Thursday, Sep 28, 2023

Overprescription of drugs under lens

Unwanted medicines may create long-term health complications; Expert

By M. Sai Gopal

Updated On - 12:21 AM, Sat - 15 May 21

Hyderabad: The second Covid wave and the rapid surge in positive cases have fuelled over-prescription of medicines and diagnostic services. Quite often, doctors end up prescribing at least seven to eight different drugs to treat even a mild Covid positive patient.

While there are protocols for treating mild, moderate and severe Covid positive patients framed by Indian Council of Medical Research (ICMR) and Union Health Ministry, there is little regulatory control over prescription and sale of medicines, which makes matters worse for patients.

The most obvious instance of over-prescription is Remdesivir and Tocilizumab injections, which are only meant for a narrow set of Covid patients, but are widely prescribed. On an average, the committee comprising senior government doctors in-charge of screening requests from private hospitals and releasing the drugs, receives anywhere from 100 to 120 applications a day.

“We are rejecting a majority of the requests because they are not needed for all Covid positive patients. After screening all the requests from private hospitals, we have realised that many doctors are not even aware of what category of Covid positive patients should be administered with such drugs,” says Director of Medical Education (DME), Dr K Ramesh Reddy, during an interaction with presspersons.

At present, patients with asymptomatic or mild Covid are routinely prescribed a combination of drugs including ivermectin, doxycycline, azithromycin, and favipiravir, which have the potential to create long term health complications for patients.

The DME urged doctors to make themselves aware of the protocols laid-out clearly for treating asymptomatic, mild, moderate and severe Covid positive patients. “If doctors keep prescribing unwanted drugs, then patients and their family members panic and run from pillar to post to buy the drugs. If such drugs are given to all Covid patients, then it may lead to health complications like black fungus,” Dr Reddy said.

In an article on over-prescription, published on May 10 in British Medical Journal (BMJ), doctors from Tata Memorial Hospital, Mumbai said “Patients with mild Covid are receiving a cocktail of multiple ineffective drugs and unneeded investigations leading to a financially bloated treatment, while those with moderate to severe Covid are currently struggling to procure indicated drugs and oxygen even on the black market”.