Achieving optimal healthcare delivery involves providing efficient health infrastructure, quality and affordable medicine and, ensuring health professionals are well-trained and paid. But the escalating cost of healthcare is often blamed on the rising prices of drugs prescribed to patients.
One of the ways to lower the cost of medicine and treatment in our health facilities is by increasing the use of generic drugs. But what are generic drugs? Basically, these are different and more affordable versions of branded medicine manufactured and sold by leading pharmaceutical companies.
Generics work in the same way and have the same benefits as branded medication. It is important to understand that medicines have two main components. One component is the active ingredient which treats the disease and heals the patient. The other component comprises inactive ingredients which do not treat the illness but give the drug its shape, form, flavour or colour.
A drug can be administered to the patient either orally or by injection but the effect is the same from a medical perspective. Thus, branded and generic drugs have what is termed bioequivalence. They have the same efficacy notwithstanding the difference in packaging or cost. So, it is not true to say that generics are less effective than branded medicine because they are cheaper.
The point to emphasise here is that contrary to common perceptions, generics are not inferior to branded drugs.
Since generic drugs are produced with the permission of the original manufacturer, they can be produced by a different company that did not incur the heavy investment costs and at a more affordable price. Generic drugs are also less expensive than branded medication as they (generics) do not have to undergo a repeat of the rigorous clinical trials that precede the release of a new drug into the market.
Promoting the use of cheaper generic formats is therefore critical to ensuring the larger population can access Universal Health Coverage (UHC) as it allows prescription drugs to be more affordable hence accessible to patients who would not ordinarily access the branded products.
More importantly, increased availability of generic drugs directly translates into reduced cost of treatment even for the most debilitating illnesses. Lowering the cost of medicine has a phenomenal positive impact on health care. A good example is HIV/Aids. According to the United Nations Development Programme (UNDP), twenty years ago, it cost on average $10,000 to access anti-retroviral drugs (ARVs) per person per year. Today, it costs $100 per person. This dramatic fall in the prohibitive cost of treating one of the world’s deadliest diseases has been attributed to increased access to generic ARVs.
It is important, however, to distinguish generic drugs from counterfeit medicines. The latter are often illegally manufactured products and often unsafe for human use. Generic drugs, on the other hand, are manufactured under the same strict conditions as their branded counterparts. Generic drugs are not “fakes” and so consumers should not worry. In fact, the US Federal Drug Administration estimates that half of the generic drugs in the global market are actually manufactured by brand pharmaceutical companies.
With this background, the directive by a local medical insurer requiring doctors and health facilities on its list of providers to restrict prescriptions to generic drugs, should be supported. In any case, prescription of generic drugs in Kenya is not new and most of the medicine given to patients is, in fact, of the generic type.
Although doctors enjoy professional autonomy when treating patients, they should be encouraged to embrace and adopt increased use of generic drugs as a way of further reducing the cost of treatment.
We only need to tighten public health safety through the relevant government agencies like the Pharmacy and Poisons Board which should vet all generic drugs both imported and locally manufactured. This will help allay fears and debunk myths surrounding production and use of generic drugs.
The government should also review taxation for imported drugs to allow more players to bring in generic medicine thus promoting competition and hence reduced prices. Overall, this will reduce the cost of health insurance premiums and allow more Kenyans to take up medical covers. In the end, the patient and the public benefit.
All said, health being a devolved function, the financial constraints afflicting the counties amplify the case for generic drugs. As the government braces to roll out the UHC program in the 47 devolved units, it should prioritise use of generic drugs as a viable alternative to the costly drugs majority of Kenyans can hardly afford.
Ms Munene is Group Chief Executive, AAR Insurance