Continuously rising medicines cost-- Why ?

Emperor said:
  1. Can you suggest any alternative to Nimesulide?
  2. Do you mean I need to change doctor as he is prescribing nimesulide (3 tablets a day and for 2 days only, not more than that)
finding good doctor in my near by area is hurricane task, just few week before local authorities catch 7 bogus doctors (no degree still was practicing)
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1) Depends on you issue. There are stronger and weaker pain killers available vs Nimesulide(safer too). Sorry, I don't want to get in trouble for prescribing anything over the internet - but there's a whole spectrum of NSAIDS ranging from effect on COX 1 and COX 2.

2) 3 tabs a day for Nimesulide ? Bro, please go to someone else. Much better alternatives available.

lockhrt999 said:
@alekhkhanna do you know if there's a way to test drugs or supplements? Do you know about spectrophotometers? Can these be used?
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Apologies, not my area of expertise. But TheLiverDr on Twitter has already published test results for many popular supplements on Twitter and as a paper. Check his Twitter account.
 
tapestry said:
How trustworthy are these guys?

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Partially agree with him. The challenge is most Indian CMOs have extremely poor history of checking bioequivalence with parent molecule. This has been noted several times by USFDA etc, and you would know this for listed companies who get such notices.
Earlier, USFDA couldn't visit a plant without prior intimation, which led to typical "clean up" of documents, areas, records etc- but now USFDA is starting random visits due to massive issues of quality concerns - look at what happened to Granules recently, these notices may increase.
Of course, pharma is one of the biggest lobbying areas in India - it is behind the scenes, and IPA has worked over the years to lobby tons of relaxations to manufacturing rules. You know leadership in pharma companies can't even be jailed even if thr drug is NSQ, leading to death of patients?

www.newslaundry.com

Modi’s Jan Vishwas Bill gives the pharmaceutical industry a get-out-of-jail card

Modi’s Jan Vishwas Bill gives the pharmaceutical industry a get-out-of-jail card
www.newslaundry.com www.newslaundry.com

For all the good intentions by MedPlus, they are retailers, and they can't do mass QC at their level, even with big CMOs.
Both I and many of my practicing colleagues have seen this for many years - certain brands work very well, whereas same molecules for other big brands don't work so well.
So take the molecule but with a pinch of salt.
 
Emperor said:
No harm with Generic Medicines but in small quantity, once you found it working than may buy quantity as per prescriptions.

I have both side of experience, one generic brand didn't work, next time same medicine with other generic brand works.
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Please don't get generics from unknown brands or Jan Ashuddhi kendras. My FIL is a bypass patient, with stents. Without telling any of us, he looked at the cost differential for his monthly meds - generics vs those prescribed by our trusted cardio - and changed them to JA meds. Within 2 months, every parameter worsened. We were unable to understand what's happening - before he finally revealed of generics. Literally threw away generics in a trash and got him the OG ones.
I'm a doctor working in the pharma industry, so I know....stuff, and I'm pretty much on top of most Indian pharma news.
Many a times public won't hear a peep when random manufacturering site inspections reveal massive API issues, NSQ products etc (even some big names). You may only find those report on some obscure med forums or activist X accounts.
 
....

Short list highlighted by media.

www.cnbctv18.com

Indian pharma giants draw FDA flak: A string of warnings in 2024 so far - CNBC TV18

In 2024, several major Indian pharmaceutical companies, including Zydus Lifesciences, Granules India and Aarti Drugs received warning letters from the US FDA. Common concerns included cross-contamination, inadequate quality controls, and lapses in aseptic processing, raising questions about the...
www.cnbctv18.com www.cnbctv18.com
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x.com

x.com x.com


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ssslayer said:
Everyone on this thread would want to be better off (monetarily) than most other people (everyone wants to be better than the average!).
This instinct is the one that results in greed since there is no well-defined line.
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Well, there is a prevalent dogma that greed, which is useful for Individuals is equally good when those pursuing greed are corporations. Capitalism needs to be reformed for companies in pharma, health, education, and scientific research for reasons that corporate greed causes excesses in these areas which can potentially lead to long term downfall of cultures, civilizations, and even mankind.
 
STOP misleading and blaming generic/ Jan Aushaddhi Kendra. Greedy mind don't differentiate between Generic or Brand, religion, caste, creed, state & nation but work for money ONLY.

One Branded nasal drop that cost Rs.65/- now same salt medicine cost Rs.20/- at Jan Aushadhi Kendra and it' as good as branded.
Acidity Capsule cost Rs.150/- same salt medicine cost Rs.25/- at Jan Aushadhi Kendra and it' as good as branded.

API issue in past also happens with Top Branded medicines (OG also) read here

that's why buy minimum and use, if works buy as pre prescription if not than buy other brand but same salt.
 
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Emperor said:
STOP misleading and blaming generic/ Jan Aushaddhi Kendra. Greedy mind don't differentiate between Generic or Brand, religion, caste, creed, state & nation but work for money ONLY.

One Branded nasal drop that cost Rs.65/- now same salt medicine cost Rs.20/- at Jan Aushadhi Kendra and it' as good as branded.
Acidity Capsule cost Rs.150/- same salt medicine cost Rs.25/- at Jan Aushadhi Kendra and it' as good as branded.

API issue in past also happens with Top Branded medicines (OG also) read here

that's why buy minimum and use, if works buy as pre prescription if not than buy other brand but same salt.
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Most Jan Ashuddhi meds are pretty crap. Experience with my prescriptions and several other in medical fraternity. Not all are crap, but you'll never know which one is good.
 
Neotheone said:
Well, there is a prevalent dogma that greed, which is useful for Individuals is equally good when those pursuing greed are corporations. Capitalism needs to be reformed for companies in pharma, health, education, and scientific research for reasons that corporate greed causes excesses in these areas which can potentially lead to long term downfall of cultures, civilizations, and even mankind.
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And why isn't it equally good?
I assume the second bolded part of your post is the answer to my question?
Any example you can cite that proves or explains your point?

What is so special about pharma, healthcare care, education, scientific research?
What kind of reforms are you thinking about for capitalism?

(Let see if we can have an ancient greek style debate here - no swords and daggers on disagreements)
 
alekhkhanna said:
Most Jan Ashuddhi meds are pretty crap. Experience with my prescriptions and several other in medical fraternity. Not all are crap, but you'll never know which one is good.
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here more horrible stories from so called Branded in your term OG Medicine (very very high PROFIT margin still .. poor quality) GREED never ends & never care for innocent lives.
I think you are Medical Representative of some Pharma Company that manufactures medicines, right?

Bhartya Jan Aushadhi Pradhikaran is good initiative by Govt. to provide good medicine at low price to normal people, they really didn't check caste/creed/status/support while selling medicines via Jan Aushdhi at same price to all.

The Central Drugs Standards Control Organisation (CDSCO) has identified more than 50 widely used drugs from various manufacturers as "substandard" in its monthly report for August 2024. The list of "not of standard quality" (NSQ) drugs includes popular medicines like antacid Pan D, calcium supplement Shelcal, anti-diabetic drug Glimepiride, high blood pressure drug Telmisartan, among others. https://www.moneycontrol.com/news/i...und-substandard-check-full-list-12829921.html
 
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Emperor said:
here more horrible stories from so called Branded in your term OG Medicine (very very high PROFIT margin still .. poor quality) GREED never ends & never care for innocent lives.
I think you are Medical Representative of some Pharma Company that manufactures medicines, right?

Bhartya Jan Aushadhi Pradhikaran is good initiative by Govt. to provide good medicine at low price to normal people, they really didn't check caste/creed/status/support while selling medicines via Jan Aushdhi at same price to all.

The Central Drugs Standards Control Organisation (CDSCO) has identified more than 50 widely used drugs from various manufacturers as "substandard" in its monthly report for August 2024. The list of "not of standard quality" (NSQ) drugs includes popular medicines like antacid Pan D, calcium supplement Shelcal, anti-diabetic drug Glimepiride, high blood pressure drug Telmisartan, among others. https://www.moneycontrol.com/news/i...und-substandard-check-full-list-12829921.html
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Bruh, where did I say all branded generics are good? I literally posted links which say there is no QC in India. But the chance of finding working API in branded generics is much much higher than JA meds.
Plus if someone sticks to bigger MNC brands like Abbott, Pfizer, GSK etc, you'll not have issues most of the time.
Before you get personal with attacks, I'm an MD in Medicine. I've worked with Doctors without Borders aka MSF in multiple missions, and I've been part of their drug procurement drives from India - so I know stuff that 99% don't.
I've been with MNC pharmas for rest of my career - working with names which only produce patented new molecules - you'll not find generics or even branded generics for our molecules. I work in Medical Affairs, closely liasing with Regulatory (aka CDSCO in India, and state licensing authorities), drug discovery, clinical development and late stage development molecules. And I cover over 30 countries as part of my job.
Long story short - I've my entire career devoted to this field.
 
alekhkhanna said:
Before you get personal with attacks, I'm an MD in Medicine. I've worked with Doctors without Borders aka MSF in multiple missions, and I've been part of their drug procurement drives from India - so I know stuff that 99% don't.
I've been with MNC pharmas for rest of my career - working with names which only produce patented new molecules - you'll not find generics or even branded generics for our molecules. I work in Medical Affairs, closely liasing with Regulatory (aka CDSCO in India, and state licensing authorities), drug discovery, clinical development and late stage development molecules. And I cover over 30 countries as part of my job.
Long story short - I've my entire career devoted to this field.
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don't take it personal attack.... I thought you were general user like me... was not aware about your educational/professional/work achievements ... my apologies
 
Emperor said:
don't take it personal attack.... I thought you were general user like me... was not aware about your educational/professional/work achievements ... my apologies
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No worries man. These are no achievements, just part of job. MSF specially required everyone to wear multiple hats - I was practicing with them at Naxalite areas in Chattisgarh, but also handling drug procurement which they are very very strict about.
CDSCO, I've been to their office for NDAs many many times. Have a fair idea on how they work.
Many skeletons in the closet.
 
Emperor said:
STOP misleading and blaming generic/ Jan Aushaddhi Kendra. Greedy mind don't differentiate between Generic or Brand, religion, caste, creed, state & nation but work for money ONLY.

One Branded nasal drop that cost Rs.65/- now same salt medicine cost Rs.20/- at Jan Aushadhi Kendra and it' as good as branded.
Acidity Capsule cost Rs.150/- same salt medicine cost Rs.25/- at Jan Aushadhi Kendra and it' as good as branded.

API issue in past also happens with Top Branded medicines (OG also) read here

that's why buy minimum and use, if works buy as pre prescription if not than buy other brand but same salt.
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Name of the salt is same, quality of the salt is questionable.
In healthy people most of the times problems resolve themselves or even 50% efficacy is enough.
 
Party Monger said:
even 50% efficacy is enough.
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Dude, pleeeeeease. No. Not enough. There's a reason we do 4 phases of human studies after animal trials. Phase 1 and 2 will look at dose ranging, efficacy and safety signals (pertaining to planned dose) before going to RCTs for phase 3.
If someone needs 40 mg of Olmesartan, 20 mg will not do. Their BP will not be controlled.
Please don't do this.
 
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