Ethics in Pharma Marketing Essay

The pharmaceutical market in India today is worth Rs.57206 crores up from Rs. 5000 crores in 1995*. It is one of the fastest growing markets with a growth rate of around 15%. India has a large number of Pharmaceutical companies which operate in an environment of high competition. The competition is even higher in a high generic market like in India where drugs are in fierce price competition. It is estimated that there are around 20,000 pharmaceutical companies* in India, competing for a share of the market, in a poorly regulated environment. To be ahead in the race, pharmaceutical companies are investing highly in marketing and promotion of their drugs. The Consumer International Report 2010, on an average, the Indian Pharmaceutical companies spend almost 30% of their revenue in drug promotion which is one of the highest percentage in the world. Drug promotional strategies are communication strategies through which Pharmaceutical companies convey the benefits of their products and services to their target customers. The World Organization defines promotion of drugs as all information providing and persuasive activities by drug manufacturers and distributors, which influences the prescription, supply, purchase and/or use of medical drugs. In India, the promotion of drugs is fairly pervasive and has become a part of the everyday life of most doctors. Virtually all medical journals contain advertisements of different drugs, doctors are provided unsolicited information on new drugs by the pharmaceutical companies and branded drugs are directly marketed to the consumers. However, many marketing strategies are far more personal; involving provision of gifts to the doctors, sponsoring certain educational or social activities for the physicians and cultivating a close relationship between the company’s Medical Representatives (MRs) and the physicians. This interaction and relations between the Pharmaceutical companies and the doctors has attracted a lot of attention in recent times, mainly because the primary ethical duty of the doctor is to provide patients with the most effective treatment and the pharmaceutical companies with their primary motive of extracting maximum profits through their drug sales influence the prescriber’s decisions by unethical drug promotion. While the Pharmaceutical companies have always been blamed for bribing doctors, the doctor’s perspective of not considering acceptance of gifts as unethical shouldn’t be ignored. However, among the various forms of drug promotion acceptance of gifts by the doctors from the company’s representatives has been a matter of concern as it leads to conflict of interest between the doctors and the patients. Four fundamental principles of medical ethics are as follows, 1) Autonomy To provide informed choice and to respect the patient’s decision. 2) Beneficence To always act in the best interest of the patient 3) Nonmaleficence To always protect the patient from any harm 4) Justice To follow equity in providing healthcare When physicians accept gifts or get influenced by the unethical promotion of drugs, there may be a conflict of interest between their responsibility to provide the most effective and most affordable treatment to their patient and any obligation which they may be facing to prescribe a particular company’s drug. Other activities which are unethical and still followed by the Pharmaceutical companies are- giving selective or inaccurate information to the prescribers and the patients, giving poorer quality of drug information than it is given to their western counterparts, etc. in India, currently there is no legal requirement in periodic recertification or continuing medical education. So for the prescribers there is no other way but the company’s medical representatives in obtaining information about the latest developments in the field of therapeutics. Recently in India, due to public concern about these practices, there has been development of various guidelines in the area of unethical drug promotion. However, these guidelines did not impose any restrictions on prescribers. In 2009, the Medical Council of India (MCI) passed amendments on the Code of ethics which now contains strict measures against any medical practitioner who benefits from any pharmaceutical company. Thus elaborated guidelines on the appropriate relationship between the prescribers and the pharmaceutical companies are in place. Inspite of this, medical professionals continue accepting gifts and getting influenced by the unethical drug promotion. So this raises several questions on the doctor’s perspectives on what he considers to be ethical in the current drug promotion practices. Do the prescribers consider the personalized marketing tactics to be ethically acceptable despite the critical concerns regarding it? This paper will aim to understand the prescriber’s perspective of ethics in drug promotion. The aim of this paper is to study the ethics in the drug promotion activities undertaken by the pharmaceutical companies in India and to understand the doctor’s attitudes and perceptions of ethics in these activities. Till date no study has been undertaken on the ethics in drug promotion in the Indian concept. The present study attempts to address this problem. Also the study is important for two reasons. 1) Data from India on attitudes and practices of doctors regarding ethical drug promotion are virtually non-existent. 2) In view of the recent guidelines by the Medical Council of India (MCI), it is important to know the magnitude and nature of the problem amongst the doctors.