The prescription audit is a quality assurance mechanism that aims to enhance patient care and outcomes through systematic analysis of care against explicit requirements and the implementation of change. It is a part of the holistic clinical audit. Prescription auditing is also an educational activity that, if performed on a regular basis, will help to improve prescription consistency, allowing patients to receive high-quality treatment. India’s drug price regulator, the National Pharmaceuticals Pricing Authority (NPPA), has agreed to perform a “prescription audit” to better understand how drug cocktails are used in the country. This is the third time in the last three months that the authority has expressed concern about the growing number approved of fixed-dose combination (FDC) medicines or drug cocktails in India.

In October, the NPPA raised concerns about drug cocktails in India citing “overmedication” as a possible threat as well as the possibility of “profiteering” by pharmaceutical firms. The authority noticed the pattern again in a meeting on December 23, saying it is “undesirable in the overall public interest and health.” The NPPA agreed to perform a “prescription audit” at its most recent meeting on January 27th of this year. According to the minutes of the meeting, which were recently posted on the NPPA website, “it was addressed and felt that conducting a ‘prescription audit’ may shed light on the prescription patterns of different drugs and their usage.”

Since 2016, the Modi government has approved over 2,100 FDCs out of 6,600 that were evaluated for efficacy. Many FDCs have been banned over the years due to concerns about their effectiveness. The NPPA expressed concern in October, after noticing a pattern of more FDCs being submitted for price fixation approvals, that “approval of these FDCs may undermine the logic in the use of the drugs and may lead to over-medication.”

What are drug cocktails?

Drug cocktails, both antibiotic and anti-cancer, are becoming more common because, among other things, targeting pathogenic cells with multiple methods at the same time decreases the risk of drug resistance. Doctors and pharmaceutical firms are also involved in the advancement of drug “mixology” because it can aid in the development of innovative applications for existing medications, which are expensive to produce and take a long time to enter the market. However, combining drugs does not always result in the number of their results. For instance, one drug can alert mechanisms in a cell that pump the other drugs out of the cell, thus changing the dose at which the other drugs will be effective. Conversely, side effects can add up, so researchers often want to identify the lowest possible dose of any given drug.