I refer to the letter to Editor by W. Ariyasinghe (W.A.) which appeared in your esteemed journal on 7th January 2008. As W. A. had mentioned in his article, all three of us, D. P. Athukorale (D.P.A.) Prof. Carlo Fonseka (C.F.) and Prof. Sanath Lamabadusuriya (S.L.) are physicians which means that we are medical doctors; out of the three of us S. L. and myself (DPA), are practising consultants, whereas C.F. is a very well known senior physiologist and has been teaching physiology (scientific study of normal function of living things), to medical students. As far as I am aware, he has not been practising as a clinician and has hardly any experience in treating patients. Although he has been advising the practising doctors and the Ministry of Health Care and Nutrition on Pharmacology (scientific study of drugs and their use in medicine), he has no specialised knowledge in Pharmacology. He is also not a member of the Sri Lanka Drug Regulatory Authority (DRA) as is the case of DPA and S.L. who have served in the DRA for quite some time.

Professor Sanath Lamabadusuriya (S.L.), is a well known and very popular paediatrician with vast experience in treating children. In my case, I am a senior consultant cardiologist with 43 years of clinical experience, out of which I have been working as a cardiologist in the Institute of Cardiology, National Hospital Colombo for 23 years and I have saved thousands of dying heart patients.

Eric J de Silva and Dr. Mahinda de Silva have already given the most illuminating accounts of generic drugs and brand name drugs and I am sure that W. A. who appears to be a regular reader of ‘The Island’ must have already read their articles which give the answer to W.A.’s questions.

For all practical purposes, almost all the drugs used in our government and private hospitals and the majority of drugs (over 95 percent), sold in our pharmacies (both private pharmacies and at SPC) are branded drugs.

There are only a very few pure generics (less than 100), sold in our pharmacies and some of these are manufactured by the SPC and some are not very effective.

There are over 3000 branded drugs sold at our pharmacies. There are three types of brand drugs.

The majority of the drugs available in our government hospitals are very cheap brand drugs. When we doctors refer to SPC drugs, what we mean are generic drugs plus cheap brand drugs. Cheap brand drugs are usually imported from countries such as India, Pakistan, Cyprus, Bangladesh and Thailand, and some of them are of very low quality and some are not effective. Sri Lanka does not have sufficient facilities to test the quality of most of these branded drugs at present.

I have written an article on 15th November 2007, and another on 1st January 2008, giving my clinical experience and the experience of other physicians as to how (a) generic antiepileptic drugs (b) generic insulin (c) saline (d) generic amoxcillin and (e) generic vitamin A capsules imported by SPC had to be destroyed as the above generic drugs did not have any effect on the ailments for which these were imported. In my November 15th article, I have given my personal experience about the SPC drugs (i.e. cheap brands and generic). A very well known non-practising physiologist, who is said to be advising the Minister of Health Care and Nutrition, has criticised me for writing the above two articles, although I have never criticised this professor in any of my articles.

These drugs are very effective in my personal experience and most of these branded drugs are imported from India, Pakistan and Cyprus. Most of the doctors doing practice, usually prescribe these slightly expensive brand drugs for patients in the private sector and thousands of patients get cured with these expensive brands drugs. Although an experienced physiologist who never treats patients always mentions in his articles that there is no difference between cheap generic and cheap branded generics, as compared to expensive branded generic drugs, my experiences is quite different.

One academic professor, who appears to have senile delusions has written to a news journal that when we doctors prescribe expensive drugs we receive part of the profits, from the drugs firms; There is no truth in his statement as far as I am aware and a significant number of my patients who have changed from expensive branded drugs to cheaper SPC drugs, after reading articles written by non-practising academics, NGO experts and politically motivated armchair doctors, have got into trouble and one of my neighbours living in Horton Place, whose very rich miserly husband bought very cheap SPC drugs, developed a heart attack and died about three months after taking cheap SPC drugs.

The very rich miserly husband, after a few months developed hypertension and depression and had visual and auditory hallucinations and died after a few months, following a stroke, all due to wrong advice given by academic doctors who advise ordinary patients to buy cheap generic drugs, but who always buy the most expensive drugs for themselves and their relatives.

These drugs are usually imported from developed countries such as the U.S.A, U.K., and France, and are very expensive and I usually don’t prescribe these expensive original brand drugs unless there is a life and death emergency. A few cases of these very expensive original branded drugs are Valium, Inderal, Augmentin Mevocor, Zocor, Zantac, Zestrl, ISMO, Capoten, Lopressor and Visken.

I am of the opinion that Health Ministry officials have been taken for a ride by the academic (non-practising) doctors, WHO experts and NGO doctors and other armchair doctors, who always quote Professor Senaka Bibile’s 40-year-old list of essential drugs.

It is advisable for Health Ministry officials to make arrangement to have discussions with the professional associations, such as Sri Lanka Medical Association, Ceylon College of Physicians, Paediatricians, Neurologists, Neurosurgeon Endocrinologists, Oncologists, Family Physicians, Obstetricians and all others concerned, and get their views and cooperation and take their advice regarding practical problems faced by them when they prescribe generic and brand drugs.

WA: You must always follow the advice of your family physician who knows everything about your past illness and whom you can contact in an emergency, unlike academic professors and NGO experts who wont help you in a medical emergency. Never change your drugs (to generic or cheap branded drugs) on the advice of politically motivated non-practising armchair doctors and other theoreticians.