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In Mumbai has made cutting of tablet strips mandatory.

A recent circular issued by the Food and Drug Administration, Maharashtra to retail chemists in Mumbai has made cutting of tablet strips mandatory. The circular directed the chemists that strips should be cut if the customer so desires. In fact, most of the chemists in the country are indulging in this practice for several years now. 

Therefore, the rationale to issue such a circular is not very clear. What is actually required is to curb this practice in the interest of the consumers. It is possible that some poor patients may ask for strip cutting if the prescribed drug is an expensive one. But that is to be discouraged by the pharmacists at the counter in the interest of the patient safety as it could lead to under dosing and consequent in effectiveness of the drug. Incorrect and inadequate dosage of medicine by the patients is one of the main reasons for the recurrence of diseases among the poor. As such the strip cutting is not a desirable practice as that can lead to sale of expired drugs to unsuspecting and illiterate customers. At a time when some of the drug companies are colluding with retail chemists to sell expired drugs, strip cutting can actually help such unethical practices to flourish. It is obvious that when the strips are cut, the ingredient details, expiry date and batch numbers may not be there on the cut portion of the strip. This could be dangerous to patients.

Although Maharashtra FDA directed the chemists in the state in this regard, there is a lot of confusion on the issue amongst the pharmacist community including amongst regulatory officials. Indian Pharmaceutical Association, the national body of pharmacists in the country has alreadytaken objection to idea of legalising strip cutting. It has informed the DCGI that there is no
clear-cut provisions in the law whether strip cutting is allowed or not and regulatory officials have different views on the matter. 

IPA has rightfully urged the DCGI that the issue should be included in the agenda of the next meeting of the Drug Technical Advisory Body for discussion and appropriate action. Earlier pharmaceutical companies used to sell almost all drugs belonging to different therapeutic categories in strips of 10. Marketing of tablets in multiple strip sizes and different strength developed over the years as the drug companies wanted to escape price control. Today, many pharmaceutical companies including reputed ones have strip sizes of 6 to 10 and 15 to 30. 

In some cases, there are even strips of 30, 40 and 50. Such huge sizes of strips can certainly create a chaotic situation and some discipline needs to be brought in. A rationalization of strip sizes is necessary based on the therapeutic value of the drug, dosing and cost of medicine.

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