Wednesday, October 30, 2024

Medicare at stake

Medical representatives go for aggressive promotion during busy hours at hospitals
In aggressive promotion of pharmaceutical drugs the country’s medical representatives invade hospitals during busy working hours in violation of marketing code and medical ethics, according to doctors and witnesses.
Visiting the outpatient sections of several public hospitals in the capital The Daily Star correspondent found many medical representatives talking to doctors in their rooms, while patients waited outside.
Public hospital doctors usually see patients from 8:00am to 2:30pm. Medical representatives are allowed to visit doctors when they are not busy with patients, and most hospitals have specific time and date set for the drug promoters.
But medicine promoters are seen roaming hospital corridors and invading doctors’ chambers all through the working days and even during hours when doctors are supposed to take care of patients.
The representatives even check patients’ prescriptions to see whether doctors prescribe the drugs manufactured by their companies, in violation of what some experts said medical ethics and marketing code.
Besides talking to doctors about their new drugs, their efficacy and use, the promoters offer gifts, including foreign trips, to the doctors. There are many takers of such gifts.
“It is an unhealthy competition,” said Prof Rashid E Mahbub, former President of Bangladesh Medical Association, adding that it encourages doctors to prescribe unnecessary drugs just to satisfy the gift-giving pharmaceutical companies.
He said no one other than a doctor is allowed to see patients’ prescriptions, as it violates medical ethics and patients’ right to privacy. Such practice exposes patients’ diseases to medicine promoters, which is not ethical.
“This is complete hooliganism,” said Vice-chancellor of Bangabandhu Sheikh Mujib Medical University Prof Pran Gopal Datta.
He said when hospital authorities restrict entry of medical representatives during working hours, they simply buy tickets as patients to see the doctors. “There they tactfully examine the prescriptions of patients.”
The Bangladesh Association of Pharmaceutical Industries (BAPI) has a code of marketing practice. But it is not followed at all, said Prof ABM Faroque, dean of the faculty of pharmacy at Dhaka University.
According to Bangladesh Health Watch Report 2009, the latest available, the country’s pharmaceutical companies have about 20,000 medical representatives to promote and market their products.
According to another estimate nearly all of the country’s 246 registered pharmaceutical companies have drug promoters.
The medical representatives defend their work saying they meet the doctors to see the status of the use of their drugs.
Representatives from pharmaceutical companies including Popular, SK+F, Beximco, and Incepta told this correspondent that they need to assess the prescription status of the drugs of their companies. It is allowed in the business, they claimed.
A medical representative has a target to sell even up to 450 products of the company he or she is working for.
And common market promotion practice is to visit the doctors at hospitals, diagnostic centres, and the doctors’ chambers, the promoters said.
The number of representatives of a pharmaceutical company range from 150 to 1,200.
When asked about controlling such promotional activities, General Secretary of BAPI Abdul Muktadir said if they control the promotional activities, it will halt the competition and ultimately that will create opportunities for only a handful of companies.
“More competition means more good products at lower prices,” he said adding that the situation will be under control soon after the economy matures.
He also said prescription examination by medical representatives is a part of market research, and it does not violate patients’ rights or their privacy.

-With The Daily Star input

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