Unethical practices indulged in by physicians have been under the government scrutiny for some years now in the country. The government could not curb such practices of physicians as there has been no cooperation from the members of this noble profession or its regulatory body. One of the main complaints against the medical practitioners has been their collusion with the pharmaceutical companies in prescribing expensive medicines by accepting bribes and favours. This has been a practice existing for several years to promote the products of pharmaceutical companies but was not so well known to the general public. With increased competition amongst the pharma companies to push up their sales, the practice has become widespread and crossed all the limits. It is no more a secret that a major part of the price of the prescription drug is on account of the loading of promotional costs on medicines. It is difficult to gauge what percentage of the cost of medicine is promotional expenditure but is estimated that it accounts for a substantial part of the cost the medicine. For the pharma companies, increase in prescriptions will decide the sales growth and profits whereas for doctors, dependability of companies on them, bring unlimited returns by way of incentives for prescription. A large number of doctors are also found to be stocking and selling medicines directly to the patients in their clinics. Several such incidents have been reported from different parts of the country although such practice is in violation of the provisions of the Drugs & Cosmetics Act. Under Schedule K (5) of the Act, doctors are allowed to dispense medicines in their clinics only under certain conditions. But, doctors are found to be flouting this Schedule by dispensing medicines indiscriminately, at times, even charging higher prices.
In order to check the practice of bribing doctors by the pharma companies, the Department of Pharmaceuticals had come out with a Uniform Code of Pharmaceutical Marketing Practices June last year. It was decided then to introduce the code as a voluntary one to be followed by the drug companies in promoting their products. And if the Department finds adoption of the code is not satisfactory by the companies, it will make the same a statutory code. As per the terms of the code, no gifts, pecuniary advantages or benefits in kind may be supplied, offered or promised to persons qualified to prescribe or supply by a pharmaceutical company. The code of conduct, however, did not work so far and the Department could not also enforce the same on the companies. Now, the Union health ministry has taken the initiative in this regard and asked the Medical Council of India to take action against the doctors who accept gifts and freebies from the pharma companies. How the MCI will monitor such unethical practices of the physicians and whether the body will take any punitive action against its members is something to be seen. Health ministry is also thinking of bringing a legislation to curb this practice of the doctors. In case of selling medicines directly to patients by doctors, the respective state drug control departments have to act as it is violation of the D&C rules. For successful enforcement any existing rule or new act, some amount of cooperation is required from the members of medical profession and its association. Unless that happens, it seems very difficult to discipline this profession.