That some pharmaceutical companies give expensive gifts, distribute cash and pay for extravagant pleasure trips of doctors is no news. What is alarming is that there is no law to punish those guilty of this unethical practice; and the Government refuses to blink. As a result, patients are forced to buy costly medicines while the nexus between the pharmaceutical companies and the doctors flourishes.
The Medical Council of India (MCI) has a code of ethics which bars doctors them from accepting any gifts, cash, travel facilities or hospitality from pharmaceutical companies. However for the companies, there is a voluntary code, known as the Uniform Code of Pharmaceutical Marketing Practices (UCPMP), which experts says is a not a very effective mechanism.
The Government, it seems, has only lately woken up to the malpractices being resorted to by the drug companies. The Finance Bill, 2022 has come up with an amendment to Section 37(1) of the Income Tax Act that says freebies/expenses by the pharmaceutical companies that violate the MCI ethics will not be eligible for deductions while computing their business income.
Tax experts, however, opine that the amendment is a very small step towards cleaning up the unhealthy practices in the healthcare system. There is very little regulation or checks on malpractices, they say. In the last 10 years, only a few doctors have been debarred from practice. A study found that seven major pharmaceutical companies alone spent a total of Rs 34,186.95 crore on marketing during the eight years, which significantly increased the price of the drug. Sales promotion, says the report, accounts for about 20 per cent of the cost of a drug.
The Government had proposed implementing the Uniform Code for Pharmaceuticals Marketing Practices in 2015, which was then made voluntary, after many protests. The code was to be implemented for six months, after which it was to become a legal provision. But this has not happened till date.
India needs a strict law, like the international provisions, which not only curbs unethical practices but also mandates severe punishment for playing with the health of the people.
There are stringent laws in place to reduce corruption in the pharmaceutical sector in countries like the United States, France, Germany, Hungary, Italy and the UK. And these laws are effectively implemented. In 1996, a doctor was sentenced to death for a heart valve scandal in Germany. Johnson & Johnson was fined $2.2 billion in 2009 while Pfizer was fined $2.3 billion in 2013.
There are more such examples, like Glaxo Smith Kline paying a fine of 3 billion euros in 2014, in a case in which four officials went to jail in China. In 2018, Pfizer had to pay a $23.85 million fine for bribery in India to settle a US kickback probe. Unless India, too, comes up with a robust law, the nexus between drug manufactures and doctors, who prescribe their products under undue influence, will continue to thrive.