Health of a nation

The move by the Medical Council of India to amend the code of conduct for doctors barring them or their family members from accepting gifts or hospitality from pharmaceutical companies is welcome. But it also raises questions about the delay in amending the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. The anti-competitive practices in pharmaceuticals and the health delivery system have become too blatant to be ignored. Many voices have been raised within the medical profession, the pharmaceutical industry and in the civil society about such unholy nexus which has seen rapacious profiteering by the pharmaceutical industry in collusion with a section of medical community which has been untrue to its Hippocratic oath. Consumer interest organisations have come out with many instances of differential mark-ups for the same generic drug by different companies and doctors prescribing the higher priced drug when lower priced alternatives are available in return for rewards in the form of cash, foreign trips and upgrading of facilities of clinics at the cost of the pharma companies. The chemists or pharmacists too have colluded in such practices.
There have been instances of private medical practitioners prescribing drugs on trial and medicines that have been banned in the West. Some private practitioners, particularly in rural areas, routinely administer to their patients drugs that they receive as samples from pharma salesmen. There have also been complaints that doctors are paid by the pharma companies on ‘per prescription’ basis, encouraging them to prescribe unnecessary and costlier drugs to patients. The lax manner in which the Drugs Control Authority operates has contributed to such unethical practices.

It is apparent that the MCI has been remiss in checking such practices while being aware of them. Its newfound alacrity in attempting to pull up its socks may have something to do with Union Health Minister Ghulam Nabi Azad announcing that the government was contemplating a bill to break the nexus between doctors and the big pharma. Having announced the changes to the code, the MCI will obviously lobby with the government to pre-empt the bill. The government must not only resist such pressure, but go further to set up a commission with statutory powers to check such dangerous practices and afford cheap and effective health care for all.