NEW DELHI: Patients may no longer be forced to buy an entire strip of tablets or capsules when they need only one or a few of them.
India’s apex drugs regulator plans to introduce a rule mandating pharmacies to dispense the exact number of tablets and capsules prescribed by allowing the sale of cut strips, according to two government officials and documents reviewed by Mint.
Many drugs, including antibiotics, are typically sold in strips of 10 or 15 tablets or capsules when patients may require only five tabs. A proposal on dispensing exact prescription quantities of strip-packed medicines was discussed at a meeting chaired by the Drugs Controller General of India on 20 March.
This regulatory shift is significant for India's $50 billion pharmaceutical industry and perhaps even more so for the retail pharmacy market, which was valued at $20 billion-27 billion in 2024. The change has been driven by mounting public grievances against the common practice of pharmacies refusing to cut strips of tablets, forcing patients to buy excess medication.
According to one of the documents, the regulator received a public grievance highlighting the refusal of pharmacies to dispense cut/loose strips of 10-15 tablets when only five tablets were prescribed, forcing patients to buy excess medicines and incur unnecessary costs ( ₹5-100 per strip).
“The issue persists even at the major chains like Apollo and MedPlus. Further, the appellant has also mentioned that denial of sale of cut strips and insistence on the purchase of a full strip is not punishable under the existing Drugs Rules, 1945,” according to the document. “In view of the above, it is proposed to introduce a clause under the Drugs Rules regarding the sale of cut/loose strips.”
"A sub-committee has been formed for this, and further deliberations will be held on implementation," one of the officials said.
Implementation concerns
However, doubts have been raised on how the regulator will implement the new norm, given the concerns of pharmacies over inventory management and the lack of batch details on cut strips.
“It is important that this issue is addressed holistically, including from a packaging and labelling standpoint,” Madhivanan Balakrishnan, chief executive officer at Apollo 24/7, said in a WhatsApp response to Mint, acknowledging that reducing medicine wastage and improving affordability are important priorities for the healthcare system.
According to Balakrishnan, medicine strips carry critical information such as manufacturing date, expiry date, batch number and other regulatory details. When strips are cut, this information may not remain available with the dispensed portion, potentially impacting patient awareness, traceability, and overall safety.
“Apollo Pharmacy already endeavours to cater to customer needs by dispensing medicines in exact quantities wherever feasible at store level. In online fulfillment, however, full strips may sometimes be dispensed, as cutting them can make it difficult to retain critical labelling information, including expiry details,” Balakrishnan added.
Prashant Tandon, co-founder and CEO of TATA 1mg, an online pharmacy chain, told Mint on a call that once a strip is cut, the portion that is left may not contain the name of the medicine, the strength and the price.
“If the regulation comes, it will have to be an encompassing regulation on what to do with the remaining stuff,” Tandon said. “In the West, they bottle it for 10 days and do compounding in the pharmacy. India doesn't have that as the model. We'll be happy to comply with whatever the rule is, but I hope there is consultation around solving this."
Queries emailed to the spokespersons of the health ministry, the DCGI and MedPlus on 22 March remained unanswered till press time.
Unsold drugs
Rajiv Singhal, general secretary of the All-India Organisation of Chemists and Druggists (AIOCD), which represents 1.24 million chemists, pharmacists and pharmaceutical distributors, said the AIOCD does not object to selling loose medicines if manufacturers take back unsold cut strips to prevent financial losses from expired stock.
“High costs make discarding partial strips unfeasible for chemists. Additionally, the organization calls for reducing bloated strip sizes—sometimes containing 50 tablets—to a maximum of 10. This change would better align packaging with standard medical dosages and minimize unnecessary waste,” Singhal said.
Health experts said such a radical move requires careful planning.
“The move to allow dispensing of exact quantities of medicines is a much-needed reform that can reduce the economic burden on patients and curb unnecessary wastage, but it also brings new risks that cannot be overlooked,” said Dr Aashish Chaudhry, managing director of Aakash Healthcare, a super-specialty hospital in New Delhi. “Many patients are hesitant to purchase medicines from cut strips due to issues of trust and safety. This change demands careful planning, robust guidelines and stakeholder dialogue to ensure implementation is cautious, standardized, and protects patient health.”
Drug manufacturers suggest therapy-based packaging for antibiotics and perforated formats for SOS drugs such as paracetamol to minimize consumer waste.
Drug makers’ responsibility
“The responsibility for appropriate medicine dispensing does not rest with chemists alone, but must involve manufacturing companies as well,” said Namit Joshi, a director at Centrient Pharmaceuticals, which makes antibiotics, statins and anti-fungals. “If a five-day antibiotic course requires two tablets daily, the strip should contain exactly 10 tablets rather than 15.”
Allowing the cutting of strips for such treatments can lead to patients being either under-treated or over-treated, while also posing an environmental risk when non-therapeutic packaging leads to wasted medication, Joshi said. Dispensing cut strips can also run counter efforts to combat antimicrobial resistance.
Experts have said there is a need for a national system to collect and destroy expired medicines because improper disposal of unconsumed drugs can aggravate environmental pollution and antimicrobial resistance.
“SOS medications like paracetamol or painkillers should utilize cut strips or perforated packaging to allow flexible dispensing. Mandatory strip-cutting across all categories creates logistical chaos for retailers as removing portions often strips away vital expiry and batch tracking data, making safe inventory management nearly impossible,” Joshi added.