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The role of physicians in prescribing irrational fixed-dose combination medicines in India

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  • Bhaskarabhatla, Ajay
  • Chatterjee, Chirantan

Abstract

Many irrational fixed-dose combination (FDC) medicines have been approved by the state and central regulatory authorities in India and their use is promoted extensively by pharmaceutical firms. In this study, we examine the previously-neglected role of physicians in India, as their prescriptions are essential for the continued proliferation of FDCs. Primarily using longitudinal data on prescriptions by 4600 physicians spanning 19 disciplinary categories for 48 months between 2008 and 2011 provided by IMS Medical Audit, we study 201 medicines in the cardiovascular and oral-antidiabetic markets. We find that 129.6 million (8.1%) prescriptions for irrational FDCs were written by the sample of physicians in India during the study period, half of which were written by cardiologists and consulting physicians. A further analysis of the regional markets reveals that cardiologists prescribe more irrational FDCs in the richer, metropolitan cities of western India. We also document the role of medical practitioners without an undergraduate degree in medicine in generating prescriptions for irrational FDCs. Our results suggest that an effective government strategy to curb irrational FDCs must recognize that spreading greater awareness about the perils of irrational FDCs is at best an incomplete solution to the problem in India as many who prescribe them are specialists. Organizations such as the Indian Medical Association must develop clear guidelines to stop prescribing such FDCs.

Suggested Citation

  • Bhaskarabhatla, Ajay & Chatterjee, Chirantan, 2017. "The role of physicians in prescribing irrational fixed-dose combination medicines in India," Social Science & Medicine, Elsevier, vol. 174(C), pages 179-187.
    • Handle: RePEc:eee:socmed:v:174:y:2017:i:c:p:179-187
    DOI: 10.1016/j.socscimed.2016.12.022
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    References listed on IDEAS

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    1. Chatterjee, Chirantan & Kubo, Kensuke & Pingali, Viswanath, 2015. "The consumer welfare implications of governmental policies and firm strategy in markets for medicines," Journal of Health Economics, Elsevier, vol. 44(C), pages 255-273.
    2. Richard Schmalensee, 1978. "Entry Deterrence in the Ready-to-Eat Breakfast Cereal Industry," Bell Journal of Economics, The RAND Corporation, vol. 9(2), pages 305-327, Autumn.
    3. Roger Bate & Ginger Zhe Jin & Aparna Mathur, 2012. "Counterfeit or Substandard? Assessing Price and Non-Price Signals of Drug Quality," NBER Working Papers 18073, National Bureau of Economic Research, Inc.
    4. Rao, Krishna D. & Sundararaman, T. & Bhatnagar, Aarushi & Gupta, Garima & Kokho, Puni & Jain, Kamlesh, 2013. "Which doctor for primary health care? Quality of care and non-physician clinicians in India," Social Science & Medicine, Elsevier, vol. 84(C), pages 30-34.
    5. Antara Dutta, 2011. "From Free Entry to Patent Protection: Welfare Implications for the Indian Pharmaceutical Industry," The Review of Economics and Statistics, MIT Press, vol. 93(1), pages 160-178, February.
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    Cited by:

    1. Arzi Adbi & Ajay Bhaskarabhatla & Chirantan Chatterjee, 2020. "Stakeholder Orientation and Market Impact: Evidence from India," Journal of Business Ethics, Springer, vol. 161(2), pages 479-496, January.
    2. Ajay Bhaskarabhatla & Priyatam Anurag & Chirantan Chatterjee & Enrico Pennings, 2021. "How Does Regulation Impact Strategic Repositioning by Firms Across Submarkets? Evidence from the Indian Pharmaceutical Industry," Strategy Science, INFORMS, vol. 6(3), pages 209-227, September.
    3. Mayank Aggarwal & Anindya S. Chakrabarti & Chirantan Chatterjee, 2023. "Movies, stigma and choice: Evidence from the pharmaceutical industry," Health Economics, John Wiley & Sons, Ltd., vol. 32(5), pages 1019-1039, May.
    4. Chatterjee, Chirantan & Mohapatra, Debi Prasad & Estay, Manuel, 2019. "From courts to markets: New evidence on enforcement of pharmaceutical bans in India," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.
    5. Aggarwal, Mayank & Chakrabarti, Anindya S. & Chatterjee, Chirantan & Higgins, Matthew J., 2023. "Research and market structure: Evidence from an antibiotic-resistant pathogenic outbreak," Research Policy, Elsevier, vol. 52(1).

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