The Amar Singh-led Parliamentary standing committee on Health and Family Welfare has called upon the government to take strict and speedy action against the erring pharmaceutical companies which roll out gifts to the doctors for promoting their medicines in violation of the rules laid down the government.
The committee, in its 45th report on 'issues relating to availability of generic, generic-branded and branded medicines, their formulation and therapeutic efficacy and effectiveness', noted that even after the MCI notification restraining the doctors from accepting gifts, there is no let-up in this evil practice. The pharma companies continue to sponsor foreign trips of many doctors and shower with high value gifts like air conditioners, cars, music systems, gold chains, etc. to obliging doctors who then prescribe costlier drugs as quid pro quo.
The committee noted that despite there being a code of ethics in the Indian Medical Council Rules introduced in December 2009 forbidding doctors from accepting any gift, hospitality, trips to foreign and domestic destinations etc., there is no let-up in this unethical practice. Ultimately all these expenses get added up to the cost of drugs.
Since MCI has no jurisdiction over drug companies, the government should take parallel action through drug controller general of India (DCGI) and the Income Tax Department to penalize those companies that violate MCI rules by cancelling drug manufacturing licences and/or disallowing expenses on unethical activities, the report said.
One of the suggestions put forth before the committee was to make it mandatory for all doctors to write all prescriptions in generic names only. However, the committee feels that going for a “generic only” prescription policy has its flip side. Even if the doctor prescribes a drug by generic name, the chemist will be free to dispense any equivalent. Thus the power will shift from doctors to the chemists. The pharma companies would unethically start wooing the chemists instead of doctors. This will be worse than current situation. If the patient does not get any relief, doctor will blame the chemist. Moreover while the doctor has some interest in the continued patronage from the patients, chemists could not care less. For them profits will be the only criteria of selling medicines, the 31-member committee in its report said.
The committee is aware that in its bid to help bring down healthcare costs the Union health ministry had recently issued directions to doctors in the Central Government-run hospitals to prescribe only generic drugs as far as possible and not branded drugs. In order to eliminate middlemen (C&F agents, distributors, wholesalers, retailers) the Committee recommends that the Governments, both at the Centre and the States procure generic drugs in bulk from manufacturers and dispenses them directly to patients, through its health centres, the report which was presented to the Rajya Sabha on August 4, 2010 said.