Govt must prescribe norms for strip cutting of medicines on emergency basis

The ethical fact is that strip cutting is not a desirable practice as that can lead to sale of expired drugs to gullible customers. This could even prove fatal. Given that a sizeable percentage of the country’s population is illiterate, strip cutting can actually help unethical practices to flourish

For lakhs of retail pharmacists in the country, strip cutting of medicines has been a major issue for a long time now. Arguments and counter-arguments have been flying thick and fast and against the practice of cutting of strips by pharmacists. In fact, there is still a lot of confusion on the issue in the pharmacist community and also regulatory officials as there is no clear-cut provisions in the Drugs and Cosmetics Act whether strip cutting is allowed or not.

This has resulted in regulatory officials taking different views on the matter. While some regulatory authorities are of the view that strips must be cut if a patient desires, or the doctor prescribes so, pharmacists argue that Rule 65 of Drugs and Cosmetics Act being quoted by the drug authorities to mandate strip cutting is irrelevant today as it was formulated much before strips actually came into existence in the country. Pharmacists contend that this one issue that is beyond the understanding of the lawmakers, FDA officials, pharmaceutical industry and even doctors. It is finally the customers and the retailers, who have to face the brunt of losses andthe risk of selling and consuming medicines after their expiry date leading to conflicts with each other. It is sure that while cutting a long strip to dispense six or seven pills to a patient, the packet will lose its batch number, MRP, expiry date and formulations. Strips without these pieces of information on the label cannot be sold and consequently the retailers have to bear the loss. Moreover, such dateless medicines will not be taken back by the manufacturers, resulting in a huge loss to traders.

It is a fact that almost every day, one or the other product strip size is increased or changed by the manufacturers, including the reputed ones. From 6 to 10 to 15 to 30, some strip sizes are now of 30, 40 & even 50. Increasing the size of strips is actually a new business strategy being adopted by the pharma manufacturers as it fetches more profits.

For instance, until a few months ago a strip of ‘Telma-H’, a combination drug of telmisartan and hydrochlorothiazide for treating blood pressure, manufactured by Glenmark Pharmaceuticals, used to have 10 pills. Today, each strip has 30 tablets. Ranitidine-150, a drug to treat stomach problems, manufactured by the Indian MNC Torrent Pharma, now comes in strips of 40 as against the earlier packet containing 10 pills. This is used rarely and a minimum of five or seven are only prescribed by doctors. The strip of Warf- 3, a drug by Cipla to prevent formation of harmful blood clots in the legs, lungs, brain and heart, contains 30 tablets. The drug was available in the market in small strips of 10 pills a few months ago. USV product, Roseday- 5, a statin family drug used to lower cholesterol was available in a strip of 10 pills, but now it comes in larger packets with 15 and 30 tablets.

Irrespective of the stand taken by the stakeholders, the ethical fact is that strip cutting is not a desirable practice as that can lead to sale of expired drugs to gullible customers. This could even prove fatal. Given that a sizeable percentage of the country’s population is illiterate, strip cutting can actually help unethical practices to flourish. It is obvious that when the strips are cut, the cut portion of the drug may not contain the details about expiry and manufacturing dates, batch number and even the name of the drug.

Such huge sizes of strips can certainly create a chaotic situation. This increases the likelihood of cutting a strip. Otherwise, the consumers will have to shell out money for the entire strip which is not actually needed. Certainly, it is an unnecessary financial burden on the consumers.

The situation now calls for rationalization of strip sizes based on their therapeutic value, dosing and cost of the drug. It is a sensitive issue that needs deeper probe, analysis and a neutral attitude.

It is time drug authorities take a final call on this issue by amending the law suitably as there is no clear-cut provision in the Drugs and Cosmetics Act regarding strip cutting of medicines and their sizes.