Observing that a cartel of doctors, pharmaceutical companies and diagnostic laboratories was fleecing patients, the Madras High Court on Wednesday wanted to know when a separate union ministry for pharma would be created and when a Uniform Code of Pharmaceutical Marketing Practices would be brought into force to control unethical marketing practices.
Justices N. Kirubakaran and P. Velmurugan raised the questions in an interim order passed by them on an income-tax appeal preferred by a private pharmaceutical company which had spent ₹42.81 lakh in 2012-13 towards sales promotion expenses, which included payments made to doctors for promoting the company’s medicines, and claimed tax exemption.
Authoring the order, the senior judge in the Bench said that around 50 million patients avail themselves of treatment from one million doctors in the country every day. The Indian pharmaceutical sector supplies over 50% of global demand for various vaccines, 40% of generic demand in the US and 25% of all medicines in the UK. Valued at $33 million in 2017, it had recorded a substantial rise in turnover from ₹1.16 lakh crore in 2017 to ₹1.29 lakh crore in 2018, the Division Bench said.
“It is being said that medical mafia is controlling the pharmaceutical field and they are responsible for overpricing of the drugs. For the purpose of promoting their drugs in the market, it is being said, the companies are giving incentives such as providing hospitality and foreign trips to doctors who prescribe their medicines.
“A study conducted by Support for Advocacy and Training to Health Intiatives (SATHI), a NGO, states that big pharmaceutical companies bribe doctors through high value bribes such as smart phones, credit cards, e-vouchers and even female companionship... Thus, patients are compelled to pay more unnecessarily because of overpricing of drugs,” the judges said.
Though such overpricing was prohibited under Section 3 of the Drug (Price Control) Order of 1995 and there was also a body titled National Pharmaceutical Pricing Authority (NPPA) to keep a check on such illegal activities, “the mechanism is stated to be powerless to take action,” the Bench added.
Further, the Medical Council of India (MCI) had taken note of doctors being bribed by pharmaceutical companies in 2009 and amended the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations of 2002. The amendment prescribed punishments ranging from a fine of ₹5,000 to suspension of medical practice for more than one year.
“Inspite of the above regulations, companies and doctors are indulging in malpractices. Therefore, there should be an integrated approach to bring down malpractices by the Union Ministry of Health and Family Welfare, NPPA, MCI and the Income Tax department by taking appropriate proceedings,” the court said.
It directed Assistant Solicitor General G. Karthikeyan to submit by January 20 the details of action taken by MCI, NPPA and other authorities against erring doctors as well as pharmaceutical companies in the last five years.
