The Indian pharmaceutical industry has earned global accolades and earned the title ‘world’s pharmacy’. The level and variety of medicines manufactured in India is staggering. Ironically though, India does not have a unified, standard, and retrievable system to monitor drugs in circulation. This is not merely a textbook problem or an IT service opportunity. This is a void in India’s healthcare system. This void is capable of disrupting patient safety, public health policy, and the myriads of digital healthcare services invested in the country. The root cause of the problem is the fragmented Drug Formulary we have or rather, the one we don’t have. There are thousands of real-time ancillary data, but we are in dire need of a consolidated Drug Database to facilitate quick, lifesaving decisions.
The Sheer Scale of India’s Pharmaceutical Data Chaos
The first thing to do before diving headlong into a problem is to understand the scale of the problem. There are more than 60,000 branded formulations in the Indian market, each one more complex than the last. This is a problem that has multitudes of layers to it. This level of complexity is attributed to matter of culture that is not witnessed elsewhere.
The “One Molecule, Many Names” Phenomenon
Compared to the West, the Indian market is zenith in branded generics. The active ingredient Atorvastatin can be branded under several hundred companies each with multiple SKUs.
In the context of a physician constructing a prescription, a pharmacist in charge of stock, or a customer looking for a generic, this situation is greatly perplexing. ‘Brand X’ can be replaced with ‘Brand Y’ without any problem. Are the drugs therapeutically interchangeable with respect to the register of the stock of a hospital? In the absence of a comprehensive Medicine Index that intelligently consolidates these products, often the response is “no.” The absence of standardization is the source of duplication and erroneous data.
A Fragmented Regulatory and Data Landscape
While the boundaries of our country are still filled with the prevailing, unfading light of civilization, its regulatory framework is a patchwork quilt. The Central Drugs Standard Control Organization (CDSCO) is responsible for approving new drugs, but the primary administrative authorities at other levels territory control the licenses for manufacturing and sales. To the already perplexing licensing controls, one must add the National Pharmaceutical Pricing Authority (NPPA) which controls the prices of vital drugs.
The end result is that the is that the drug data is locked away in silos. There are New Product Approvals (NPAs), pricing changes, batch recalls, and new guideline releases for manufacturing that are separately stored in silos. Many times, these silos are incompatible. For any one stakeholder which might be a List of Medicines that is usable, the chronic effort is Herculean for a hospital or even a national e-pharmacy.
Who Suffers the Consequences? The Impact of a Poorly Constructed Drug Index
The data gap is not an abstract issue. There are real-life implications for all the participants in the healthcare system.
For Patients & Clinicians: The Cost of an Elevated Risk
The most serious impact is for the patients. Whenever a physician is using an e-prescribing system, they always rely on the underlying drug database. But if this database is not accurate or complete, doctors may:
- Prescribe an inappropriate drug that may have serious interactions with other medicines the patient is taking.
- Fail to recognise a new, and hopefully better, effective and cost affordable alternative drug that is a generic.
- Prescribe the wrong dose or even formulation with serious adverse effects.
For pharmacists, the level of uncertainty that is created in the e-prescriptions as a result of the drug formulary failing to meet standardization leads to avoidable “call backs” to the physician that waste time and delays patient treatment.
For Public Health & Policy: No Compass, No Direction
For instance, consider if you had to deal with a health crisis in a a different country, but you had no idea whatsoever about the location of health concerns, medical personal or health equipment. For a certain group of people, a disjointed system of drug data renders them as though they had no clue about the matter at hand.
- Pharmacovigilance: How can we effectively track adverse drug reactions (ADRs) nationwide if we can’t even standardize the name of the drug being reported?
- Supply Chain Management: Deficiencies in essential medicines is more of an after the fact descriptive analysis instead of a proactive, data-oriented approach.
- Consumption Patterns: There is no single repository of data that can be relied upon for tracking to help find the patterns of antibiotic misuse and over prescription to help researchers.
For Healthcare Tech: The First Step to the Road Block to Growth
The digital health industry in India is at an all-time high. There is considerable investment being channelled to e-pharmacies, telemedicine, and HMS. All of these platforms face the same issue: the absence of a drug database that is reliable, comprehensive and up-to-date.
To create this in house is where many start-ups venture in with a naive mindset. Within a blink of an eye, they realize on the painstaking task of coming up with an entire herbal information (List of Medicines) containing 6 lakh SKUs with the proper medicines, the company that made the products, the package sizes, the price in real time, ultra clear images, and compositions which is difficult. This is wherein a sophisticated, specialized drug formulary provider becomes mission critical. Entities such as Data Requisite have emerged to address this highly specialized niche: they provide the structured and clean data that enables tech innovators to devote their time on what they do best – developing solutions that interact directly with patients.
Constructing The Bridge: The Pillars of Modern-Day Indian Drug Formulary.
The Bridge between Pie Data and Executable Decisions based on Actionable Intelligence is a shift from a single column to a smart ecosystem which Multimodal Approach.
1. The First Principle of The Multimodal Approach is Standardization, which is The Construction of the “Common Tongue”.
The first order of business is to develop a “Rosetta Stone” for Indian medicines. In order to achieve this goal, we must have a “uniform” system – that is, a system that has a single, distinct identifier for each and every SKU that is in existence in the Indian subcontinent. This identifier must be able to associate (i.e. the same) the brand name with the active ingredients (composition), strength, manufacturer, pack size, and therapeutic category. This interoperability is the “structured data” that is the basis of the foundational constituent which permits a hospital system to communicate with a pharmacy system and a regulatory bank.
2. Centralization & Accessibility: The “Single Source of Truth”
Wel, it would be rather ideal to create a master Medicine Index that allows for a single source of truth for all data, rather than having a stagnant and underutilized list. It cannot be a single static Excel file that is updated once annually. It must be a cloud-hosted, dynamic, living resource. Furthermore, it must be updated and made accessible via APIs, or Application Programming Interfaces, to all authorized users.
For instance, a software used for a remote clinic, or a national e-pharmacy, should be able to pull drug data dynamically and in real time. Full integration capability spanning across 6.1 lakh digital products, or e-pharmacy platforms for that matter, is also a crucial contributor. This is the exact type of problem that expert providers like Data Requisite aim to solve, based on years of experience in the field.
3. Dynamic Maintenance: The Database Must be Alive
You cannot argue that a drug formulary is a product. Rather, it is a productive form of venture that generates revenue. The Indian pharmaceutical market sees hundreds of new product launches, MRP revisions, and product packaging changes every month.
Strengthened connectivity, with a high-speed modern data base must be alive, with a team of pharmacists and data experts that are always in motion. This team also includes one that focuses on curation, and researching product images. High resolution images of products is crucial for e pharmacies to help users build trust and ensure correct order fulfilment.
The Future: Intelligent Ecosystem from a Fragmented List
Clearing up the drug formulary spreadsheet is simply one of the many requirements for next generation healthcare advancement.
An intelligent drug database would enable the development of:
- AI-Driven Clinical Support which would automate the identification of drug interactions and treatment options based on a patient’s history with the providers.
- Predictive Supply Chains which would forecast critical drug shortages through the analysis of real-time dispensary data from across the country.
- Personalized Medicine which would finally correlate drug formulations and genomics data for individualized treatment.
This is future healthcare and depends on a solid foundation of data. The lack of integration is one of the internal obstacles of Indian healthcare. It needs a partnership between regulators, technology-based organizations, and focused data frame companies. Data Requisite is one of the companies trying to solve this gap. It is not simply selling a List of Medicines, but offering the healthcare of country foundation based on safety, efficiency, and intelligent technology.
Also Read: Why Your E-Prescription Software is Incomplete Without a Centralized Drug Database
