By: Priyanka Saurabh
The Supreme Court (SC) is hearing a petition regarding gifts given by pharmaceutical companies to doctors and has asked for a response from the central government on the matter. In the petition regarding the link between the companies and the doctors for the sale of drugs, it was alleged that several doctors over-prescribed a particular drug after receiving gifts from the companies. This is a serious allegation that casts a shadow over the noble profession.
Ordinary people already know this even though they cannot establish it. They know that there is a network of drug retailers, wholesalers, doctors and companies that the pharmaceutical market has used and therefore climbed the ladder of progress. Due to the lack of control in the medical market, the arbitrariness is such that the salt that gets 10 tablets for nine rupees is sold, after giving a brand label, for ninety rupees. All this is done without any consideration for sick and sick people and such scams also create problems with the price of drugs in the market.
This bond is growing with each passing day and to increase sales, companies have made their giveaways more lucrative and except some, most doctors are not in a position to turn down alluring opportunities. Medical representatives also claim that only 10-20% of physicians adhere to MCI’s code of conduct, while in some cases physicians even seek “incentives” to promote a product. Not only allopathy, but medical representatives from Ayurvedic and homeopathic companies have said they are under immense pressure to achieve higher sales targets, which leads to such a practice.
One report, in this regard, quotes medical representatives saying that company executives are also monitoring the business generated by doctors in which they have “invested”. Pharmaceutical companies hold workshops or training sessions for sales representatives, focusing more on sales skills and “customer relationship management (doctors)”, rather than improving their technical knowledge of the product they handle. The report also mentions a new trend – promotion and distribution companies nowadays creating new entities which are franchisees of pharmaceutical companies who buy drugs in bulk from manufacturers, give their brand names and sell them directly to retailers. Incentives include gifts, cash, hospitality and travel facilities granted to physicians and healthcare professionals.
The Medical Council of India has a code of conduct for doctors which prohibits them from accepting gifts, money, travel facilities or hospitality from pharmaceutical companies. Although there is a voluntary code for pharmaceutical companies known as the Uniform Code of Pharmaceutical Marketing Practices or UCMP, experts say it is not a very effective mechanism to check for common misconduct. Worryingly, there is no law to punish those guilty of unethical conduct. As a result, patients are forced to buy expensive drugs. The central government is still sitting on a 2015 proposal to introduce a uniform code of business practice for pharmaceutical companies, which includes stiff penalties.
A year and a half ago, draft regulatory codes sent to the Department of Justice to exclude unethical practices under the Essential Commodities Act were rejected. Yet the Ministry of Health, in response to a right to information report, said the project being discussed poses a threat to the health of millions of people who fall prey to irrational prescriptions pushing drugs which could be hazardous to health. The growing use of antibiotics is the main cause of antimicrobial resistance, one of the biggest health threats in the world. Bacteria naturally develop drug resistance over time, becoming superbugs, but large-scale or inappropriate use greatly speeds this process.
A mandatory code is needed to identify and sanction unethical promotions by pharmaceutical companies. Mandatory disclosure by pharmaceutical companies of expenditures for drug promotion, drug testing in continuing medical education and health care is not just a consumer product, it is more than that. The idea of putting patients first is embedded in our culture. This is a major downside when the actions of large healthcare systems, pharmaceutical companies, device makers, and insurance companies can have a greater impact on patients than the actions of individual physicians.
To solve the problem, it is absolutely necessary to pass a new law under which pharmaceutical companies will be required to disclose the amount paid to doctors for research, conferences, travel and entertainment. There should also be a code of ethics, under which pharmaceutical companies cannot offer any type of gift, money or other benefit to doctors for the promotion of their medicines, nor organize meetings or conferences in places associated with entertainment, sporting events or providing pleasure and recreation. Emphasis should also be placed on the need to punish anyone who adopts unethical methods. Only legal intervention can break this immoral link between doctors and pharmaceutical companies, in addition to awareness campaigns that could help patients better understand the system.
The author is a political science researcher, poet, freelance journalist and columnist.