THE growth and prevalence of unethical and aggressive marketing strategies pursued by the pharmaceutical companies that spend a large amount of their annual turnover in bribes and gifts in different forms to physicians to promote their medicines eventually burdening the consumers as the companies recover the expenses through increased drug prices are worrying. A study on the prospects and challenges of the pharmaceutical industry in Bangladesh published on December 1 by the Bangladesh Institute of Development Studies reveals that pharmaceutical companies in Bangladesh spend more than Tk 6,000 crore on marketing a year. The study also shows that pharmaceutical companies spent 29.6 per cent of their turnover on marketing in 2018, while the drug market was worth Tk 20,511.88 crore that year. A major amount of this marketing expenditure, the BIDS study says, is spent to give gifts to doctors which is, by local and international laws and policies, an unethical practice that affects the whole industry and the brunt of which are borne by consumers as they are forced to pay more for medicines. The drug prices, experts say, would drop by 70 per cent if such unethical marketing could be stopped.
In the absence of a strong monitoring mechanism and legal provisions, the pharmaceutical companies line their pockets with the money of patients to meet their marketing cost which is the main reason for an increase in drug prices. A 2015 BRAC study says that approaches such as inducements, persuasion, emotional blackmail, serving family members of the doctors and others are used by the pharmaceutical companies to influence popular physicians to establish brand loyalty. Such marketing strategy goes completely against the code of marketing practices. For example, article 19 of the Ethical Criteria for Medicinal Drug Promotion of the World Health Organisation says, ‘Medical representatives should not offer inducements to prescribers and dispensers. Prescribers and dispensers should not solicit such inducements’; while the Code of Pharmaceutical Marketing Practices in the country mentions that ‘no gift or financial inducement shall be offered or given to members of the medical profession for purposes of sales promotion.’ But there are, as health experts rightly observe, no regulatory directives or punitive provisions for companies breaching the code. Even the Drugs Act and the Drug Control Ordinance do not stipulate any punitive measure for violation of the code leaving the pharmaceutical marketing scene in anarchy. As many countries have enacted laws criminalising such unethical practice in marketing, Bangladesh urgently needs a similar enactment with punitive measures for the violation of the code.
The government, under the circumstances, must amend the code and laws on drug marketing keeping to international legal instruments and the WHO guideline and include punitive measures to gain control over the pharmaceutical industry. The government, especially the Directorate General of Drug Administration, must put an effective monitoring mechanism in place to arrest any unethical practices to ensure consumers’ right to medicines at reasonable prices.
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