Cracks in doctor freebies codeDrug companies in India will be prohibited from handing out cash or gifts or stand-alone entertainment to doctors under a code of ethics proposed by industry associations to govern the marketing of medicines.

But the code has run into rough weather even before it has been adopted, with at least two industry associations disassociating themselves from the document, tabled at a meeting called today by the government’s department of pharmaceuticals.

Cracks in doctor freebies codeThe two associations, however, said they were not against having a code. The Small and Medium Pharma Industries Confederation (SPIC) said it wanted a legally enforceable code rather than a voluntary one. The Indian Pharmaceutical Alliance (IPA), whose members account for half the revenues from medicine sales in India, said it hadn’t seen the document and didn’t know what it contained.

The Uniform Code of Pharmaceutical Marketing Practices, however, lists six associations as signatories, including the SPIC and the IPA.
It bans companies from providing doctors cash, gift certificates or personal gifts including music CDs, DVDs, other electronic items and sport and entertainment tickets. It also bans standalone entertainment, leisure or social activities.

The move by the industry bodies, under government prodding, follows years of concern among health activists and even some doctors that the marketing practices of drug companies in India have transgressed ethics. In recent years, several doctors and other health professionals have cautioned that the incentives provided by companies to influence prescriptions made by doctors could lead to higher treatment costs for patients.

The incentives have ranged from an evening cruise with food and drinks for doctors and their families on the Hooghly to all-expenses-paid foreign trips and the payment of instalments for cars, according to doctors and medical representatives familiar with promotional practices.
But the proposed code sanctifies the current practice of sponsorship, foreign travel, and hospitality, linking them to conferences aimed at providing doctors with scientific or educational information about products.

A company should not sponsor travel to a foreign country “unless it is appropriate and justified to do so from the logistical point of view”, it says without explaining. It justifies international conferences when participants from many countries are involved.

“This is a complete eyewash,” said Lalit Jain, SPIC vice-president. “We want something with legal teeth, not just a voluntary code.”

The six signatories listed by the document are the Confederation of Indian Pharmaceutical Industry, Federation of Pharmaceutical Entrepreneurs, Indian Drug Manufacturers’ Association (IDMA), Organisation of Pharmaceutical Producers of India, SPIC and the IPA.

“We haven’t even seen this code; so we have no clue what it contains,” said Dilip Shah, IPA secretary-general. “But we’re adopting our own code of ethics that was developed by the IDMA.”