Dolo, Docs & Pharma

Source: The post is based on an article “Dolo, Docs & Pharma” published in The Times of India on 24^th August 2022.

Syllabus: GS 2 Government Policies and Interventions for Development in various sectors and issues arising out of their Design and Implementation; Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources.

Relevance: Issues Medical Professionals and Pharma Industry Relationship; Out of Pocket Expenditure etc.

News: In recent times, Bengaluru-based Micro Labs was accused of offering freebies to doctors to promote its paracetamol brand Dolo 650. This led to sharp criticism of the relationship between the medical profession and the pharmaceutical industry due to scandals involving freebies to doctors.

What are the problems in the medical profession and pharmaceutical industry relationship?

Traditionally, pharma companies need to inform and update doctors about their products. But there is a thin dividing line between legitimate promotional activities (normal samples, pens, writing pads, small printed books, hand sanitizers, and masks) and illegitimate incentivization (like pharma-sponsored trips to foreign countries.). Therefore, most of the promotion seems to be going in the wrong direction.

One of the biggest sources of income for hospitals is the profit margin on drugs. Therefore, doctors tend to prescribe high-cost drugs, rather than cheaper generic medicines, to their patients.

Although there are codes of conduct that attempt to draw a thin line between legitimate promotional activities and illegitimate ones.  For example, MNC pharma companies are bound to comply with their internal codes of conduct. But such voluntary ethics codes have failed so far.

Why have voluntary codes and guidelines in healthcare been ignored with impunity and regularity?

Both medical professionals and the pharma industry are enthusiastic about their mutual interests. These are:

(1) For pharma it is a way to push new products, including irrational combinations.

(2) For the medical profession it is a bonanza of individual gifts and trips, and for medical associations to earn money through conferences.

What should be the course of action?

Pandemic-inspired opportunity for reform: Covid-19 has made ordinary citizens acutely aware of the dangers of unregulated healthcare in India. For example, drug prescriptions and costs have aroused their suspicions. Thus, covid has created a sense of urgency for collective action on healthcare.

In India, the previous MCI code and the upcoming ethics code of the National Medical Commission label gifting and hospitality as unethical conduct.

Federation of Medical and Sale Representatives Association of India (FMRAI) has asked the SC for early implementation of the Uniform Code for Pharmaceutical Marketing Practices (UCPMP), which is currently a voluntary code on paper. The apex court has agreed to examine their plea seeking direction to the Centre to give teeth to UCPMP by making it law, thus ensuring an effective monitoring mechanism and transparency as well as punishments for violations.