Hridkamal Roy, Editor, India Pharma Outlook
Research conducted by India Pharma Outlook revealed that many physicians have been bribed for decades to prescribe specific medicines and, in an extended number of cases oncologists have been bribed to validate clinical trials of certain drugs. As per sources, pharmaceutical companies offer gold, gift card vouchers, expensive phones, home appliances and cheques to physicians in order to get their company medicines prescribed by them. Many other unethical marketing practices such as providing expensive brunches at five star restaurants and sponsored family trips to foreign countries have also come under the radar. The revised Uniform Code for Pharmaceutical Marketing Practices (UCPMP) published on 12th March by the Dept. of Pharmaceuticals aims to curb the ongoing unethical marketing practices exercised by pharmaceutical companies to get their medicines sold in the market.
“The UCPMP can work out positively for all the native pharmaceutical manufacturers who are producing generic drugs that are pocket friendly for consumers. If pharmaceutical MNCs are unable to influence physicians for prescribing expensive drugs, the equivalents of which are present in the market for much lower prices, it will mean benefits for the native pharmaceutical economy”, said sources to India Pharma Outlook.
Although according to the Federation of Medical and Sales Representatives’ Association of India (FMRAI) statement to the media, the revised UCPMP is nothing but “old wine in a new bottle” as nothing about penalizations has been stated by the government. However, there are still various issues which the revised UCPMP can help in solving in order to put an end to the unethical practices for pharmaceutical marketing.
The question here arises, when does a physician prescribe a branded or a generic drug? Research revealed that most of the trusted physicians in the industry would go for branded drugs because of lack of standardization in the generic versions for them. As a result, if a generic is prescribed and there is an adverse reaction in the patient’s health, the accountability that needs to be taken by the manufacturer is very less. On the other hand, the manufacturer of a branded drug which is much costlier than the generic version will have to take complete responsibility for any adverse event that takes place.
This aspect might not apparently seem to be associated with the UCPMP but the validation for both the branded and the generic versions are provided by the Central Drugs Standard Control Organization (CDSCO) and if that is the case, how can the efficacy of drugs be brought into the question? And if a branded drug is more efficient than the generic one, why was the generic drug validated and brought into the market in the first place?
In this regard, the PIL issued by the Supreme Court of India in August, 2023 mentions that physicians are to prescribe medicines using their generic names. Even if they are prescribing drugs with brand names, the formulations for those must be mentioned beside it. This will act as a huge benefit for the consumer who will now have the choice to choose from a number of medicines under similar formulations. It will also add to consumer education of medicines and their prices.
“It has become mandatory to mention the formulations but most of the physicians are not doing it. There can be various reasons behind it but it is one the aspects that need to be regularized in the market and all physicians must follow it. In fact, it will very soon be mandatory”, said sources from the medical community.
The revised UCPMP can play a vital role in this regard. If pharmaceutical companies are strictly directed to follow the guidelines, it will put an end to the unethical practices that lead to physicians writing drugs of specific companies without mentioning the formulations. Then they will be forced to write the name of the formulation and leave it to the will of the consumers which drug they want to buy.
It is not very old an incident where a physician would not only advise a patient on the medicines that need to bought, but also advise from which shop it needs to bought. As times passed, the scenario changed slightly. Now physicians would say that medicines could be bought from any shop but the names of the medicines must be ones prescribed. In most of the cases, the prescribed drugs would be branded drugs, the generic versions of which are available in the market at much lower costs. According to our research, private hospitals, nursing homes and various other kinds of medical institutions are directly involved in taking monetary benefits from manufacturers for spreading their products among consumers.
An example of this is the industry for baby food. Despite several brands being available in the market, many hospitals and pediatricians stick to prescribing specific baby food products on the ground of their unethical collaboration with the manufacturers. Similar instances can be seen the gynecological segment, in the section of medicines for the aging population and even in the vaccinations for children.
“The government has been trying to stop the unethical practices and has been able to control them on the grounds of prescribing new drugs and providing samples to physicians. However, the bribery and addition to the black economy is still on. Close to 15 percent of the medical practitioners in the country are involved in this”, said sources.
The hindrances lie at different stages of the sector and the revised UCPMP has provided guidelines that will be able to detect and solve some of them. It can be regarded as one of the many positive measures that need to be taken by the government in order to stabilize the pharma economy of the country and completely restrict the growth of black money.