On Prescriptions Without Motives

Pharmaceutical industry associations will present a code of ethics governing their marketing practices to the Department of Pharmaceuticals by the end of this month. Dubbed the Uniform Code of Marketing Practices (UCMP), the move is a response to a government directive to the drug industry following media reports of unethical inducements to doctors such as foreign junkets, expensive gifts etc. “It is expected that all stakeholders will help maintain its sanctity to address this public, sensitive issue, effectively,” says Tapan Ray, director-general of the Organisation of Pharmaceutical Producers of India (OPPI).

The UCMP is unlikely to alter the landscape, though. According to a source familiar with the drafting process, it will be a combination of the codes currently adopted by the OPPI (comprising largely multinational firms) and the Indian Drug Manufacturers’ Association (IDMA, representing homegrown ones). These codes cover most or all forms of promotional communications such as visual aids, sponsored visits to international scientific symposia, and fees given to doctors to speak at events. However, there are no set limits on spending and adherence is voluntary. The source says there is no indication from the government that this is anything but a self-regulatory initiative.

If the intent is to curb doctor inducement, then this is far from satisfactory. More effective would be a legal mechanism that requires companies to disclose payments or gifts to physicians above a particular value after a consultative process involving both doctors and firms. It is not unheard of: in the US, legislation for a national registry of payments by drug and device firms is being debated. In its wake, two drug companies, Eli Lilly and Merck, have begun disclosing payments above a certain value voluntarily. Three states in the US have also set limits on payments and gifts to doctors.