00:00Joining me on this broadcast is Dr. Vishal Rao, an oncologist at the HCG Cancer Centre based in Bengaluru.
00:07So you can imagine really how doctors too in the city are feeling about what's happening.
00:11Seeing these details, Dr. Rao, emerge now of a racket in which so many of these hospitals were supplied with
00:17fake drugs.
00:18As an oncologist, as someone who treats these cancer patients, your first reaction?
00:25Namaste. I think what has come to light is something very alarming, very disturbing, and I'm sure this must be
00:35something that should be immediately curbed and something where strict enforcement should take precedence.
00:44I personally feel this is something which is such a deep-rooted racket which needs to be, we need to
00:53go to the depth of this investigation because from the manufacturer to the distributor to the retailer or a hospital,
01:01I think somewhere a complete chain of trust has been broken, a chain of regulatory structure has been broken, and
01:13even a complete chain of structured protocols have been broken.
01:18How could some, from the manufacturing unit to logistics, to distributors, how is it that it's possible that the batches
01:31and the vials completely change and fake drugs enter the market?
01:34Which means that a hospital where I'm working in, if I'm giving the drug to a patient, I myself as
01:42a doctor do not know if it's real or not.
01:44Now, that's a very, very sad situation for a doctor, for a patient, and for a hospital.
01:49So, somewhere I think this is the kind of a situation wherein the regulator needs to step up, create a
01:57proper electronic tool system like barcoding or QR codes which ensure that it has got a trail, an electronic trail
02:07for authenticity to ensure that even as end users, we are feeling safe as doctors and patients.
02:14I think it's, you know, it's shocking, honestly, gives you such a sense of fear that even hospitals are not
02:21safe from these kind of rackets.
02:23But I want to understand from you, Dr. Rao, how dangerous are these fake cancer drugs for patients?
02:30What kind of harm are we talking about? Is it just a question of being ineffective? Is it a lot
02:35more serious than that?
02:40No, I think this is a complete disaster. I personally would believe that if you're giving fake drugs, and I'm
02:47saying you're talking about critical illness drugs, ICU drugs, drugs that are related to cancer.
02:53Now, these, every single door in our books, for us, each of them is life-saving. Every single door actually
03:05is able to move the patient to a cure, and if it is fake, it's as good as a placebo.
03:13That means the cancer has a chance to spread, and even threaten a person's life.
03:19So, the accountability question comes very significantly over here, because this patient somewhere who is working, who is receiving this
03:30kind of drugs.
03:31Now, typically, if you say in solid tumour, that is like lung cancer, bone cancer, headache cancer, other cancers, we
03:39give chemotherapy in very advanced stages, and in leukemias and others, they are the mainstream of treatments.
03:46Imagine, imagine in any stage of cancer, if the drug is not effective, that means it's like the next dose
03:54of therapy we give after three to four weeks, we have delayed the treatment by a month, and in one
04:00month, it's good enough for the tumour to double spread or become incurable also.
04:04And I think that onus now needs to be taken by somebody, if the patient has received it, and that
04:13pushes the patient more towards the chances of no cure or towards chances of complication.
04:19And hence, it's very, very important that we do not take this matter lightly.
04:24No, you're right, that, you know, I hope they get to the root of whatever the scam is, whoever is
04:30involved, because the suspicion is that this is a massive network.
04:32But also, Dr. Rao, you know, how you've highlighted what this means for a cancer patient, who's, you know, fighting
04:40against time, essentially to ensure that they get better by more time.
04:44And these are extremely, extremely expensive medicines.
04:48Some of them spend everything they've earned through their lives to get these dosages, to get these medications.
04:56And in Akshida, in today's unfortunate era of capital medicine, today it's not easy.
05:02People really spend heavy on insurances, heavy out-of-pocket expenditures, and even governments are spending very high amounts in
05:12their schemes in order to procure these drugs
05:14and ensure that we are able to move an inch towards cure, to giving somebody a five-year life survival,
05:21or sometimes lesser.
05:24Every day matters in their lives.
05:26And in this kind of a situation, we need to take this into the much larger picture.
05:31That if this is the story of Bengaluru, then I'm not sure what's the story in other states where vigilance
05:38and monitoring are still more worse.
05:40What could be the scale of fraud, what could be the scale of such kind of fake activities, and who
05:47all could be involved in this?
05:48So this is something that should be really investigated at the highest level, and the punishment for such kind of
05:54activity should be detrimental.
05:57No, but I have to ask this as well, Dr. Rao.
06:00You know, when we speak of accountability and the checks and balances in place right now in the country,
06:06how feasible is it for hospitals to step in here to verify the authenticity and quality of every drug that
06:12they procure,
06:13particularly these high-cost, life-saving medicines?
06:19So I think one learning lesson from this incident is a distributor who has been now held responsible for this
06:28particular thing has supplied it to the hospital.
06:31It's very important here that distributors' validation, that means every hospital knows their distributor's reputation,
06:39licenses, licenses, regularly reviews it, and governments also ensure high time that QR codes or barcoding is done from the
06:50point of manufacturing to the point of retailer
06:53to ensure that at the point of hospitals with a simple QR code, I can check if it's fake or
06:59not.
06:59Today, in the era of AI, today, there are so many easy software available that can just quickly scan and
07:07tell if something is authentic or not in other areas of consumer products.
07:13So why not in such an important area that we implemented?
07:17And I think that's the need of the hour that I see, one.
07:20Second, I would also add to say that it cannot just be a distributor in this.
07:26It has to be a complete nexus.
07:29It cannot be done by one single distributor.
07:31No, 100%.
07:32My understanding, this could be because you have to change the badges, you have to take those medicines out, then
07:37you have to fill in new medicines.
07:39That must be a complete, I would say, a complete mafia of a nexus that is very well-structured ecosystem,
07:49that is doing this regularly.
07:51You know, you're right.
07:52I don't think this is a Bengaluru problem.
07:54It's been busted in Bengaluru, but unfortunately, this could happen across and could be happening really across the country.
08:01But I have to also ask, Dr. Rao, is this an India problem, that there's a lack of regulation, there
08:07are these loopholes, that these kind of scammers, racketeers are able to go ahead and exploit?
08:12Would you ever see anything like this anywhere else in any other country?
08:19My take on this is, today, if you see that the Western countries have learned and become so tight in
08:27regulatory because they see the possibility of all of these and preempt it.
08:33Whereas, sometimes in our country, we have the best laws, but our implementation is very poor.
08:41So, what happens to us is we end up reacting every time a situation blows up and it comes to
08:46the notice, and this has happened earlier also.
08:49So, I think we need to now look at understanding and preempting such kind of situations where it's not a
08:56loophole, it's a manhole.
08:57There's clear evidence that this kind of thing, when there is such loose chains of logistics, transportation, shifting, unreliable distributors,
09:08loose distributors, unregistered distributors, is a possibility of so many leakages here.
09:15In such a situation, the regulator needs to take more stringent coherence and more stringent cognizance to ensure that there
09:24is a tight-locked system like they do for narcotic drugs.
09:29So, I think it's a good eye-opener for us to, for the regulator to ensure that this doesn't happen
09:34at all.
09:36That's right. Dr. Rao, thank you for joining us.
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