Editorial: Playing with public health

The allegation that freebies worth over Rs 1,000 crore were paid to the doctors for prescribing an irrational dose of popular fever drug Dolo-650 during the Covid-19 waves exposes the deeply-entrenched corruption in pharmaceutical marketing. The brazen indulgence in unethical practices also brings the conduct of the drug regulatory system under scanner. While the market […]

The allegation that freebies worth over Rs 1,000 crore were paid to the doctors for prescribing an irrational dose of popular fever drug Dolo-650 during the Covid-19 waves exposes the deeply-entrenched corruption in pharmaceutical marketing. The brazen indulgence in unethical practices also brings the conduct of the drug regulatory system under scanner. While the market price of tablets up to 500 mg is controlled, the pricing of drugs exceeding 500 mg can be fixed by the companies. This is where the bribing comes in. Offering gifts, paying cash and sponsoring trips of medical practitioners to influence prescription of unwarranted drugs, or push for high-cost and over-priced brands, is an open trade secret. The plea for a statutory code of ethical marketing with penal consequences, along with introduction of stringent transparency and accountability mechanisms, offers a chance to clean up the healthcare sector. The instances of ghost-management of medical research and sponsorship of clinical trials to influence results exemplify the extent of the rot. Taking a serious note of a petition by the Federation of Medical and Sales Representatives Association of India, the Supreme Court has asked the central government to respond to the allegations within ten days. The National Medical Commission, too, has sought from the Income Tax Department details of the doctors who allegedly received bribes from six pharma companies, including the Dolo-650 maker against whom raids were conducted last month. Though couched as sales promotion, pharma companies offer inducements to doctors in exchange for an increase in drug sales.

Unethical drug promotion can adversely influence doctors’ prescription attitudes and harm human health by prescribing higher doses of drugs than necessary and for a longer period than necessary. The Centre must take the initiative for formulating a uniform code of pharmaceutical marketing practices to curb unethical practices of pharma companies and ensure an effective monitoring mechanism, transparency, accountability as well as consequences for violations. Though it is well known that corruption exists in the pharmaceutical sector, there is a lack of concrete data to assess the extent of corruption. Most existing laws and institutions are often too weak. There is a need to formulate a new legal system that is fair and balanced. At present, the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations of 2002 prescribe a code of conduct for doctors in their relationship with the pharmaceutical and allied health sector industry, and prohibit acceptance of gifts and entertainment, travel facilities, hospitality, cash or monetary grants by medical practitioners from pharmaceutical companies. However, the code is not enforceable on drug companies. As a result, they go scot-free. For an industry that is projected to witness a three-fold growth in the next decade, the pharma sector cannot afford an erosion in public trust and reliability. It needs to undertake self-introspection and initiate course correction.

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