Tuesday, 19 April 2011

Doctors-pharma nexus: Pharma industry's gifts to doctors

By Syed Akbar

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What doctors get from drug firms
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1. Personal gifts like car, air conditioner, refrigerator, flat, plot and gold coins.
2. Hospital or nursing home equipment.
3. Cash as commission.
4. Five star hotel stay.
5. Foreign trips.
6. Free medical course for the children of doctors.
7. Supply of medicines to medical shops owned by doctors.
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Unethical practices indulged in by doctors
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1. Commission for referring their patients to superspecialists or specialists.
2. Employing PROs to foster their business.
3. Paying commission to quacks/RMPs in rural areas for referring patients to their hospitals or clinics.
4. Commission from diagnostic centres.
5. Being part of clinical research organisations.
6. Being part of multi-level marketing chains.
7. Manipulating drug prices by irrational combinations, not in Drug Price Control Order.
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Games small pharma companies play
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Small and medium pharma companies sell their products to propaganda-cum-distribution dealers, who tie up with doctors. A local brand of drug made by these companies is only sold in medical shops around the select  doctor's clinic or hospital. Such drugs are not sold elsewhere. The same drug manufactured by MNCs or reputed pharma companies is available for less. Here the patient has to shed more money for the local brand as he is denied access to the drug of the company known for the quality.

This usually happens in the case of B complex, vitamin syrups, antibiotics, antacids and anti-ulcer drugs.

In rural areas, RMPs and quacks also prescribe these local drugs and get commission ranging from 50 to 60 per cent of the maximum retail
price.
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Modus operandi by big pharma units
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The modus operandi of pharma companies and distributors, in luring medical
practitioners, is quite interesting. Most of the multinational and big Indian pharma companies has specialist doctors on their payrolls and booked for the next few decades.

These firms lure doctors by offering them trips to Singapore, Bangkok, Malaysia and even Europe in case of specialists.

Manipulating things with Drug Price Control Order is another major
aberration in the industry. There are around 74 drugs in the price control order and it has not been reviewed after 1995. The government has fixed MRP for all these drugs in the Order.

Pharma companies add an ingredient to make it a combination drug and
sell it under a different brand to escape the Price Control Order. They fix their own MRP. Even the recent high-end medicines like retroviral, TB and cancer drugs, stents and implants used in cardiovascular and orthopaedic surgeries do not fall under the Price Control Order category.


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