nation in introducing a mandatory scheme for use of generic names following the implementation of the Drugs Act 1972 (Generic Names). This legislation prohibited manufacturing, distribution and prescription by brand or proprietary name (Quraeshi et al., 1983). The objective was to make local manufacturers competitive with the multinational companies, which was expected to result in lower medicine prices.
The generics drug policy operated only until 1975, when manufacturing licences for 38 companies were suspended on account of substandard drug manufacture (Medical Gazette, 1975). This cancellation had an adverse impact on all local manufacturers, including those producing quality medicines (Quraeshi et al., 1983). At the same time, multinational companies accelerated their efforts to persuade doctors to prescribe under the name of the manufacturer along with the generic name. They also revamped packaging by using exaggerated colours or pictorial representations unique to each company, promoting their brands via mass media campaigns and through discounting and bonuses to retailers. This marketing effort resulted in the multinationals retaining their market share in the presence of generics competition, and the plan to bring down prices eventually failed. In 1976, after scrutiny of this experience, the Director General of Health issued orders that terminated the compulsory requirement of manufacturing and marketing by generic names (Quraeshi et al., 1983).
A study by the WHO/HAI on medicine prices and availability has shown that both consumers and prescribers favour brand products and believe generics to be of lower quality (WHO/HAI, 2003). Only 50 per cent of medicines are prescribed as generics (WHO, 2004). It is noteworthy that there are very few well-established laboratories with the capacity to conduct bioequivalence studies (Ali, 2007). In a country with such a huge and poor population, however, it is imperative that the use of cheaper generics be maximized. There is a clear need to sensitize patients, pre- scribers and providers to increase the judicious use of generic medicines (Babar and Jamshed, 2008). This requires improvement of the quality of generic medicines and government backing for the promotion of generics to physicians and pharmacists, as well as to patients. Several recent studies recommend educating prescribes and consumers about the quality and efficacy of generic medicines (Jamshed et al., 2011a, 2011b, 2011c).