Pill pushers: Dolo PIL another reminder of dubious doctor-pharma relationships. Generics can minimise the problem

Source: The post is based on the article “Pill pushers: Dolo PIL another reminder of dubious doctor-pharma relationships. Generics can minimise the problem” published in The Times of India on 23^rd August 2022.

Syllabus:  GS 3 – Changes in industrial policy and their effects on industrial growth.

Relevance: About the pill-pushing activity of pharma firms.

News: The Federation of Medical & Sales Representatives Association of India (FMRAI) has moved to the court with public interest litigation (PIL), accusing the marketer of Dolo-650 of bribing doctors with “freebies” worth ₹1,000 crores to recommend the tablet. This has again put the doctor-pharmaceutical firm relationship under scrutiny.

Why pill-pushing is often ignored by patients?

a) Demand for medicine is often urgent considering the medical conditions of the patient. For example, the opioid crisis in the US was a particularly shocking demonstration of this, b) There’s a huge information asymmetry between doctor and patient.

This is clearly evident by India’s out-of-pocket medical expenditure. India’s OOP medical expenditure is 55% of citizens’ total spend, as compared to the global average of 18%.

Note: In the opioid crisis, pain-management pills were prescribed by doctors across the US, their addictive and harmful after-effects hidden or ignored. It took years for the crisis to be officially acknowledged. Litigation and finally bankruptcy filings by drug manufacturers followed.

How government is regulating pill-pushing?

1) Since 2015, for pharma firms, there’s a voluntary code of marketing practices in place, 2) The Indian Medical Council regulates the conduct of doctors through powers flowing from statutory legislation.

In both these regulations, the misconduct is expected to be addressed within the fraternity.

How does the government regulate pill-pushing?

The government should aim to neutralise doctor-pharma “deals” by 1) Effectively using the government’s existing programme of bulk purchases and sales of generic drugs. Bulk buying provides a price discount of 50-90% over branded medicines, 2) Expanding government distribution program and utilising the existing network of private chemists to improve its effectiveness, 3) Creating awareness about palliatives and the availability of generics can substantially reduce the scope of pill-pushing.