The Bold Voice of J&K

Commercialization & misconduct of medical prescriptions

111

Shivanshu K Srivastava

Recently, the controversy relating to the raid by the Income Tax department on Micro Labs, the manufacturer of Dolo 650 mg drug, for alleged tax evasion surfaced in the news. Moreover, the Indian Pharmaceutical Alliance (IPA) has lately given a clean chit to Micro Labs against the allegations of providing undue advantage to the medical practitioners by distributing freebies to them worth Rs. 1000 crores as consideration for prescribing their tablets to the patients.
Although there is an allegation against the pharmaceutical manufacturing company Micro Labs for evasion of tax, this allegation is subservient to a larger problem linked with professional misconduct that is often swept under the carpet and therefore remains unattended.
The whole controversy reveals that this particular pharmaceutical company is just the tip of the iceberg and there is a very high possibility of other big names being involved in such illegal activities.
Under the Prevention of Corruption Act, 1988, if any public servant accepts or obtains any sort of gratification whatsoever, other than his legal remuneration to which he is legally entitled, then his or her act would come under the purview of the Prevention of Corruption Act and he or she shall be liable for the punishment prescribed under the Act.
There are several other statutes and regulations that are attracted in cases of professional misconduct and medical malpractice.
Among those legal provisions, the regulations framed for the purpose of regulating the professional conduct of the medical practitioners and the code of ethics relating thereto are more significant in this regard.
The Indian Medical Council has been empowered under clause (m) of Section 33 of the Indian Medical Council Act, 1956, to make regulations in respect of the standards of professional conduct and etiquette, and the code of ethics to be observed by medical practitioners with the previous sanction of the Central Government. Accordingly, the Indian Medical Council framed and notified the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations in the year 2002.
Para 1.5 and 6.5 of the said regulations are of great relevance in respect of this particular issue. First, let us analyse para 1.5 under Chapter 1 (Code of Medical Ethics) which reads as: “Every physician should, as far as possible, prescribe drugs with generic names and he/she shall ensure that there is a rational prescription and use of drugs”. This is an open secret that pharmaceutical companies very often lure private as well as government doctors into prescribing some specific medicines to the patients under the brand name of their manufacturing company so as to increase the sales of their pharmaceutical drugs. This is a flagrant violation of the Code of Medical Ethics under which a medical practitioner is bound (subject to the extent of feasibility) to mention the generic names of the drugs he is prescribing to a patient besides ensuring the reasonable prescription and use of such drugs.
This clearly has the implication that the physician must not use the brand name of any medicine produced by any particular manufacturing company.
Similarly, the latter part of para 6.5 under Chapter 6 (Unethical Acts) reads as: “All the drugs prescribed by a physician should always carry a proprietary formula and clear name”.
A generic drug is produced by various companies that manufacture a specific drug under different commercial names. Thus, a particular medical drug has different commercial names and yet the generic name would remain the same. For instance, if you go to a chemist and hand him the doctor’s prescription having the generic name of any drug, then the chemist would give you that drug under any brand name, whichever is available to him.
However, if you hand give him a prescription having the brand name specifically mentioned instead of the generic name of the drug, then he would be bound to give you the drug of that particular brand only in case he has it. Otherwise, he will tell you that he does not have that particular brand’s drug and would offer you the drug under another brand name. As a layman, we often become sceptical about using the medicine under a brand name other than the one suggested by our doctor and therefore we tend to visit other chemist shops in hope of getting that particular brand’s drug.
We all have previously encountered occasions wherein the doctor prescribes some brand’s medicines to us which are available only in certain medical stores and most frequently in the medical store of the doctor’s own clinic.
This is how the marketing and sale of some pharmaceutical drugs are carried out on an enormous scale without even having the need to advertise the drugs.
The pharmaceutical industry is one of the biggest and most powerful industries of the world and as the ancient adage goes, ‘with great power comes great responsibility’.
The pharmaceutical companies ought to realize that the thousands of crores of money that they spend on the indirect sale of drugs through prohibited ways could be utilized in lowering the price of medicines or in researching ways to increase the effectiveness of the drugs with the aim to reduce the dependency of patients on drugs. Some industries are not meant just for the sake of profit-making but for transforming and healing the world to make it a healthier place to live in.
(The author is pursuing LL.M. from Banaras Hindu University (BHU) and an advocate in Bar Council of Uttar Pradesh).

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