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Generic medicines and the part they play – an interview with Medkart Pharmacy founder Ankur Agarwal

antibiotic. Pharmacy of the world concept. Generic medicines concept.
Image credit: Alexander Raths / 123rf

Generic medicines are a core component of India’s reputation as the so-called ‘pharmacy of the world.’

The country has long been-renowned for its exports of affordable medicines to developing nations. As previously reported by Health Issues India, “generic medicines cost a fraction of the monopoly prices charged in countries like the United States, and competition among Indian manufacturers has reduced the price of cancer and HIV treatment by as much as 90 to 1000 percent. For example, first line HIV treatment that costs over USD24000 annually to treat just one patient in the US, costs the Indian AIDS programme approximately USD 100 per patient.”

Not only are generic medicines a boon for those abroad, they also have a positive domestic impact. The Centre has acknowledged this, with initiatives such as the Pradhan Mantri Bhartiya Jan Aushadhi Pari Yojana Kendra (PMBJPK) which seeks to dispense generic medicines via sales through dedicated Jan Aushadhi kendras with the aim of making high-quality generic medicines affordable to consumers. Nonetheless, generic medicines are not free from controversy — including as it pertains to consumer confidence.

To discuss these issues, Health Issues India talked to Ankur Agarwal, the founder of Medkart Pharmacy. Our conversation can be read below.

Access to affordable healthcare is an issue in India — why is this the case and why are generic medicines part of the solution?

In any medicine, there is no pre-decided or government-approved profit margin on top of the manufacturing cost. The manufacturing cost is almost the same for the medicine marketed by different companies, but the retail companies add their profit according to their brand name.

Medicines should be available to everyone at an affordable price as they are a necessity and not a luxury. Hence, it should be sold as a necessary commodity that is affordable. Generic medicines are of the same composition and in some cases even better than the branded medicines but are available at an affordable price. Access to affordable healthcare can be possible by promoting generic medicines which are WHO GMP approved and hence are of good quality.

What is the role of Medkart Pharmacy in addressing these issues?

Medkart plays a role in providing affordable healthcare. The doctors may not prescribe a certain molecule or composition as they may not be aware of the quality of generic medicine and hence might not be comfortable about it. As Medkart deals in WHO GMP quality approved medicines only, it is our responsibility to spread awareness among the doctors and patients that the best generic medicines are being sold by us which have the same ingredients as the branded medicines. We have successfully addressed this to more than 2,000 doctors. It is very important to educate patients about generic medicines being equally effective as the branded alternatives.

You note that “recent studies have concluded that about 36 percent of people never receive a bill from chemists. 32 percent believe medicines are dispensed by unqualified pharmacists. 63 percent don’t receive proper counselling of medicine dosage at the chemist. 48% report multiple visits to pharmacies to procure all medicines. Although 68 percent of people personally visit the physical medical stores, they seem to be unsatisfied with the services at the counter.” How are you working to address this?

In India, there are around 1000 types of Molecule compositions that lead to various sets of medicines. These molecules correspond to around 50,000 brands. A normal chemist wouldn’t keep a track of all these brand’s compositions which is also practically not possible.

At Medkart, to simplify things, we do not talk about 50,000 brands but understand the 1,000 molecule composition and educate the pharmacist about it. This will lead to better counselling and dispensing of medicines and their dosages. Also at Medkart, every order is sent with the bill on their respective phone as well as the paper form.

Are there issues with consumer confidence when it comes to generic medicines and, if so, how do we address such issues?

The main issue/obstacle faced in acceptance of generic medicine is that they are perceived as medicines for the poor as they are cheap. A greater mass carries this notion that cheap medicines are not efficient or appropriate. To gain/win trust on this end we need to provide them with generic alternatives from the trusted manufacturers like Cipla, Abbot, etc as these brands carry a sense of trust with them.

Next, we need to assure consumers about the quality factor, that we as a brand only

keep medicines that are WHO-GMP approved. Also, the packaging, the touch and feel of generic medicines play a major part in initiating trust in the consumer’s mindscape and WHO-GMP approved medicines take care of this factor very well.

At Medkart Pharmacy, our main and continuous effort is to work towards educating the customer to drive acceptance of generic medicines by the critical mass and making them more aware of it.

About Medkart Pharmacy

Starting 28th September, 2014 we embarked on a journey to make medicines affordable or rather affordable medicines available to the patients. It was painstakingly slow as people came in confused as to what we meant by it. For some it was too good to be true, for some it was going against the doctor himself but for a vast majority it was beyond comprehension.

Hence, we began by educating people about generics. This is where Satyamev Jayate was a pioneer but now I see that we need more efforts and examples to ensure that this message goes through to the general public.

We realised that it was not the lower class but the middle and upper middle class who trusted, understood and correspondingly accepted the facts and started switching to generics. Thereafter followed the second wave of response wherein those who benefited from our efforts started talking about it. People came back with friends, relatives, servants, helpers and many more to show them practically and finally convince them to switch. Believe me when I say, that, for a good number of them it was either medicines or square meal a day for the family and it was this person who blessed us the most.

Slowly but steadily the word started getting around and we were humbled by the response

and supported by them to take it ahead. During this there was a time when the entire community of pharmacies was against us as we challenged the very basics of this business and we were pushed from pillar to post, some even threatening our very existence. We came across some doctors who visited us to understand and even buy their regular stock from us and others who wanted to understand how we were threatening their extra incomes. “Where there is a will, there is a way” and we were finding ways to counter the threats and support poured in from unexpected quarters, people who understood the cause came forward to help us to fight it out.

The biggest challenge we face today is to make the lowest strata convinced about generics which are at par or even better than their branded counterparts and yet a lot cheaper due to a simple reason i.e. it is this part which believes in God the most and considers the doctors at par with God. Hence, they go word by word according to the doctor. I hope we are able to do something about this and help them. As we stand here at the end of 45 months we are humbled by the fact that we have earned blessings from across which otherwise would have taken much more than a lifetime.

About Ankur Agarwal, Founder, Medkart Pharmacy

Ankur has worked in multiple business functionalities like product development, finance and accounts, marketing, distribution and organisation building etc as part of core management team in his 15+ years of professional experience. Before Medkart, Ankur worked with Endeavor at senior management level. He was involved in strategic decision making and played a pivotal role in building a solid foundation for the future growth of the company. During his time at Endeavor, the company scaled significantly and witnessed 5x growth in revenue.

Post his MBA he had a brief stint of working with Reckitt Benckiser where he was responsible to wards development of new products and market. He is an engineer from NIT Kurukshetra and did his MBA from IIM Lucknow.

Ankur started Medkart in 2014 with a simple objective of providing quality generic medicines to people at large by educating them about generics in an industry where no one knew the truth about it and in the process save money. As India ages and chronic diseases increase there are more and more people who will need medication at a juncture in life when the incomes dry up. The reason for education and adoption of generic medicines becomes more obvious than ever.

We believe in the AAA philosophy

  • If there is no awareness then no one will ask about generics, hence we need to make then aware or in simple words educate. We have to be clear that no one in the industry or outside in educating the patient even remotely about generic medicines. Making the customer know the truth in entirety is important. In our dipstick we realized that even doctors do not know the truth about generic medicines
  • Second one is availability: if there is no availability or the patient/customer does not know where to go then there is a problem of closing the loop
  • Last one is acceptance with awareness and availability the customer is able to touch feel and understand the product better and gain confidence which will lead to the acceptance

The development of the philosophy along with making the working of the entire thing smooth in order to ensure best customer service took time and lot of effort. The first 3 years were slow and tedious to shape the building blocks with only 6 stores. The next 3 years saw the bigger growth to 50 stores and a much wider scale and acceptance.

In future we wish to make Medkart a one stop solution for different medical needs of the patients, from medicines to other allied services which are required from time to time. I strongly believe that medicine and health is a need/ necessity and not a luxury. Having profiteering in this segment is not in the overall interest of a humane society. We strive to make sure that we are making a difference

in the lives of people by removing the barriers and easing accessibility. In our endeavor to make quality assurance in generics a basic necessity we have started a process of testing the generics in an NABL-accredited lab before it gets to the customer. We have reached a benchmark of testing 60% of the medicines sold at Medkart being tested and approved by an external authority.

The Franchise model is to spread to more geographies where it is not possible for the company to be present directly. We look forward to allowing every nook and corner of Gujarat to have access to quality generic medicines.

Discover more about Medkart Pharmacy here.

The views expressed above are those of the interviewee and do not necessarily reflect those of the Health Issues India editorial board, nor its publisher.

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