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A couple of years ago, a newspaper carried a chilling report of a doctor in a Delhi government hospital performing angioplasty on perfectly health persons who did not need any such intervention. It subsequently came to light that the doctor was in league with a supplier of disposables and together they "manufactured" blockades in hearts where none existed , so that they could make a quick buck by putting stents in healthy hearts. This is an extreme case
of a pharmaceutical company or a supplier and a doctor putting profit
before the health of the consumer. At the other end of In the middle , you have other, but more common kinds of unethical drug promotions such as using disease awareness programmes to promote drugs, or sponsoring conferences and even research. But of more serious concern is the misleading claims about drugs and also deliberate suppression of side effects of drugs. Worse, even when such side effects come to light in one country and the drug is banned, pharmaceutical companies are known to sell them in other countries, unmindful of its consequences on the health of the consumers. With effect from March 15 this year, consumer groups the world over have started scrutinising and monitoring the marketing practices of drug companies to ensure that they do not compromise consumer safety and health. Consumers International (CI), a coalition of consumer groups worldwide, has chosen "Unethical Drug Promotion" as the focus for this year’s International Consumer Rights Day (March 15) and * seeks to replace unethical drug promotion with clear, credible and transparent information* As an example of unethical drug promotion, CI quotes the case of Vioxx (Rofecoxib). Promoted as a safe and gentle pain reliever for those suffering from arthritis, the drug posed a serious threat of cardiovascular problems and even death as a side effect . Says CI:’’ Merck suppressed information about cardiovascular side effects associated with the drug , despite having this information at least four years before the drug was eventually taken off the market. The company spent US $ 160 million annually on marketing this drug. It caused between 88000-140,000 cases of heart diseases in US alone. Roughly about 105 million prescriptions were written for Vioxx for 20 million patients in the US between May, 1999, and August 2004. ( Rofecoxib was banned in India in 2004). Similarly, the BBC programme Panorama documented the increased risk of suicide in children who were prescribed the anti-depressant drug Seroxat and alleged that the pharmaceutical company—-Glaxo SmithKline—-was aware of the risk, yet promoted it. Roughly 50,000 British children were reported to have taken the drug before it was banned in 2003 for use by patients under 18. Ironically, the industry associations have voluntary codes for self-regulation at the global, regional and the national level. Then there are also codes drawn up by individual drug companies, particularly in respect of drug promotion activity. But, says CI, these codes are not always exhaustive or enforced stringently. CI quotes as an example how there were 972 confirmed breaches of the Association of the British Pharmaceutical Industry’s code by the 20 biggest drug companies between 2002-2005. Over 35 per cent of these braches had to do with misleading drug information. Similarly, in Australia and the UK, in the year 2005, 19 of the 20 largest companies failed at least once to keep within the standards that the industry had written for itself. World Health Organisation sets out a global benchmark to judge if drug promotion is unethical, but their criterion is not mandatory and does not carry any legal obligation. Then there are government regulations and codes, but these are again not strictly enforced. Or pharmaceutical companies find ways of circumventing them. So obviously, consumer pressure is necessary to prevent such practices, as unethical drug promotion violates consumers’ right to information, choice and safety.
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