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Creating super drug addicts through supermarkets – News Healthcare

By Dr. Rajendra Pratap Gupta

The decision of the government to allow supermarkets and grocery stores to sell medicines (over-the-counter) is one of the worst things not just for the retail sector but for the consumers. India, so far, has no definite list under the OTC Category, and CDSCO has accepted that all drugs outside of prescription drugs fall into the OTC category. 

Over-the-counter medications constitute over 15 % of the country’s retail sales for chemists and druggists (pharmacy stores), which number between 700,000 to 1,000,000. As a result, a couple of things will happen- Customers will start buying over-the-counter medications like fever and pain relief, cold and cough, and other acute indications from supermarkets and
groceries. A week back, Nimesulide, which was once freely available as a painkiller, was reported as causing Adverse Drug Reactions, and an alert was issued by the Pharma standards body Indian Pharmacopoeia Commission (IPC). If it had been sold in grocery stores instead of pharmacies, the consequences would have been even more severe, as anyone could
purchase it from a grocery store.

I recall my early days of working in the field when the sales of leading cough syrups (mostly used as a substitute by addicts) were high even in summer and in border areas. When I used to enquire about this issue, I was informed by leading
distributors of pharma companies that neighbouring countries did not have that brand, or it was banned, so the people would cross the border and buy cough syrups. Imagine, if this started happening in grocery stores and supermarkets! Today, the reality of healthcare is that the first port of call for any general condition is a chemist; mostly, this is a qualified
pharmacist, as required by law, so the consumer may get advice from someone who studies pharmacology. Just imagine in the new scenario, the ‘salesman’ will advise, ‘This medicine sells the most,’ and the gullible customer will consume it. There will be more side effects and adverse OTC drug reactions than ever in history, and this will lead to unimaginable unhealthy
consequences for the commoner. 

A few weeks ago, we conducted a workshop on Antimicrobial Resistance (AMR), and a few issues emerged. Some chemists who require prescriptions for antibiotics are losing their business to those who sell antibiotics without prescriptions, which has become a common practice nowadays. Those adhering to good pharmacy practices expressed concerns about the
potential impact of this new rule, which may exacerbate the challenges faced by pharmacies, mainly due to the rise of online pharmacies.

Large corporate houses running grocery stores see an opportunity to add over-the-counter (OTC) medications to their product profiles. This move could substantially increase their sales and profits, leading them to develop in-house labels for OTC medications. From a business perspective, supermarkets and grocery stores will expand their operations, leading to
three significant downsides. Firstly, consumers will purchase medications from grocery stores for common ailments such as fever, earache, diarrhea, headache, cold and cough, and inflammation. The long-term impact of this trend is concerning; as consumers increasingly view medications as easily accessible commodities, they may misuse them, exacerbating the
issue of Antimicrobial Resistance (AMR). Akash Kumar, for example, may not differentiate between antipyretics and antibiotics, perceiving all medications as equal. Consequently, we anticipate a significant increase in AMR challenges over the next five years. Secondly, traditional chemists will become financially unsustainable as they face stiff competition from online stores. It is estimated that half of them will eventually close their doors, resulting in widespread job losses and the availability of medicines in local areas and rural markets.

Thirdly, large retail stores will begin selling medications under their private labels due to increased sales volumes from direct customer access. This trend may compromise the quality of over-the-counter (OTC) medications. Additionally, these stores may push for the inclusion of more medications under the OTC category, a strategy commonly employed by corporates.
Therefore, there is no rationale behind the government’s decision to permit the sale of chemist products through supermarkets and grocery stores. Whosoever has been involved in this decision has yet to learn about the ground realities,
consumer psyche, and the impact of such decisions on population health. This must be immediately reconsidered, and any such missteps should never be considered, let alone implemented. We should refrain from succumbing to the lobbying efforts by large corporate houses to undermine the importance of pharmacists in the system by allowing the sale of drugs online and over-the-counter (OTC) offline through grocery sources.

Online medication sales today are one of the biggest disasters; you can buy any medication without a prescription. We have tried this with one of the largest retailers and the biggest corporate house, where antibiotics were prescribed on a plain piece of paper with no doctor’s registration number, and yet they were dispensed. So, we need to strengthen the regulations rather than dilute them and support pharmacists rather than taking away their businesses and making them unviable. Today, pharmacists and pharmacies remain crucial pillars of primary care delivery. Every village may not have a
hospital or clinic, but it has a pharmacy, which serves as the first point of contact for most people for common ailments. Consumers rarely go to a doctor for pain, fever, cold & cough, or stomach ache but certainly goes to a pharmacy and ask the pharmacist for advice. Let’s remember the important role of pharmacists in the system. Let us not mix healthcare and
retail as one business and treat it as the same. Let us give it the seriousness that it deserves.

(The author is the founder of the International Patients’ Union & Health Parliament and is the former Advisor to the Union Health Minister. Views expressed are personal and do not reflect the official position or policy of the

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