Unethical promotion of drugs through the doctors has been an issue of serious concern worldwide and also in India for some years. Such promotion by pharmaceutical companies often end up in the marketing and consumption of several non-essential and irrational drugs at high prices. Probably this is one of the key reasons for the steadily increasing medical costs amongst the people of the developing countries. In India, the practice has been widespread and most of the large and medium scale companies have been indulging in it for several years. The Central government as a first step to regulate this practice had entrusted Organization of Pharmaceutical Producers of India to frame a set of guidelines to be followed by the drug companies voluntarily. This set of guidelines, based on the IFPMA code, has been in existence from January 2007 but most of the drug firms have not been adhering to these guidelines as they are not legally binding. The Department of Pharmaceuticals then came out with a draft Code of Marketing Practices for the pharmaceutical industry on June 2 banning all kinds of gifts and favours to doctors. The Code clamps down on foreign junkets by restricting industry sponsored continuing medical education (CME) events and drug trial meetings within the country. The code also prevents such meetings from coinciding with sporting, entertainment or other leisure events or activities, and asks companies to maintain a detailed record of expenditure incurred on these events.
Now an expert panel attached to the health ministry has suggested a rather comprehensive set of measures to promote rational use of medicines, to make compulsory use of generic names and also to develop a code of conduct for marketing pharmaceuticals. The proposal to encourage the use of generic names at all stages of procurement, distribution and prescription of drugs sounds excellent as it can contribute to a sound system of procurement and distribution, drug information and rational use at every level of healthcare system. Irrational fixed dose combinations, non-essential vitamins, tonics and cough syrups are mostly the top selling pharmaceutical products in terms of value and volume but they do not contribute to public health. In fact, many of these products harm the patients with serious adverse effects besides imposing huge financial burden and causing drug resistance. Therefore, more stringent criteria for marketing approval of new drugs and routine regulatory review of already marketed drugs is called for. This helps to weed out substandard and irrational medicines from the market over a period of time. The need to have a tough law on promotion is critical to achieve the objective of rational use of drugs. And the rational use of drugs is extremely important to bring down the treatment costs and thereby unnecessary healthcare expenditure.