Pharmaceutical Promotion and Its Influence on Prescription Behavior: Ethical Issues and Legal Framework in India

Abstract

Pharmaceutical companies employ various techniques to promote their drugs to the physicians. Some of these techniques are purely informational like advertisements in medical journals and detailing by medical representatives, but some other techniques aim to induce the physicians to prescribe particular drugs by offering them financial incentives like gifts, sponsorship of visits to attend educational conferences, funding of research, etc. The latter category of promotional techniques may unduly influence the prescribing behavior of physicians leading to irrational prescription of drugs that are not in the best interests of the patient. Given the potential of these techniques to cause harm to patients, efforts have been made to regulate it in India as well as other countries. In India, the regulations issued by the Medical Council of India regulate the conduct of physicians in their relationship with the pharmaceutical industry; however, they are ambiguous, non-comprehensive, and not enforced properly. The pharmaceutical companies, on the other hand, are subject only to self-regulatory codes issued by the pharmaceutical associations and by the government that lack teeth. These regulatory measures have not been sufficient in curbing the undue influence of the promotional techniques on physicians’ prescribing behavior, and thus, there is a need to overhaul the regulatory framework in India by taking guidance from other countries. However, ultimately, it is the reflection by the pharmaceutical companies and especially the physicians on their ethical duties and adherence to them that will result in ethically appropriate prescription of drugs.