Doctors and pharma company deny charges
The Department of Pharmaceuticals (DoP), under the Union ministry of chemicals and fertilizers, recently held a series of meetings with some ministries and pharma companies to check how the companies market their products to doctors. Though the talks were inconclusive, it is learnt that DoP is now planning to introduce a law to regulate pharmaceutical companies so that they adhere to ethical drug marketing norms.
While the government is moving at a snail's pace to draft this new legislation, a letter sent recently by a member of Parliament to the Prime Minister exposes how Indian doctors are working in complete disregard of medical ethics prescribed by the Medical Council of India (MCI), India's apex body for regulating medical education.
Lok Sabha MP, Jyoti Mirdha's letter dated June 1, cites an instance of 15 doctors of Madhya Pradesh flying to England and Scotland with their spouses and relatives (totalling 30 people) for an eight-day tour between March 24 and March 31. It is alleged that Ahmedabad-based pharma company, Intas Pharmaceuticals Limited, paid for the trip. The documents attached with the letter, which are also with Down To Earth, show that the total cost only of just flight tickets for 30 people amount to over Rs 17 lakh. The itinerary of the trip carries the logo of Intas Pharmaceuticals.
As per the MCI rules, no doctor can accept any gifts or favours from pharmaceutical companies. “This malpractice not only leads to inappropriate and irrational prescriptions by indebted doctors but adds to the cost of medicines,” writes Mirdha.
To make the rules stringent for doctors, MCI amended the code of ethics on December 10, 2009. A new section—6.8.1—was added. It says: A medical practitioner shall not accept any travel facility inside the country or outside, including rail, air, ship, cruise tickets and paid vacations from any pharmaceutical or allied healthcare industry or their representatives for self and family members for vacation or for attending conferences, seminars, workshops, CME programme etc as a delegate.” It adds that a medical practitioner shall not accept individually any hospitality like hotel accommodation for self and family members under any pretext.
No doctor penalised
Despite these rules being in place for the last two-and-a-half years, no doctor has been penalised under it, says Babu K V, an opthalmologist based in Kerala who had filed complaints with MCI earlier regarding doctors not following medical ethics. “MCI is not serious about implementing its own code of ethics. If they are serious, these faulting doctors should have been suspended,” says Babu.
MCI also has provision to penalise doctors who do not follow the medical ethics.
“If MCI punishes even a few doctors for taking gifts from pharmaceutical companies, it will act as a deterrent for other doctors as well,” adds Babu.
However, the pharmaceutical companies who pay the doctors are insulated from any punishment. Pointing out this loophole Mirdha says in her letter: “While MCI rules bar doctors from accepting gifts, tickets, hospitality from healthcare industry, there are no corresponding obligations on the part of drug industry not to offer such freebies and face penal action in case of violations.”
The 45th parliamentary standing committee report, of which Mirdha was a member, recommended that appropriate regulations be added to the Drugs and Cosmetics Rules to forbid the pharmaceutical manufacturers from offering such freebies that are prohibited under MCI rules. It was released on May 8. But no action has been taken by the DoP on the suggestion. “A non-binding toothless code on marketing practices has been proposed which will not address the issue at all,” Mirdha adds.
Travel agent wrongly used company logo: Intas
Meanwhile, Intas Pharmaceutical Limited, a $350 million organisation, denies that it paid for the doctors' trip. “The company has not sponsored any doctors for any foreign trips and reserves the right to pursue legal recourse to protect its interests from any collateral damage as a result of negative publicity,” says Jayesh Shah, chief finance officer at Intas, in an email. “The company follows the laws of the land and is in full compliance with the MCI guidelines,” he adds.
Two of the doctors whose names appeared in the list also say that the trip was funded out of their own pockets and no company had any kind of involvement. “We travelled on our own and no company is involved,” says Srikant Rege, doctor from Indore, Madhya Pradesh. “I paid Rs 2.7 lakh from my own pocket. It was a trip planned by a group of doctors,” said Alok Agarwal, neurosurgeon from Jabalpur, Madhya Pradesh.
Shah further clarifies: “The travel agent involved had wrongfully used the company's trademark and has since profusely apologised for the same. The travel agent has confirmed to reimburse the company appropriately and suitably for any damages resulting from this alleged incident.”
Intas specialises in producing medicines for the central nervous system, gastroenterology, nephrology, urology, orthopaedics, cardiology and diabetes. Some of their popular brands of medicines are: Zoryl, Ceftas, Hifenac, Amtas, Clavix, Rabium.
MCI could not be reached for comments.
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