Big pharma lures doctors through high value bribes through medical representatives, such as smartphones, credit cards, e-vouchers etc, according to a study conducted by Support for Advocacy and Training to Health (SATHI).

The study is based on 50 in-depth interviews with medical representatives in six cities. “From high value gifts like smartphones costing ₹80,000, microwave ovens, tablets, silver items, gold jewellery to petro-cards, credit cards, e-vouchers for online shopping are trends in promotional practices among doctors,” the study reported.

And at the receiving end of this are medical representatives who are tracked by their supervisors using iPads, which is a source of constant stress, said the study.

“We don’t have data on how many medical representatives are committing suicide. Three months ago, a representative of Mankind pharma committed suicide in Gurgaon. Last month, a representative of Alkem in Uttar Pradesh killed himself,” said Pankaj Kumar, Secretary of Federation of Medical and Sales Representatives’ Associations of India (FMRAI).

A trend of the propaganda cum distribution companies are new entities which are franchisees of the pharma companies who buy drugs in bulk from manufacturers, give their own brand names and directly sell them to retailers and doctors at huge discounts and incentives including gifts, cash, hospitality and travel facilities, said the study.

Regulations needed

It added that the pharma companies offer bribes up to ₹50,000 showing doctors as principal investigators in research paper when they have had nothing to do with the research. There is no law to regulate unethical promotional practices prevalent in pharmaceutical industry.

“A year and a half ago, a draft of regulatory codes which was sent to Law Ministry to reign in unethical practices under Essential Commodities Act was rejected. Yet, the Ministry of Health in a reply to a Right of Information (RTI) report said that the draft was being discussed,” said Amitava Guha, co-convenor of Jan Swasthya Abhiyan.

Puneet Bedi, senior gynaecologist from private-run Apollo Hospital, said: “Drug companies are traditional villains, then come the equipment manufacturers, then are corporate hospitals for incentives, and the latest in the line are corporate labs who are major players luring doctors to prescribe unrelated tests.”

Bedi recounted a case of a pharma company CEO who told him, “Everyone has their price - just name yours.” He further added that he signed as many as 40,000 cheques per month allegedly in bribes to doctors.

“He was surprised to know that I don’t accept bribes,” said Bedi.