Govt trusts pharma cos to stop bribing doctors
Rema Nagarajan | TIMES INSIGHT GROUP
In what seems to be a case of giving the fox the job of guarding the hen house, the government has decided to curb the practice of bribing doctors for promoting drugs by allowing pharmaceutical companies to self-regulate rather than have a legislation to tackle the menace.
This is despite the fact that more than a quarter of the members of the Organisation of Pharmaceutical Producers of India (OPPI)—an association mainly of multinationals which is estimated to account for 70% of the drug market in India—are subsidiaries of companies that have been penalised in the US for illegally promoting various drugs through inducements for doctors.
The latest to be penalised is the pharma giant Pfizer, which shelled out a whopping $2.3 billion in one of the biggest health care fraud settlements. Billion-Dollar Payouts $2.3 billion
Pfizer | Pays the biggest criminal fine in US history
on Sept 2, 2009 for wrongly promoting 9 drugs, paying kickbacks to doctors by wining & dining them and sending them on exotic trips $1.4 billion
Eli Lilly | Pays up in January
2009 for illegal marketing of drug Zyprexa to treat a range of ailments in elderly and kids for which it is not approved, ignoring side-effects of weight gain and diabetes $4.8 billion
Merck | Agrees to pay up in 2007 to settle thousands of cases
registered by patients who suffered heart attacks and strokes after taking Vioxx, used to ease arthritic pain. Drug was pulled out of market in 2004 Huge profit margins let pharma cos bribe docs
New Delhi: Pharma major Pfizer was recently fined $2.3 billion for promoting drugs for usages not approved by the US Food and Drug Administration (FDA) by inducing doctors to prescribe the drugs by wining and dining them and sending them on exotic trips.
Another big player, Eli Lilly, was fined $1.42 billion at the beginning of the year for illegally promoting a drug, Zyprexa, by funding continuing medical education of doctors through millions of dollars in grants to push them to prescribe the drugs for unapproved use.
Glaxosmithkline (GSK) has reserved $400 million to settle charges of promoting unapproved use of drugs and of kickbacks to doctors related to several products.
Yet another OPPI member, Bristol-Myers Squibb, had to pay $515 million in 2007 for giving illegal remuneration to physicians and other health care providers in the form of consulting fees, other programmes and travel to luxurious resorts to get them to promote BMS drugs.
Of the 53 pharma members of the OPPI, over 25% have figured in such cases in the US. This is despite the fact that the Pharmaceutical Research and Manufacturers of America (PhRMA), which includes many of these penalised companies, already has a voluntary code on interactions with health professionals which explicitly prohibits members from giving illegal inducements to doctors to get them to prescribe their products.
Many of these companies also claim to have their own stringent ethical guidelines applicable globally regarding interactions with health professionals. When stringent laws in the US, unlike India which has no laws to tackle illegal inducements to doctors, could not stop these companies from indulging in kickbacks to doctors, it is anyone’s guess how effective self-regulation can be.
However, answering a question in the Rajya Sabha on the steps taken to curb drug companies bribing doctors, the department of pharmaceuticals said it has asked pharmaceutical company associations to formulate guidelines and mechanisms for their strict enforcement.
The government appears satisfied to leave it at that despite being aware that the largest pharmaceutical associations, the OPPI and the Indian Drug Manufacturers Association (IDMA), already have codes which don’t seem to be enforced at all.
The huge profit margins on drugs allow companies to effectively bribe doctors. Small-scale manufacturers of drugs have maintained that the prices of drugs can easily be brought down by 50%. Can big pharma do that?
Bitter Tonic In Chocolate Spoons $600 million Abbott | In 2003, Abbott Laboratories pays up for its subsidiary trying to defraud the govt health insurance provider through false pricing of its products $515 million Bristol Myers Squibbs | In 2007, settles allegations from 1994-2005 of illegal promotion of Abilify (approved to treat bipolar disorder and schizophrenia) for paediatric use $400 million GlaxoSmithKline | Settles charges of offlabel marketing and kickbacks related to several products sold from 1997 to 2004, including antidepressant Wellbutrin $355 million Astrazeneca | Fined in 2003 for illegal pricing and marketing of prostate cancer drug Zoladex, the company’s best selling drug, fetching $794m globally $97.5 million Bayer | Pays in 2008 to settle allegations that it bribed several diabetic suppliers between 1998 & 2002 to convert their patients to Bayer’s products from its competitors $6.8 million Baxter | Pays up in July, 2009, for inflating the average wholesale price of drugs paid for by government insurance $4.5 million Johnson & Johnson | Fined in August 2009 for false and misleading promotion of drug Risperdal, an antipsychotic and Duragesic, a painkiller. Company did not inform of addiction risk of Duragesic and that Risperdal (more than 25% of usage in kids and adolescents) increased risk of diabetes
Don't be fooled by the title of this blog and the article quoted from " The Times of India".On the face of it ,there appears to be a contradiction.Actually there is no contradiction.My story will explain every thing.
It all started about 20 years back. My parents,both of them doctors ,got married.Marriage brought them luck and their practice picked up.They got real busy.Naturally they became the darling of pharmaceutical companies and thus my story began.
One of the pharma company was also manufacturing and marketing condoms. The local representative thoughtfully provided samples of these to my father.Unfortunately for my parents as they were not planning a family just yet and the pharma company, the sample condom ruptured and i was conceived.The repentant representative dutifully arranged all the routine supplements required during the ante natal period.Nine months later i was born. My bonding with pharma companies began even before my birth.
Although unplanned, the first child, that is i, brought even more luck. My parents became busier. It was becoming difficult for my mother to look after me, feed me and spend time with me. As luck would have it i developed lactose intolerance and spared my mother the task of breast feeding. One of the leading companies took care of my needs with their lactose free milk supplements for the next 6 months. So long as i was fed, i did not bother about the hand holding the bottle. another company dutifully supplied the diapers.
As i grew up, i found that all those things a child needs while growing up , were always available to me.I distinctly remember that unlike other kids my parents never took me to market for buying these goodies,instead they were always there in my father's hospital. I can visualize the large plastic bath tub, the tortoise shaped potty, the walker ,tricycle and what not. Those colorful nursery rhyme books,color pencils ,school bags and various tiff ins made my bond with pharma cos ,stronger.A young smart fellow with a tie and a leather bag, brought joy and goodies.
I lived in style . My journey from childhood to adolescence has been very smooth and enjoyable thanks to the unstinting support of the pharmaceutical industry. The result of all this pampering was that i became a spoilt child. I was not a very bright student and no amount of free samples of memory enhancing drugs could make any difference. My parents thought otherwise and wished fervently that i become a Doctor like them and take care of all the investment they had made in the hospital.Well as things stood it was very unlikely that i could secure admission in a medical college on the basis of merit. Here again two companies have jointly undertaken the burden of my medical education in a private medical college. They have also promised to take care of postgraduate studies. I was on cloud nine. Only two things could put a spanner in the scheme . If my parents died ,the pharma cos will not touch me with a ten foot pole.the second thing was the rumour about the government bringing in a legislation to curb pharma cos bribing doctors.
As luck would have it both parents are in the pink of health and as for the other worry you have just read the article.
There is no confusion now. Is there?
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