UNHEALTHY RELATIONSHIP

Law to stop rogue doctors, drugs makers exploiting patients

Ndhiwa MP Martin Owino says overprescription is driven by greed and has put patients on unnecessary drugs and financial burden

In Summary

• Kessess MP Dr Swarup Mishra said it was common for doctors to prescribe multiple drugs, while cheaper combinations are available.

• We have seen doctors prescribing what they were told last night by pharmaceutical sales reps. These products may not even be available at Kemsa

Dr Jonah Manjari, CEO of the Kenya Medical Supplies Authority.
CONCERNED: Dr Jonah Manjari, CEO of the Kenya Medical Supplies Authority.

MPs have called for regulations to control drug prescriptions in Kenya. 

They noted that currently, doctors have a free-hand in dictating which drugs patients should take. 

The lawmakers said there is a growing problem of overprescription, driven by collusion between doctors and drug manufacturers. 

The MPs made the proposal after the Kenya Medical Supplies Authority complained some public facilities and counties were requesting, under emergency, unnecessary and expensive drugs where cheaper substitutes are available. 

"Overprescription is driven by greed and that has put patients on unnecessary drugs and financial burden," said Ndhiwa MP Martin Owino, a member of the Health Committee. 

Owino called for a review of Acts and regulations that guide prescriptions in Kenya.

Kesses legislator Dr Swarup Mishra admitted it was common for doctors to prescribe multiple drugs, while cheaper combinations are available.

The committee urged the ministry of health to develop regulations to guide how drugs are prescribed. 

Kemsa CEO Jonah Manjari complained that many Kenyans are taking unnecessary medicines.

"We have seen doctors prescribing what they were told last night by pharmaceutical sales reps. These products may not even be available at Kemsa," he said. 

"We need to standardise drugs prescriptions in this country," he told the MPs during the committee sitting in Nairobi. 

Manjari called for guidelines where medics are not allowed to prescribe certain drugs depending on their professional level.

"An intern should have a different prescription book, a medical officer, a different book, a consultant and a professor should also have a different book," he said. 

Some countries such as South Africa have laws guiding drug prescriptions.

While professional pharmacists should approve a prescription before a drug is dispensed, this hardly ever happens in many hospitals. 

Although Kenya has an essential drugs list as recommended by the World Health Organization, prescribers have the freedom to give patients different medications. 

The WHO says there is no global standard for prescriptions and every country should have its own regulations. 

The WHO also warns that African countries face a growing problem of polypharmacy, where patients are prescribed too many unnecessary drugs.

The organisation says whenever a patient exceeds five daily drugs, that prescription must be evaluated by a qualified pharmacist.

"Adverse events (from drugs) are now estimated to be the 14th leading cause of morbidity and mortality in the world, putting patient harm in the same league as tuberculosis and malaria," says the WHO in its 'Medication Safety in Polypharmacy 2019' report.

A 2016 study by the University of London showed over a third of all medicines in Kenya are prescribed, dispensed or sold inappropriately, with many of them harming patients.

Pharmaceutical Society of Kenya President Dr Louis Machogu says Kenya lacks national guidelines on drugs prescriptions. 

"Without a medication use history done by a professional pharmacist, patients may end up with complications like failing kidneys, failing heart or coma, from simple errors like medication refill," he says.