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I. Introduction
A physician prescribes Olvance, an antihypertensive with Olmesartan, whiles the pharmacist, distracted and in a hurry, pulls Oleanz, an antipsychotic with Olanzapine. The two names share similar opening and internal letter patterns. The distinction between the two becomes indistinct under these circumstances, unlike a mismatch in shoe size, where the remedy is simple and reversible.1
The pharmaceutical industry in India ranks among the most extensive and highly fragmented in the world. There are thousands of companies manufacturing drugs, and the competition among them is fierce. Companies design brand names based on factors such as memorability and marketing ability. In this scenario, the difference between competitive branding and potentially hazardous phonetic deception has become increasingly insignificant.
The problem of Look-Alike Sound-Alike drug confusion is an issue in the medical world. It happens often than people think. Look- Sound-Alike drug confusion is a serious problem.
The main way to stop Look-Alike Sound-Alike drug confusion is by using trademark law. This means that companies cannot use names that're too similar to names that already exist. They also cannot use names that are already being used by companies.
This blog is asking if this system is really working. Is it doing enough to stop Look-Alike Sound-Alike drug confusion? This is not a problem, about trademarks it is also a public health issue.
This blog will look at what happened in three court cases in 2025 and 2026. It will also think about what the government did after the Drug Technical Advisory Board made some recommendations in 2024. Look- Sound-Alike drug confusion is a big problem and we need to find a good solution. What will it take to solve the Look-Alike Sound-Alike problem?
II. The LASA Problem: How Big It Is And Why It Happens
The LASA problem in India got a lot of attention in a paper that was published in The Lancet Regional Health – Southeast Asia in 2024. The people who wrote the paper noticed that there are a lot of LASAs in India's market. They said that the reasons why LASAs can cause problems are because of the way things are set up.
It is easy to see why this is happening. Pharmaceutical companies want to make money so they give their drugs names that're similar to their competitors. This might make it easier for people to remember the names. It can also confuse them. This is where the people in charge like the CDSCO need to do their job. They need to check the names of drugs to make sure they are not confusing before they allow companies to sell them.. It took someone taking them to court to make them do this. The LASA problem is an issue and the CDSCO needs to make sure that the LASAs are not causing problems for people. The LASA problem is something that needs to be fixed.
However, the overlapping nature of the two regulatory systems adds another layer of complexity. One of these, namely the Trademarks Registry, is responsible for examining whether the names used are distinctive or similar to those used by other brands. On the other hand, the CDSCO, whose function is primarily that of ensuring consumer safety should theoretically be doing the same.2
III. The Statutory Framework
The principal legislation for this purpose is the Trade Marks Act of 1999. Section 2(1)(h) of the Act stipulates that where a mark is such as would be likely to deceive or confuse by its resemblance to some other mark, the former will be deemed to be 'deceptively similar'. Section 9(1)(a) forbids the registration of a mark which lacks distinctiveness. Under Section 11(1), no mark which is identical or deceptively similar to an already registered mark for identical or similar goods will be registrable provided there is a likelihood of confusion between the two. Section 13 explicitly prohibits registration of any mark which is the same or deceptively similar to an International Nonproprietary Name (INN) designated by the WHO and notified by the Registrar of Trademarks.3
As far as regulation of drugs is concerned, it is governed by the Drugs and Cosmetics Act, 1940 and Regulations made thereunder, pertaining to licensing and marketing authorization for manufacture and sale of the medicines. The CDSCO working under the Ministry of Health & Family Welfare is supposed to ensure that drug brand names do not mislead anyone. The judiciary has ruled that a trademark search report has to be looked into before marketing authorization of the drug is given; which may not necessarily have been done so far by the regulatory body.
There appears to be a huge disparity between the two systems. In a trademark examination, the issue before an examiner is that of whether two trademarks are similar in nature. However, as far as the safety of patients is concerned, the issue before one should be as to whether two drugs can be confused by either a prescriber or a pharmacist or even the patients themselves.
IV. The Judicial Response: Decisions from 2025-26
It would seem that the most active respondents to the LASA issue in institutions have been the courts, which have provided us with three extremely important and enlightening decisions between 2025-26, outlining the current legal state of pharmaceutical trademarks.
A. Aventis LLC v. Healing Pharma India Pvt. Ltd. — Bombay High Court, February 2025
The first and most notable decision in this regard was the case involving the ongoing dispute over Aventis' antihistamine product 'Allegra', manufactured by the company belonging to the Sanofi Group. The plaintiff found in October 2020 that the defendant companies were producing antihistamines, using the name 'Allergegra' (which sounded exactly like 'Allegra') and having exactly the same packaging variations as 120 mg, 180 mg, and 'M'. An ex parte injunction was granted by the court in November 2020, and finally, an out-of-court settlement was reached by March 2021.
However, in 2022, the court was approached again on account of the fact that the defendants had introduced their new product named 'Algreat' into the market, with its packaging resembling very much Allegra's trade dress. In a petition filed in the High Court of Bombay in February 2025, regarding an issue of contempt, the defendants were held liable for wilful disobedience of the 2021 order and fined ₹5, 00, 000, with a direction for imprisonment in default of payment.
The Court used the principle of the "safe-distance rule", whereby in cases where a person has already been found guilty of infringement, a safe distance needs to be kept from the original trademark, both verbally as well as visually. In this case, although the defendants tried to replace Allergregra with Algreat and use similar packaging, the principle of the safe-distance rule was clearly violated.4
B. Rajvaidya Shital Prasad and Sons v. Karna Goomar – Delhi High Court, December 2025
The second case, decided by Justice Tejas Karia on 24 December 2025, pertains to the ayurvedic medicine, Hempushpa, which is a ladies' tonic having been in existence since 1933 and made by Rajvaidya Shital Prasad and Sons. The mark 'Hempushpa' is registered under Class 05 and enjoys nearly 90 years of goodwill. The opposing party had registered the mark 'Activepushpa' for identical medicinal products under the same class.
In accordance with Section 57 of the Trade Marks Act, the mark 'Activepushpa' was challenged and sought to be cancelled by the petitioner, who argued that it was deceptively similar to 'Hempushpa'. The Delhi High Court granted the prayer of the petitioner and ordered the removal of the mark 'Activepushpa' from the trade marks register.
The rationale behind the judgment was based on the doctrine of dominant feature test and the principle of non-dissectability. According to this judgment, the commonality between the two marks, 'PUSHPA', was the dominant and distinguishing feature of both the trademarks, especially considering the way the mark had been prominently used by the respondent on his packings. The respondent's contention regarding the word being a generic word in Sanskrit language and hence not eligible for exclusive use was negated by the court. While the word itself could not be monopolized by either party, the nature of its adoption by the respondent, namely prominently using it on identical goods with full knowledge about the petitioner's trademark, was regarded as dishonest.
This case law highlights the application of the dominant feature test in the pharmaceutical industry, as well as the use of generic words as dominant features of trademarks in cases where bad faith is proved.5
C. Alkem Laboratories Ltd. vs Prevego Healthcare & Research Pvt. Ltd. — Delhi High Court, 17 January 2026
In contrast to the above decisions, this decision made by Justice Tejas Karia on 17 January 2026 highlights an instance in which one can clearly understand the present legal scenario with respect to pharmaceutical trademarks. Alkem Laboratories, an Indian multinational pharmaceutical company, has been using the trademark A TO Z for their multivitamin and nutraceutical preparations since 1998, while variants have been used such as A TO Z-NS. In a case where Prevego Healthcare started selling health care products with the mark Multivein AZ, Alkem complained of infringement based on the similarity of 'AZ' in the marks.
An ex-parte injunction order issued in January 2025 had been vacated by the Delhi High Court in January 2026, as interim relief had been refused by the Court to Alkem. The Court followed Section 17 of the Trade Mark Act, according to which registration of a composite mark shall entitle the owner of the trade mark to an exclusive right in the mark taken as a whole and not in its component parts alone, and held that Alkem did not have exclusive rights in the letters 'A' and 'Z'. The term 'A TO Z' was found to be merely descriptive of a multivitamin preparation, connoting completeness in vitamins, and hence could not be exclusively appropriated by Alkem.
Applying the doctrine of anti-dissection, the Court further held that 'Multivein AZ' should be considered in entirety and not part-by-part. Adding the term 'Multivein', which had a completely different meaning associated with the word being vascular, would sufficiently change the overall impression.
The decision provides a good antidote to the attitude of always assuming that all disputes involving trademarks for medicines should lead to an injunction. The Court was very firm that in an industry where public health issues can be taken into account, certain basic rules concerning trademarks still hold true. These include the principles of distinctiveness, non-dissectability, and the bounds of registration.6
V. Regulatory Response: Action Already Taken and Action Required
The judicial trends referred to above have been matched, but not pre-empted, by certain regulatory responses. For instance, in early 2024, the Drug Technical Advisory Board (DTAB)7 proposed a ban on the marketing and manufacture of different drugs under the same brand name, in reaction to the well-established dangers of LASA confusion. Subsequently, in May 2024, the Director General of Health Services (DGHS), in a letter to the Controller General of Patents, Designs, and Trade Marks, expressed the need for increased scrutiny regarding trademark protection, specifically highlighting the connection between similarly named medicines and "medication errors, adverse drug reactions and other health hazards."
In addition, the government is also planning to make it mandatory for drug makers to share details regarding the formulation of their products along with the branding information on a government website where they can be scanned in real time for conflicts. The National Health Authority's discussion paper on the Drug Registry has suggested setting up a centralised database for drug names which would facilitate systematic phonetic and spelling checking of names prior to their launch.
This is progress. Cooperation between the Trade Mark Registry and the CDSCO, if formalized, would resolve the crucial structural deficiency in the system, which is the lack of a single point entry for the commercial approval of brands and the safety analysis of the drug. Nevertheless, there needs to be enforcement of regulations through legislation.
VI. Conclusion
The three judicial decisions mentioned above provide a clear indication that the judges in the Indian courts are taking an increasingly sophisticated view of pharmaceutical trademark infringement disputes. The decision in the contempt of court case involving Allegra shows that the court will be enforcing compliance using the safe distance test without any room left for mere cosmetic changes. Hempushpa's case reveals the application of the dominant feature test and the requirement of good faith in trademark registration. The Alkem judgment helps bring balance back to trademark law by making it clear that generic features in pharmaceutical products are not protected under trademark law.
Overall, there seems to be more strictness involved in judging pharmaceutical trademark infringements than when considering trademarks from any other product category.
That which the courts themselves cannot do is tackle the problem up-stream, which is a system where pharmaceutical drugs continue to be named without adequate phonetic analysis, prescribed in terms of their brand names rather than INN, and distributed by a system of independent pharmacies lacking a real-time verification process. If the regulatory action of 2024 is actually implemented in enforceable regulation and true collaboration between agencies, then it is only from there that we have any reasonable hope of a pharmaceutical nomenclature that reduces the possibility of such errors from start to finish.
REFERENCES
2. Parth Sharma et al., 'Look-alike, Sound-alike (LASA) Drugs in India', The Lancet Regional Health — Southeast Asia, Vol. 26, Article 100425 (July 2024), DOI: 10.1016/j.lansea.2024.100425.
3. Sections 2(1)(h), 9(1)(a), 11(1) and 13, Trade Marks Act, 1999.
4. Aventis LLC & Anr. v. Healing Pharma India Pvt. Ltd. & Ors., Commercial IP Suit No. 139 of 2021, Bombay High Court, order dated February 3, 2025. See also World Trademark Review, 'Bombay High Court Clamps Down on Wilful Contempt in Pharmaceutical Infringement Dispute' (February 2025), https://www.worldtrademarkreview.com
5. Rajvaidya Shital Prasad and Sons v. Karna Goomar and Anr., C.O. (COMM.IPD-TM) 385/2021, Delhi High Court, judgment dated December 24, 2025 (Neutral Citation: 2025:DHC:11881). See Live Law, 'Delhi High Court Cancels ACTIVEPUSHPA Trademark for Similarity with Ayurvedic Brand HEMPUSHPA' (January 2, 2026), https://www.livelaw.in
6. Alkem Laboratories Limited v. Prevego Healthcare and Research Pvt. Ltd., CS(COMM) 84/2025, Delhi High Court, judgment dated January 17, 2026. See Bar and Bench report on the judgment (January 2026), available at https://www.barandbench.com
7. Drug Technical Advisory Board (DTAB), Minutes/Recommendations regarding prohibition on marketing of different drugs under the same brand name, January 2024. See K. Singhania & Co., 'Look-Alike Sound-Alike (LASA) Drugs: A Multifaceted Challenge' (June 2025), https://singhanialaw.com
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