Non-profits bring to light doctor-pharma nexus

Group accuses Novartis of providing inducements to medical professionals; company says it has not violated any norms

Published - December 10, 2019 01:39 am IST - Mumbai

A network of non-profit organisations and advocacy groups has written to the Centre highlighting the corrupt nexus between doctors and pharmaceutical companies. Citing a complaint received from an Andhra Pradesh-based man, the group has made specific allegations against pharmaceutical major Novartis of providing perks to doctors as inducement.

The allegations come at a time when a scathing study by the Pune-based Support for Advocacy and Training to Health Initiatives (SATHI) has revealed doctors taking incentives in the form of gold jewellery, smartphones, international pleasure trips and even demand women for entertainment from pharmaceutical companies.

“Novartis provided inducements to doctors in the form of honorariums for participation in conferences, travel assistance, accommodation, food expenses, and registration fees, all of which are strictly prohibited under the Uniform Code of Pharmaceutical Marketing Practices (UCPMP) as well as the Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002, for registered medical practitioners,” said the letter by the All India Drug Action Network (AIDAN) along with the Third Party Network, Partners in Change, Praxis: Institute for Participatory Practices and Prayas.

Addressed to the Ministry of Chemicals and Fertilizers and marked to other departments on December 7, the letter further adds that Novartis had drawn up “consultancy” agreements with doctors, but these were illegitimate and unethical and the company had provided inducements to doctors affiliated with government institutions as well.

“Even though this evidence is in respect of a single company, it is our understanding that almost all pharmaceutical companies — Indian and foreign alike — are indulging in unethical practices in the guise of consultancies and varied professional engagements,” the letter said.

Malini Aisola, co-convener of the AIDAN, said, “That commissions and incentives in various forms are given to doctors is well-known. We have highlighted one such example because we have the evidence.”

She said the regulation for trade margin rationalisation will not be successful until the government stops the marketing and promotion of pharmaceuticals and medical devices. The group has demanded an in-depth investigation into the unethical agreements of Novartis, the practice of retaining “scientific advisors” by companies, among other things.

Dr. Arun Gadre, co-author of the SATHI study, said not all doctors resort to wrong practices. “But there are miscreants, and we need to act against them,” he said, adding that the UCPMP should be made statutory to regulate pharmaceutical companies.

The SATHI study consists of 50 in-depth interviews conducted in six cities. Besides revelations on incentives in the form of leisure trips, microwave ovens, tablets, silver items, gold jewellery and petrol cards, the study also cites a startling case of three neurologists from Mumbai on a sponsored foreign tour along with “two south Indian heroines for entertainment.”

In a response to an email sent by The Hindu , listing the allegations against Novartis, a company spokesperson said it has not violated any provision of either the Medical Council of India (MCI) guidelines or the UCPMP, or looked for loopholes as insinuated.

“All agreements with the medical community are conducted in a transparent manner in full compliance with MCI guidelines and UCPMP, and all contracts are made as per the law of the land with full disclosure and transparency,” the spokesperson said. The company does not provide any hospitality or travel expenses or any form of reimbursement to doctors for participation as delegates in conferences, said the spokesperson.

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