Doctor-drug firm nexus robs patients

March 10, 2008
By Syed Akbar
Hyderabad, March 9: Doctors get more than what you pay as consultation fee
every time you visit them.
They get commission from pharmaceutical companies for prescribing their
products, including those which are classified as "irrational" medicines.
The "commission" or "gift" is directly proportional to the number of
prescriptions the doctors write a month. The higher the number of prescriptions, the more the valuable the gift is. There are instances of drug companies luring doctors with cars and expensive cell phones or even "bearing" the tuition fee of their
children. The expenditure they incur on gifts is made up in the form of higher MRPs for the medicines.
Such doctor-drug firm nexus is limited not just to a "poor" nation like India. But it extends to highly developed and "rich" nations like the USA and the UK too.
The Indian National Commission on Macroeconomics and Health conducted a study some time back on how pharmaceutical companies hustle their products. Its report revealed
that doctors are prescribing drugs that are "irrational or non-essential or (even) hazardous." Taking a close look at India's 25 top-selling medicines, the Commission's study found that 10 of the 25 fell into that category.
Even if pharma companies do not offer direct incentives to doctors, they make up the shortfall in their relationship through sponsoring medical conferences or continuing medical education programmes. Health experts say, "medical conferences are unfortunately becoming into a sort of melas. The presence of drug industry is felt everywhere at the venue, from their advertisement on the walls to offering free lunches and gifts".
"The drug industry, immensely powerful and profitable, spends more than 11 billion US dollars each year in promotion and marketing. It has succeeded in tightening its grip over the medical community over the last two decades. It tempts doctors by such offers as expensive gifts and foreign junkets, which often leads to the unscientific, costly and irrational use of drugs," points out Dr SP Kalantri, associate editor of the Indian Journal of Medical Ethics.
In a bid to check the doctor-drug firm nexus which is taking a heavy toll of the patient's pockets, the World Medical Association has come out with a set of guidelines for its members all over the world.
The guidelines suggest that no individual doctors should receive direct
payment from commercial companies to cover travelling expenses, room and board at
a conference, or compensation for their time. Drug companies should have no influence on the content, presentation, choice of speakers, or publication of results.
The names of any companies providing financial support should be publicly disclosed.
Funding for a conference can be accepted as a contribution to the general costs of the meeting but not as payment for any specific lecturer or participant. Physicians should not accept gifts, hospitality, services, and subsidies from industry if acceptance might diminish, or appear to others to diminish, the objectivity of
professional judgement.
But are doctors listening?