Unethical Pharmaceutical Promotion: Now It Is Time to Act
Correspondence Address :
Dr. Viral Shah,Senior resident, Department of Endocrinology, Postgraduate institute of medical education and research,Chandigarh,(India).E-mail: viralshah_rational@yahoo.co.in ,Phone- 09872308785.
It was a very interesting article by Masood I (1). The article has highlighted various issues on pharmaceutical promotion as an industry and a professional perspective. I want to share my opinion about the pharmaceutical promotion.
The interaction between pharmaceutical companies and physicians is not new. Since the time of Hippocrates, it has been a major concern (2). Such issues had been discussed even in the 1850s (3). As highlighted by the authors, in this era, a number of pharmaceutical companies (PC) have flooded the market with numerous products and so, there has been an increase in supply versus demand. Therefore, in this fierce competition, they (PC) want to increase their sales by any means, thus leading to unethical promotions and deviation from their original aim of creating awareness about their product to enforce physicians to prescribe their products.
India has a large pharmaceutical industry. A major expansion started in the early 1970s when the Indian government took two decisions. Firstly, it decided to permit domestic manufacturers to produce generic versions of patented molecules without permission from overseas innovators—provided a different manufacturing process was employed. Secondly, small scale pharmaceutical units were eligible for huge fiscal incentives and state subsidies. The new policy led to an unprecedented growth of medicine makers. Today, an estimated 17 000 pharmaceutical companies produce over 40 000 branded formulations, many times more than in the rest of the world (2).
Does it mean that the number of sufferers have increased in India? it is agreeable that there is increase in education; public awareness and availability of health centers in rural India have brought many diseases into focus. However, rather than the increase in the number of patients, the increase in the number of drugs in a prescription seems to be an important factor behind the huge profitable phrama business.
There are codes of conduct promoting the product as mentioned by Masood in his article. However, Gulati (3) was right in saying that no codes work for the promotion; it is the 3 Cs that work. The 3 Cs stand for convince, confuse and corrupt. Taking a step ahead, I would like to say only one C that works, and it is to corrupt, because it is very difficult to convince or confuse the grey haired and grey matter professionals.
The ways to curb the problem lies at three levels. One is by educating the consumer; the patients, two- by educating the professional and by regulating the pharmaceutical companies. I hope that rather than blaming others, we should think of our moral duties for which the medical profession is considered to be the most respectful and the noble one.
Recently, the Medical Council of India (MCI) has amended the Professional Conduct, Etiquette and Ethics Regulations, 2002 (4) for medical professionals in India to curb unethical pharmaceutical promotions. But the million dollar question is that whether these regulations will solve the problem. I think that until and unless we, the medical professionals decide and stop unethical practice for the sake of money; nothing will work. Another question is that, ’Who should take the lead?’ Medicalassociations? The MCI? Government authorities? The solution starts with the word “I”, that we ourselves should be determined to stop unethical promotions to maintain the dignity of our profession. Otherwise, as time goes by, this noble profession will become a business and we all who are considered to be next to god today, will become the businessmen of tomorrow. I think that NOW is the time to
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com