Implementation of PPR Act key for improving standards of pharmacy profession in India

In the international level, the duty of a pharmacist is fast evolving from a mere dispenser of medicines in a retail medical store to checking drug dosage, drug-drug interactions, drug- allergy interactions, drug food interactions, patient counselling, etc.

Pharmacists of today are expected to interact with patients, doctors and nurses in a collaborative model as is the case with the developed countries. But in India, the pharmacist community has not yet received the kind of status and respect which actually they deserve. The pharmacists are mostly seen by the people in India as salesmen handing over medicines at the retail shops prescribed by doctors. But, the fact is that there is a paradigm shift that is happening in the duties of a pharmacist in the entire world. And India is no exception.

It was especially manifest in the times of Covid-19 pandemic. Braving all the risks associated with this highly infectious disease, the pharmacist community has also done a yeoman's service to the Covid-19 patients across the country. The focus of pharmacy practice in developed countries has shifted from product centric to patient centric with the implementation of modified pharmacy practice regulations favouring patient safety. But in India, it is a fact that a significant number of retail stores are still being operated by non-pharmacists who rent pharmacy diplomas and degrees from graduates in this discipline.

It was under this background, the Pharmacy Practice Regulations (PPR) was notified by the central government in January 2015, to curb the malpractices prevailing in the lakhs of drug stores and thereby enhancing the status and practice of pharmacy profession in the country. Till then, the pharmacy profession was regulated by two statutes namely the Pharmacy Act and the Drugs & Cosmetics Act. The intention of PPR-2015 was to lay down a uniform code of pharmacy ethics, responsibilities of pharmacists towards patients, role of a community pharmacist, etc. Another key provision in the PPR was to empower the state pharmacy councils to appoint pharmacy inspectors in all the districts of every state in the country.

As per the provisions of PPR, pharmacy inspectors are authorized to inspect the retail outlets for checking whether medicines are dispensed by a qualified pharmacist. Currently, drug inspectors of the state drug control departments are conducting such inspections at the retail outlets. But the inspections of pharmacy outlets, especially in rural areas, by the drug inspectors have been far and few between, thanks to the perennial issue of shortage of manpower in the state drug control departments.

In such a situation, appointment of pharmacy inspectors as laid down in the PPR would have gone a long way to ensure that only qualified pharmacists dispense medicines in all the retail outlets. In a country where certificate-lending is rampant, the appointment of pharmacy inspectors in every district as laid down in the PPR would have played a key role in removing this corrupt practice across the country.

Undoubtedly, the PPR-2015 was aimed at regulating and enhancing the status and practice of pharmacy profession in the country. And the implementation of the PPR-2015, up to an extent, could have been a solution to the issues facing the profession and practice of pharmacy in the country. But it is a sad commentary that these regulations remained largely unimplemented in several states even after 7 years of its notification, mainly because of the absence of support from the state governments. After six years, the Pharmacy Council of India (PCI) had amended the PPR-2015 for incorporating the details such as qualification, duties and responsibilities of a clinical pharmacist. In the amendment, the PCI created Drug Information Centres (DIC) in all the hospitals and all hospitals should have DIC headed by a drug information officer (DIO).

The DIC should provide information and advice regarding drug interactions, side effects, dosage and proper medication storage to patients, physicians, dentists and other healthcare professionals. What was more important was that both these posts have been reserved for Pharm D graduates only. With this amendment, the role of a clinical pharmacist in healthcare settings was well defined and would have definitely opened up opportunities for Pharm D graduates in the hospital settings as clinical pharmacists.

As the implementations has been far and few between, Pharm D graduates and other pharmacy professionals from across the country have recently sought Prime Minister Narendra Modi's intervention for implementation of PPR-2015 and its amendment in 2021 without further delay. Obviously, PPR-2015 was framed with the intention of uplifting the status of the pharmacy profession and thereby achieving the goal of patient care. The government should not waste further time in implementing this law in letter and spirit.

(The author is freelance journalist with varied experience in different fields)