Monday, December 22, 2014

Pharma companies can no longer gift freebies to Indian doctors


Excerpts from a report by Rupali Mukherjee in TOI news dated Dec 23.

1. Doling out freebies, cruise tickets, paid vacations and sponsorship to educational conferences and seminars for doctors by pharmaceutical companies has been banned from January.

2. The government has woken up belatedly to curb unethical marketing practices of pharma companies by spelling out a uniform code of conduct for the industry. The code will be voluntary to start with, and kicks in from January 1. It will be reviewed after six months; if not implemented "effectively", the government will "consider"' making it mandatory, sources told TOI.

3. At present, the pharma industry follows a "self-regulatory'' code that curbs unethical sales promotion and marketing expenses, bans personal gifts, and all-expenses paid junkets for doctors and their families, but there have been several instances where companies have violated the code, industry experts say. They say the code exists only on paper as companies try to influence prescriptions through several ways.

4. This is the first time in years that the code has been finalized by the government, as earlier attempts to do so got mired in bureaucratic red tape.

5. Industry experts say that the government's Uniform Code of Pharmaceutical Marketing Practices has been modelled on the Medical Council of India (MCI) guidelines for doctors and healthcare professionals, which were further tightened in 2012.

6. The code clarifies the relationship with healthcare professionals. Regarding gifts, it says "no gifts, pecuniary advantages, or benefits in kind may be supplied, offered or promised to persons qualified to prescribe or supply drugs, by a pharma company, or any of it agents including retailers, distributors or wholesalers".

7. It says "in any seminar, conference or meeting organized by a pharma company for promoting a drug or disseminating information, if a medical practitioner participates as a delegate, it will be on his/her own cost."

8. It further says that gifts for the personal benefit of healthcare professionals and family members (both immediate and extended) such as tickets to entertainment events are also not to be offered or provided by pharma companies, nor cash or monetary grants for individual purposes. Hospitality should also not be extended to any doctor or their family members.

9. The industry associations have to upload the Uniform Code on their websites and will be responsible for informing its members, and the government in case of violations.

10. The code also adds that "where there is any item missing, the code of MCI as per the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulation, 2002 as amended from time to time, will prevail''.


eMedinewS Comments: Dr K K Aggarwal

MCI code of ethics exists for doctors. Any violation can only be challenged in High Court.

Pharma companies until now were affected for any violation in the Income Tax exemptions.  Now pharma companies will also be governed by a similar ( like MCI) code of conduct.

Unless both pharma and doctors group are covered in their respective code of conduct the problem will not be over. So far the MCI code did not cover pharma companies violating MCI regulations'

It is same like, if doctors violate any MCI code they are punished under violation of MCI ethics regulations but same violations if done by medical establishments they are not punished. The need of the hour is to have uniform code of conduct for medical establishments' also.

Another answer is to bring medical establishments and pharma companies also under the preview of MCI ethics regulations.

Saturday, December 20, 2014

Padma Shri Awardee Dr K K Aggarwal Receives Orator of the Year 2014 Award by St Mathew's School

Padma Shri Awardee Dr K K Aggarwal Receives Orator of the Year 2014 Award by St Mathew's School

New Delhi, December 20, 2014: Recognizing outstanding contribution in the field of social work St. Mathew’s Senior Secondary School New Delhi honored Dr. K K Aggarwal with the Orator of the year Award 2014 in New Delhi on its Foundation Day.

An eminent cardiologist, President of Heart Care Foundation of India and the Senior National Vice President Indian Medical Association, Dr Aggarwal has also worked extensively towards helping the lower sections of the society.

Commenting on the occasion, Dr Aggarwal, Sr. National Vice President of the Indian Medical Association and the President of the Heart Care Foundation of India said, “I am honored to receive such a prestigious award from the St. Mathew’s Sr. Sec. School. Every individual has a right to live a healthy life and keeping this mind we started the Heart Care Foundation of India and till date have continued to help many patients live a healthy and normal life. The trust recognized my efforts towards the society and it gives me immense happiness and encouragement to keep doing the same throughout life.”

Dr Aggarwal is the recipient of three National Awards, namely the Padma Shri for brilliance in medicine, Dr. BC Roy award for excellence in socio-medical awareness and DST National Award for Outstanding Efforts in Science & Technology Communication. DR Aggarwal is also Limca Book of Record holder in CPR 10.

Friday, December 19, 2014

Indian Medical Tourism Incomplete without Yoga Department in every Hospital

Recently in one of the interaction the Indian Tourism Minister Dr Mahesh Sharma said that India is going to be the hub of medical tourism because of its hospitality and culture.

It is correct but for that a slight paradigm shift is required in the way we practice medicine in the country. 

Most western patients come to India to take advantage of Yoga and Ayurveda in addition to the western medicine.

Only for a lower cost we cannot attract medical tourists for long as sooner or later the China will over power us in future for medical treatments.

Our Prime Minister has convinced the world to have an international Yoga day. But unfortunately we do not have a yoga department in every government or a private medical institution.

Let India be the first country to have a yoga and an Ayurveda department in every hospital in addition to the western medicine.

The time is to promote traditional Yoga and Ayurveda. Unfortunately as they are not getting an uplifment they are ending up in cross pathy which is not on the interest of both their profession as well as the community.

Recently a review of studies examining the benefits of yoga suggests that Yoga practice provides significant benefits on cardiovascular risk factors, including LDL cholesterol and systolic blood pressure.

Those who practiced asana-based yoga reduced their LDL-cholesterol levels by 12.1 mg/dL and systolic blood pressure by 5.2 mm Hg and increased their HDL-cholesterol levels by 3.2 mg/dL. 

In addition, the yoga practitioners also saw significant reductions in body-mass index, diastolic blood pressure, total cholesterol, triglycerides, and heart rate. Overall, the yogis lost 2.35 kg compared with non exercisers.

Individuals who cannot or prefer not to perform traditional aerobic exercise might still achieve similar benefits in cardiovascular-disease risk reduction by Yoga.
The review, which is published December 15, 2014 in the European Journal of Preventive Cardiology, included 32 randomized, controlled trials involving 2768 participants.

[The author Dr K K Aggarwal is Senior National Vice President Indian Medical Association and President Heart Care Foundation of India]

Thursday, December 18, 2014

Pharmacists Charged With Murder in Fungal Meningitis Outbreak in US

Two pharmacists at the notorious New England Compounding Center have been charged with second-degree murder in the deaths of 25 individuals who received non-sterile steroid pain injections in 2012 and 2013, according to a criminal indictment unsealed today in a federal district court in Boston, USA. The pain medicine preservative-free methyl-prednisolone acetate harbored fungal meningitis.

The two pharmacists, knew they were producing their medications in an unsafe manner and in unsanitary conditions.

The second-degree murder charges are framed as racketeering acts. Prosecutors generally do not need to prove that someone charged with second-degree murder specifically intended to kill someone, only that he or she acted with extreme indifference to human life. If convicted they could be sentenced to life in prison.

The charge framed are

using expired and expiring ingredients to compound the steroid injections and falsifying expiration dates on documents,
autoclaving drugs for less than the 20 minutes needed for sterilization,
failing to properly test drugs for sterility,
failing to recall tainted drugs when microbial growth was later detected,
falsifying drug labels to conceal how expired or untested drug solution lots were mixed with other lots, and
failing to properly clean and disinfect the "clean rooms" where the steroid injections were manufactured. Cleaning logs were falsified to state otherwise, said prosecutors.

IMA Comments: A similar charges should be framed amongst all in India who end up with substandard spurious drugs. The recent Chattisgarh sterilization case is one such example.

In India the person can be and should be booked under 304A of IPC: "Causing death by negligence.—Whoever causes the death of any person by doing any rash or negligent act not amounting to culpable homicide, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both".