- It’s a given fact that the subject matter will not fail to elicit an understanding nod and an acknowledgment from the discerning lot from around the world. Such have been the consequences of the unholy nexus between the pharmaceutical behemoths and the doctor’s fraternity that it no longer surprises anyone when reports of undue influences emerge. Did someone mention the medical ethics angle being conveniently ignored in the melee? You bet. The benefits extended by these companies in various forms of inducements, incentives, luxuries, and some such means are rampant much to the chagrin of all concerned. The pandemic only added yet another layer to the already well-established phenomenon.
PC: The MSAG
- Given the above, public interest litigation (PIL) in the Supreme Court last week by the Federation of Medical and Sales Representative Association of India has again put the doctor-pharmaceutical firm relationship under further scrutiny. FMRAI alleges gifts were the catalyst for the high incidence of prescription of Dolo 650, an analgesic when Covid was raging globally. Now, the very mention of Dolo 650 will take the majority of the global community to those dreaded days of Covid waves flattening the human race with such ferocity. The hearing will resume next month. The broader issue, however, embodies a universal regulatory challenge. Two unique features of healthcare account for it. Let’s look into the same.
- Note that the demand for it is often urgent and there’s a huge information asymmetry between doctor and patient placing doctors in a commanding position. Patients who need quick advice and know little about medicine are perfect pawns for prescriptions influenced by pharma companies’ inducements. Recollect how the opioid crisis in the US was a particularly shocking demonstration of this. For the uninitiated, 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. But it’s an open question whether the regulatory failure was addressed fully. Of course, there’s no shortage of rules governing the matter in India too.
PC: Get Free of Bills
- There’s been a voluntary code for pharma firms’ marketing practices since January 2015. Further, the Indian Medical Council regulates the conduct of doctors through powers flowing from statutory legislation. Sadly, both these regulations are bound to be toothless because the misconduct is expected to be addressed within the fraternity. Costs for such a system can be very high in India, where out-of-pocket medical expenditure is 55% of citizens’ total spending, as compared to the global average of 18%. Thus, the Union Government should smartly use the existing network of private chemists to market generics, especially for commonly prescribed drugs. This way rampant misuse of the shady pharma-doctor dalliances can be minimized.
