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Freebies
Fraud
Last
month, the US government issued warnings to pharma companies
dissuading them from offering any sort of financial
incentives not only to doctors but to pharmacists and
other healthcare professionals. This must surely be
one more screw clamped down on a beleaguered industry
already on the defensive. The Inspector General of the
Department of Health & Human services, Janet Rehnquist’s
first of its kind new standards issued to the pharmaceutical
industry encompass a wide spectrum leaving little scope
for the industry to woo their primary consumers. Drug
makers henceforth will have to give up offering incentive
payments or other “tangible benefits” to prescribe
or recommend particular drugs or even switch patients
from one medicine to another. Aggressive marketing norms,
very common for decades in this industry the world over,
has no doubt reached levels that can be perceived as
totally bereft of any benefits to the ultimate consumers,
the patients, but there is everything in it for all
the intermediate players. It wouldn’t be wrong
to say that these “tangible benefits” ultimately
are borne out by the patients via the costs of medicine.
These practices are rampant in every country, each adding
its own flavour and colour matching its traditions and
morality levels. The US government’s warning that
such practices could run afoul of federal fraud and
abuse laws is serious enough and drug makers flouting
the guidelines could be booked under the kickback statute.
There
is no doubt that the entire healthcare business in the
US is a well-oiled machinery interlinking doctors, hospitals,
home care agencies, laboratories & suppliers of medical
equipments etc leading to high costs of medicare for its
citizens. After issuing guidance to other segments in
recent past to prevent fraud & abuse, the pharma industry
is now under searchlight. The Indian Drug industry which
follows western practices is probably one-up over its
US counterparts when it comes to making payments that
far exceed “fair market value for the services rendered”
by the medical profession. Infact, the fraud and abuse
here is blatantly rampant and crude. Unlike the US, the
Indian companies can argue that there are stricter price-controls
here or drugs are anyway cheaper. But that’s not
the issue. Granted, there is tremendous competition, what
with over 20,000 companies big & small vying for the
same market. But there is a different kind of fall-out,
that of over-drugging the populace with the doctor playing
the devil’s advocate. Prescription trends and the
number of drugs recommended per patient in the past couple
of years will reveal unnecessary drugging. But targets
are sacrosanct for companies who rope in doctors to achieve
them. Having exhausted all conventional methods of “buying”
them, the latest trend is to make cash payments to doctors
who then write prescriptions ’n’ times the payments
which are pre-set. The pharma companies doling out goodies
are merely making investments shown as expenses for the
year, which are anyway factored into the cost of medicines.
Product promotion expenses of pharma companies need to
be drastically worked downwards by regulatory authorities
and ‘free samples’ ruthlessly curtailed for
older products. Doctors may need to be closely monitored
fiscally. It’s time for corrupting practices to receive
shock treatment.
—
nvramamurthy@rxpress2.indexp.co.in |
