Even as the Department of Pharmaceuticals (DoPs) voluntary and non-binding Uniform Code of Pharmaceuticals Marketing Practices (UCPMP) has so far proved to be toothless in arresting the unethical marketing practice of bribing doctors by the pharma companies for prescribing their drugs, there is growing opinion among the experts that the Indian drug authorities should look to the US for finding a more practical solution to this growing menace.
According to the experts, a new rule is being framed in the US under which it will be legally mandatory for drug companies to publicly disclose all payments and expenses, both in cash and kind, made to doctors in excess of 10 dollars. As per the new rule all expenses will need to be uploaded on the websites of pharma companies.
Any violation of the new US rule will attract stiff penalties, up to US$ 10,000 for each undisclosed payment and US$ 100,000 for deliberate default that can go to a total of US$ 1 million a year. The rules will also apply to professional bodies of doctors and advocacy groups of patients. For example the American Pain Foundation gets 90 per cent of its budget from drug and medical devices manufacturers.
The new US regulations are meant to empower patients to make a better-informed decision when choosing their doctors and making treatment decisions. According to consumer activists, patients want to know if they are getting treatment based on medical needs and not due to a lunch or financial relationship between the doctor and the drug company.
Experts said that even before the new US regulations were announced, many medical colleges had Conflict of Interest rules in place that forbade financial dealings between faculty members and the pharmaceutical industry. For example both Stanford University and University of Colorado, Denver and their affiliated teaching hospitals initiated actions against doctors on their staff that delivered promotional lectures for the benefit of drug manufacturers.
But in India, the situation is far worse. Doctors are dined, wined and flown to exotic places abroad to extract prescriptions. While the Medical Council of India (MCI) has done its duty of banning such unethical practices on the part of doctors, there is no corresponding obligation on the part of pharmaceutical manufacturers. Thus accepting bribe is banned but giving bribe is permitted!, said Dr CM Gulhati, well-known health expert and editor of the medical journal MIMS.
Despite a strong recommendation from the Parliamentary Committee on Health to bring in a mandatory Code of Conduct to regulate marketing practices of drug companies, the DOP is content with a toothless, non-binding code that is supposed to be implemented by drug industry associations whose own members are engaged in giving kickbacks! DOP has a Conflict of Interest because its mandate is to promote drug industry. Both Ministry of Health and Drugs Controller General, India (DCGI) whose job is to protect interests of patients are merely silent spectators, Dr Gulhati regretted.