Why Hyderabad patients are forced to buy more medicines than prescribed

Patients are often forced to buy full medicine strips despite prescriptions for fewer doses, leading to avoidable expenses and wastage. While the Drugs Consultative Committee has urged exact-quantity dispensing, chemists cite regulatory and operational hurdles in cutting blister packs.

Hyderabad: Almost everyone in Hyderabad might have experienced this! You walk into a medical shop with a prescription and you will be invariably told that only a single strip is in stock. If your physician prescribes just three or four pills, you are forced to buy the entire strip because the chemist refuses to cut it. Worse still, if you need more than one strip, you might have to pay in advance for a second strip, and visit the medical shop again by spending extra time, money and energy.

Whether purchasing medicines from a medical shop or placing an order through a major online pharmacy, navigating the system has become a major ordeal for patients. Ultimately, the medical shop owner and the pharma company pass the financial loss of leftover doses or when the dosage changes midway through the treatment on the hapless customer.

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For lakhs of patients with tight household budgets, the compulsion to buy entire strips, whether for short-term antibiotic courses or chronic management, becomes a systematic out-of-pocket waste.

The friendly neighbourhood medical shop owner and call center executive of the retail pharma chain blame drug regulatory authorities for making their life difficult whenever they cut a strip of medicine. Meanwhile, patients are left frustrated, helpless and unhappy.

Recently, the union Ministry’s Drugs Consultative Committee (DCC) had urged pharmacies to dispense exact prescription quantities rather than forcing full-strip purchases. The DCC maintained that the consumers should not be penalized or forced to buy surplus medication.

The DCC recommendations, however, triggered a major push-back. The All India Organisation of Chemists and Druggists (AIOCD), which represents druggists and chemists, cited legal and operational hurdles. “Under current regulations, information such as the batch number, manufacturing and expiry date are printed only at the outer strip. When a pharmacist cuts a blister pack to sell loose units, that critical information is lost. The drug regulators do not allow chemists to keep unlabelled loose tablets,” AIOCD said.

It is not financially viable for a small medical shop owner to take back leftover medicines, since pharma companies and distributors accept expired or unsold stock returns only in full, intact strips,” says T Srinivas, a senior office bearer of Druggists Associations in Hyderabad.

While the DCC has given various recommendations to resolve the crisis, a permanent solution is yet to be finalized, leaving the financial and logistical burden to fall squarely on consumers.

Solutions proposed

• Mandating pharma manufacturers to produce smaller, flexible strip configurations
• Packs of 3, 5 or 7 units of pills at match common prescription durations of doctors
• Each individual/ single pill blister must contain batch number and expiry rate
• This will enable regulators to track/trace single tablets or pills
• Make it legal for manufacturers/distributors to absorb or compensate retailers for unsold partial portions if loose dispensing becomes a statutory requirement.
• Allow chemists to log,return/receive credit for unbroken partial blister packs from distributors
• Amend Drugs and Cosmetics Act to provide legal framework on strip-cutting
• The government must adjust trade margins, to offset more labour needed by chemists to track and handle single loose units.