Abstract
The study examines the attitudes among physicians regarding acceptance of gifts, sponsorships, and drug samples in response to marketing efforts of pharmaceutical companies in India. The research also attempts to study physicians’ perceptions of the Medical Council of India (MCI) guidelines on the code of conduct for pharmaceutical marketing practices and the influence of these guidelines on physicians’ actions. A structured questionnaire was developed for collecting primary data regarding exposure of physicians to promotional tools and physicians’ attitudes and practices with regard to various professional ethical issues. One thousand physicians from private and government hospitals located in a metropolitan area were approached personally or through email for getting the questionnaire filled. A total of 189 completed and usable questionnaires could be obtained which is a response rate of approximately 20 %. Respondents in the study indicate being offered samples, sponsorship, and gifts by pharmaceutical companies with a frequency of at least once a month. Thus, many pharmaceutical firms are not following the code of conduct issued by the Department of Pharmaceuticals, Govt. of India. Further, though almost all physicians report being aware of the guidelines issued by the MCI, yet as many as 69 % of the sample admitted to be accepting gifts and sponsorships offered by the pharmaceutical firms. Educational programs were found to be influencing physician prescription behavior to a greater extent when compared with gifts. Frequency of offers made for gifts and sponsorships were found to be dependent upon physicians’ practice (number of prescriptions written) and the type of hospital they are associated with (private or government). The study focuses on sensitive yet critical ethical issues related to the promotional practices of pharmaceutical firms in India and physicians’ responses with regard to these promotional practices in the context of the guidelines of the Medical Council of India and the Department of Pharmaceuticals.
Similar content being viewed by others
References
Ashcroft R E, Dawson A, Draper H, McMillan J. (2007). Principles of health care ethics. 2nd edition (pp. 4–6). West Sussex: John Wiley & Sons Ltd.
Black Harvey (2004). “World Report”. www.thelancet.com, vol 364, November 6
Brett, A. S., Burr, W., & Moloo, J. (2003). Are gifts from pharmaceutical companies ethically problematic? A survey of physicians. Annals of Internal Medicine, 163(18), 2213–2219.
Dongre, Y., & Mahadevappa, B. (2010). Building access to healthcare in rural India: possibility and feasibility of low-cost medicine. International Journal of Pharmaceutical and Healthcare Marketing, 4(4), 396–407.
Ernst and Young (2009). Taking wings, “Indian Pharma market valued at over Rs 55 K crore in FY 10,” The Economic Times, 30 July 2009
Gaur, R. R., Sangal, R., & Bagaria, G. P. (2010). A foundation course in human values and professional ethics (pp. 220–221). India: Excel Books.
Goozner, M. (2005). Doctors who write guidelines often have ties to the drug industry. British Medical Journal, 331, 7523–7582.
Healy, D. (2000). Good science or good business? The Hastings Center Report, 30(2), 19–22.
http://delhi.gov.in/wps/wcm/connect/doit/Delhi+Govt/Delhi+Home. Accessed on: 23 September 2012
http://dictionary.reference.com/browse/ethics. Accessed on: January 9, 2012
http://pharmaceuticals.gov.in/uniformcode.pdf. Accessed on: January 5, 2012
http://www.ey.com/Publication/vwLUAssets/Pharmareport/$FILE/Pharmareport.pdf. Accessed on: January 5, 2012
http://www.ifpma.org/fileadmin/content/Publication/IFPMA_Code_of_Practice_2012.pdf. Accessed on: January 5, 2012
http://www.macmillandictionary.com/dictionary/british/ethic#ethic_3. Accessed on 1 September 2012
Katz, D., Caplan, A. L., & Merz, J. F. (2003). All gifts large and small: toward an understanding of the ethics of pharmaceutical industry gift-offering. The American Journal of Bioethics, 3(3), 39–46.
Kmietowicz, Z. (2004). Second drug firm found guilty of switching patients to new drugs. British Medical Journal, 329(741), 875.
Moynihan, R. (2003). Who pays for the pizza? Redefining the relationships between doctors and drug companies. British Medical Journal, 326(7400), 1189–1192.
Moynihan, R., & Cassels, A. (2005). Selling sickness: how the world’s biggest pharmaceutical companies are turing us all into patients. Bound Brook: Avalon.
Orlowski, P. J., & Wateska, L. (1992). The effects of pharmaceutical firm enticements on physician prescribing patterns, there’s no such thing as a free lunch. Chest, 102, 270–273.
Parker, S., Jr., & Pettijohn, C. E. (2003). Ethical considerations in the use of direct-to-consumer advertising and pharmaceutical promotions: the impact on pharmaceutical sales and physicians. Journal of Business Ethics, 48(3), 279–290.
Poirier, T. I., Giannetti, V., & Giudici, R. A. (1994). Pharmacists and physicians’ attitudes toward pharmaceutical marketing practices. American Journal of Hospital Pharmacy, 51, 378–381.
Raanan, G. (1994). Medical ethics: four principles plus attention to scope. BMJ, 309(6948), 184–188.
Sibbald, B. (2001). Doctors asked to take pledge to shun drug company freebies. Canadian Medical Association Journal, 164(4), 531.
Shapiro, J. P., & Shultz, S. (2001). Prescriptions: how your doctor makes the choice. US News & World Report, 130(7), 58–61.
Sillup, G. P. (2008). Ethical issues in pharmaceutical industry: an analysis of US newspapers. International Journal of Pharmaceutical and Healthcare Marketing, 2(3), 163–180.
Strout, E. (2001). Doctoring sales. Sales and Marketing Management, 153(5), 53–60.
www.indiaoppi.com,OPPI_Marketing_Code_2010. Accessed on: April 27, 2012
www.mciindia.org/RulesandRegulations/CodeofmedicalEthicsRegulations.aspx. Accessed on: January 5, 2012
www.pna.org.ph/files/phap.ppt. Accessed on: April 27, 2012
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Handa, M., Vohra, A. & Srivastava, V. Ethics: the physician–pharma dyad in India. Asian J Bus Ethics 3, 1–10 (2014). https://doi.org/10.1007/s13520-012-0025-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13520-012-0025-5