Schedule HX is not patient–friendly

The recent move on the part of the Union Health Ministry to amend the Drugs and Cosmetic Rules 1945 through Schedule HX is creating a stir among chemists and pharmacists, who are opposed to it. Even for the medical profession, this amendment is not patient–friendly.

Under the Schedule HX, the drugs for TB (Rifampicin, Isoniazid and Pyrazinamide), Ciprofloxacin and Norfloxacin (for Diarrhea) and Framycetin (for burns) would no longer be as easily available as they are today.

The Schedule HX has Part A and Part B. And, according to it, 16 antibiotics in Part A would be sold directly by drug manufacturers to the tertiary care hospitals, and 74 drugs in Part B can be sold by the chemist only on the prescription of Registered Medical Practitioners in duplicate. The extra copy of the prescription would be kept with the chemist for a further 2 years.

The schedule talks about the need to have tertiary hospitals, registered medical practitioners and prescriptions in duplicate for the drugs in Schedule HX.

There are no tertiary hospitals in the rural areas.

Newer antibiotics are very costly and if they can only be prescribed in a tertiary care hospital, will people be able to afford these hospitals?

ICU care in a tertiary hospital may cost 30-50,000 per day.

Today many chemists offer hefty discounts on branded drugs as they play with margins of up to 40%. No tertiary care hospital will pass on this discount to the patient.

A patient may have to be given antibiotic for weeks and most of this period may be ambulatory at home through a private nurse. Will the prescription be allowed from a tertiary care hospital pharmacy as an outpatient?

Patients requiring these drugs invariably will be required to be transferred to a tertiary care hospital for the treatment. This may not be in the interest of the patient and the treating doctor.