By
Dr Arun Mitra
With
every passing day there are new innovations in the field of medicine. New drugs
and devices are coming out. It is therefore important for the medical
professionals to be regularly updated through continued medical education (CME)
programs. Academic bodies hold their annual national meets as well as state and
local CMEs. As the advancement is very rapid, the number of such events has
increased manifold in the past few years. Various state councils made it
mandatory for the medical professionals to attend such CMEs and obtain credit
hours for renewing the registration. The medical council also gave broad
guidelines about organizing such events. The clause 1.2.3 of the Indian Medical
Council (Professional Conduct, Etiquette & Ethics) Regulations, 2002 states
‘A physician should participate in professional meetings as part of Continuing
Medical Education programmes for at least 30 hours every five years, organized
by reputed professional academic bodies or any other authorized organization.
The compliance of this requirement shall be informed regularly to Medical
Council of India or the State Medical Council as the case may be’.
The clause “6.8 of the Code for the medical
professionals relationship with pharmaceutical and allied health sector
industry says that ‘a medical practitioner shall not receive any gift from any
pharmaceutical or allied health care industry and their sales people or
representatives; shall not accept any travel facility inside the country or
outside, including rail, air, ship, cruise tickets, paid vacations etc. from
any pharmaceutical or allied healthcare industry or their representatives for
self and family members for vacation or for attending conferences, seminars,
workshops, CME programme etc as a delegate; a medical practitioner shall not
accept individually any hospitality like hotel accommodation for self and
family members under any pretext; a medical practitioner shall not receive any
cash or monetary grants from any pharmaceutical and allied healthcare industry
for individual purpose in individual capacity under any pretext’.
Similarly
the Uniform Code of Pharmaceutical Marketing Practices (UCPMP) clause 6 and 7
prohibit any pecuniary benefits to the person qualified to prescribe drugs. It
also prohibits any type of grant in aid to the persons of medical profession to
participate in the conferences in the form of travel grant or accommodation
facilities.
Most
of the conferences/CMEs are sponsored by the pharmaceutical and device making
companies. In some cases they spend exorbitant amounts on these events. The
organizers of the events give permission to the companies to hold stalls on
payment to display their products. Invariably these events are now-a-days being
held in 5-star hotels and so the charges of the stalls are also expensive. In
one such event the rate of a stall for a three day period was found to be
astonishing. The stalls were divided into various categories. Platinum stall,
size 10X10 meters @ Rs. 90 lakh and above; Diamond stall 10X6 meters @ Rs. 75
lakh; Gold stall 6X6 meters @ Rs. 50 lakh; Silver 6X3 meters @ Rs. 35 lakh;
Bronze 3X3 meters @ Rs. 20 Lakh. Then there were other less important stalls
with charges ranging from Rs. 3 lakh to Rs. 25 lakh. These companies take
stalls at several conferences every year. It is easy to make out the amount
spent. Obviously the companies paid for these stalls to get the orders from the
visiting delegates and earn profits. Whatever one may say there is always a
human factor that one is obliged to prescribe the product of the promoters.
Most
of the expenditure on healthcare is on drugs, which accounts for nearly 67
percent of total healthcare cost. It is, therefore, imperative that the drugs
should be cheap. India had been a hub of manufacture of cheap bulk drugs by the
public sector pharmaceutical units. The IDPL in particular played a vital role
in this including in the national health programmes. This type of exorbitant
expenditure on promotion adds to the cost of drugs.
It
is true that medical education and medical practice have moved a long distance
from the days of Gurukul, where the disciples used to observe strict discipline
living under most arduous conditions. Change is an obvious and natural pattern
of life. But it is also understandable that education does not need to be
obtained sitting in the high profile expensive halls of five-star hotels. Such
approach automatically makes the entry of market forces in to the system. As a
result, right form education to the delivery of healthcare, profit becomes the
norm. A doctor thus is forced to act according to market rules shedding social
responsibility.
It
is time the medical organizations come forward to speak against such market
oriented healthcare. They should enforce the ethics for not accepting pecuniary
benefits of any kind from the medical companies and organize such
conferences/CMEs on their own expenses. The companies which spend so much on
the stalls and promotional aspects are not naïve. They invest. When the expenses
cross a limit they increase the charges of their products. Ultimately it is the
consumer, the patient who bears the brunt.
Successive
governments have failed in implementing these codes. Even after so many years
the UCPMP is still voluntary. It has to be made mandatory. Medical association
too should be brought under the ambit of such codes. The health professionals
should realize that it is not fair to have lavish food and drinks at the
expense of someone. After all medicine is not a luxury. (IPA Service)
The post Promotional Activities Hurting Drug Prices appeared first on Newspack by India Press Agency.
