Tuesday, November 18, 2014

300 Doctors Summoned By MCI For Accepting Bribe From Pharma Company

The Medical Council of India has summoned about 300 doctors from across the country to Delhi to answer questions on an anonymous complaint that they had been bribed by a pharmaceutical firm. About 100 of these doctors appeared before MCI's ethics committee on Monday.

According to the complaint, the Ahmedabad-based pharma company has been paying doctors lakhs of rupees as well as gifting them cars and flats and sponsoring family foreign trips in return for prescribing its medicines even though cheaper alternatives from better known companies are available.

Of the 150 doctors summoned to appear at the last meeting of the ethics committee, 109 appeared. The rest were summoned on Monday. "About 135 are left and they have been asked to appear at the next meeting of the committee in December. According to the rules, they have to be given three chances," explained Dr KK Aggarwal, a member of the panel.
The letter asking doctors to appear before the committee on Monday said: "Please bring your ITR, bank statement for the last three years, passport in original, as well as a set of photocopies of the said documents." The letter also warned that "in case you fail to appear on the above said date and time, the ethics committee will proceed for ex parte decision against you on the basis of available records in the council office".

That had about 100 doctors thronging MCI's office. They were asked to give a response in writing. While many submitted their responses and documents immediately, others chose to wait and talk to their lawyers. "The letter sent to us with a copy of the complaint did not include the details of the charges against us though the complaint did mention that it included details of charges against each doctor. Without knowing the exact allegation against us, how can we be expected to respond?" said a doctor.

Dr Ajay Kumar, who chaired Monday's meeting, said, "They have a week to respond. We did not want to reveal the exact allegations against them in the letters. But when they appeared today, the complaint against them was read out. Now they know the content of the complaint and they have been given a proforma to fill as response."

The anonymous complaint was received by the department of pharmaceuticals in August. "The vigilance division of the department was of the view that since it involved such a large number of doctors, it ought to be examined in detail. So, they sent it to MCI in the first week of September, though anonymous complaints are usually disregarded," said Dr Aggarwal.
According to the complaint, one of the ways in which the firm would bribe doctors would be by paying lakhs of rupees for running advertisements on a TV installed in their clinics. The letter gave the name of each doctor with his or her address and the bribe given to him or her.

It alleged that the doctors were violating basic norms and claimed that the turnover of the company had grown from zero to Rs 400 crore in just five years. The letter alleged that company's brands were priced 15% to 30% higher than those of well-established companies like Cipla, Ranbaxy, Sun, Aristo, Alkem, Zydus and Cadila but still doctors were prescribing its products as the company "was buying doctors by way of offering various means of bribes".

The complainant claimed that the firm was adding the cost of bribes to its products, forcing the patient to pay up. The complainant sought an I-T probe since doctors who allegedly accepted these bribes were evading income tax.
Comment: I believe that this and cash backs from labs are two endemic problems that should be tackled by MCI.
There is certainly a case for small tokens (like pens, stationery items etc.) that can remind the doctor to prescribe a certain brand - without a significant financial value attached. This has been suggested by the American Medical Association as well. However, scientific studies have shown that when large gifts are given by pharma companies, including travel grants, this does influence doctor dispensing, even if the doctors feel that they are being neutral. Of course, cars, houses and similar extremely high cash value items are completely wrong, as is being suggested in the present case.

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