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The Pharma-Doctor Nexus: The Controversy and Ethics of Freebies to Doctors

By Amigos IAS

Why is it in the news?

  • A committee has recently proposed recommendations to the Union government urging the implementation of restrictions on the longstanding practice of pharmaceutical companies providing freebies or “Doctors’ Commission” to medical professionals.
  • These incentives, often in the form of gifts, cash, or other perks, are given to encourage doctors to prescribe specific brands of drugs.
  • The issue gained attention when Justice D.Y. Chandrachud expressed concern over the alleged extravagant spending by a manufacturer of the antipyretic drug ‘Dolo’ on marketing.

 

Key Concerns Associated with Pharma-Doctor Nexus

  • Doctors, who are expected to make medical decisions in the best interest of patients, may compromise their objectivity when influenced by financial or material benefits from pharmaceutical companies.
  • Patients rely on the unbiased judgment and expertise of their doctors. Any perceived undue influence from pharmaceutical companies can erode patient trust in the doctor’s impartiality.
  • While industry support for medical education is crucial, excessive influence can distort the learning environment and lead to the promotion of specific pharmaceutical products over others.
  • If doctors are swayed to prescribe more expensive medications due to relationships with pharmaceutical companies, it could contribute to escalating healthcare costs.
  • Accepting gifts or benefits from pharmaceutical companies may be viewed as a breach of professional ethics and integrity, as medical professionals are expected to prioritize patient welfare.
  • Violations of guidelines set by regulatory bodies, such as the Medical Council of India (MCI), can result in legal consequences for both doctors and pharmaceutical companies.
  • A perceived cozy relationship between doctors and pharmaceutical companies can negatively impact the overall image of the healthcare profession. It may lead to the perception that commercial interests are prioritized over patient welfare.

 

Measures Taken by Government

  • The MCI, which regulates the medical profession in India, has issued guidelines emphasizing the importance of maintaining professional independence and integrity.
  • Uniform Code of Pharmaceutical Marketing Practices (UCPMP): Enforced since 2015, this code prohibits medical practitioners from accepting gifts, entertainment, travel facilities, hospitality, cash, or monetary grants from pharmaceutical companies.
  • National Pharmaceutical Pricing Authority (NPPA): The NPPA monitors and regulates pharmaceutical product prices in India, ensuring fair trade practices within the industry.
  • Collaboration with Professional Bodies: The government collaborates with professional medical associations and bodies to develop and implement guidelines addressing ethical concerns related to interactions between doctors and pharmaceutical companies.
  • Need for Legislation: While laws and regulations between 1945 and 1986 regulate the manufacture, sale, and distribution of drugs, there is no specific law regulating drug marketing by pharmaceutical firms. In contrast, countries like the United States, France, Germany, Hungary, Italy, and the UK have stringent laws in place to combat corruption in the pharmaceutical sector.

 

Suggestions by the Panel

  • The committee recommends capping the price of branded gifts to doctors at ₹1,000 per item.
  • The panel proposes a prohibition on doctors attending Continuous Medical Education workshops in foreign locations, aiming to limit external influence.
  • The committee suggests that money received by medical practitioners from pharmaceutical companies for research purposes should be taxable.
  • In the case of free drug samples, the committee proposes tax deduction at source for the pharmaceutical company under the Income Tax Act if the value exceeds ₹20,000 per year.

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