Editorial: Break the unethical nexus

Supreme Court intervention must pave the way for stringent laws to curb unethical pharmaceutical marketing practices and protect patients’ interests

The unethical nexus between profit-driven pharmaceutical companies and doctors often works to the detriment of patients in India. Prescribing costly branded drugs, instead of generic ones, and unnecessary diagnostic tests are some of the practices that undermine the right of patients to exercise their options. When inducements influence prescriptions, the consequences affect patients and the cost of healthcare. Though the Uniform Code for Pharmaceutical Marketing Practices (UCPMP) has been in force since 2014 and revised in 2024, its implementation has been weak and continues to face significant logistical, structural, and legal challenges. Against this backdrop, the Supreme Court’s latest directive to the government to constitute an expert committee to curb unethical pharmaceutical marketing is a welcome development. Hopefully, the judicial intervention would go a long way in plugging a regulatory gap. The main criticism against the UCPMP is that this enforcement body was set up at the pharma association level. Since the industry peers were tasked with investigating complaints against their own members, there was an inherent conflict of interest that weakened impartial enforcement. The petition before the apex court sought to highlight the allegation that pharma companies offer doctors expensive gifts, foreign trips and other benefits to promote particular medicines. Such practices can distort clinical judgment and encourage over-prescription. Moreover, the patient is usually unable to assess whether a medicine is necessary or whether a cheaper alternative exists. The UCPMP guidelines prohibit gifts, travel facilities, hospitality and monetary grants to doctors and spell out mechanisms such as an ethics committee, expenditure disclosures and an apex panel to address complaints.

The track record suggests that voluntary compliance may not be enough. The apex panel has received only a handful of complaints. This does not by itself prove that unethical practices are rare. Other factors could also be at play, such as under-reporting, weak enforcement or reluctance to confront powerful commercial lobbies. Previous attempts to provide statutory backing through the Essential Commodities Act or the Drugs and Cosmetics Act raised questions of jurisdiction and legal validity. The proposed committee must avoid another exercise in bureaucratic delay. It should examine international models, conflict of interest, disclosure requirements, penalties, independent investigation and the role of medical regulators. The government must come up with a clear legislative roadmap, including whether a new law is necessary. Patients should not have to bear the hidden cost of marketing campaigns disguised as professional persuasion. While UCPMP 2024 claims to be mandatory, it operates under administrative directives rather than an independent act of Parliament. Without formal backing from a criminal statute, the penalties are largely restricted to peer-level actions rather than enforceable ones. This lack of legal teeth is precisely why the Supreme Court has intervened now, directing the government to draft distinct statutory recommendations. Healthcare is one area where government regulation is necessary to protect the interests of patients.

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