<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN">
<HTML><HEAD>
<META http-equiv=Content-Type content="text/html; charset=windows-1252">
<META content="MSHTML 6.00.2745.2800" name=GENERATOR>
<STYLE></STYLE>
</HEAD>
<BODY bgColor=#ffffff>
<DIV><B>From:</B> <A title=drdabade@gmail.com
href="mailto:drdabade@gmail.com">Gopal Dabade</A> </DIV>
<DIV style="FONT: 10pt arial"> </DIV>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">DECCAN</SPAN></STRONG><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">
HERALD, </SPAN></STRONG><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">Monday,
March 13, 2006</SPAN></STRONG><SPAN style="FONT-FAMILY: Arial"></SPAN></P>
<P><STRONG><SPAN
style="FONT-SIZE: 7.5pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"><A
onclick="return top.js.OpenExtLink(window,event,this)"
href="http://www.deccanherald.com/deccanherald/Mar132006/panorama1843482006312.asp"
target=_blank>http://www.deccanherald.com/deccanherald/Mar132006/panorama1843482006312.asp</A></SPAN></STRONG><SPAN
style="FONT-FAMILY: Arial"> </SPAN></P>
<P><SPAN style="FONT-FAMILY: Arial">WHEN TOO MUCH IS A BAD THING<BR>by<BR>Dr
Gopal Dabade</SPAN></P>
<P><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">Are
doctors influenced by the gimmicks on drug promotion of profit-making drug
companies? A study done by WHO unequivocally declares that drug promotion
strongly influences "prescribing behaviour" but doctors underestimate it.
Company funding of doctors, educational events and research are important
elements in this influence. The mighty question is whether drug promotion can be
regulated? </SPAN></STRONG><B><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"><BR><BR><STRONG><SPAN
style="FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">Most of us who visit
our doctor are familiar with medical representatives – those neatly dressed,
well-groomed, young men in neckties with a bagful of gifts and drug literature.
These medical representatives are at the doctor's clinic to promote their
companies' products. This is only one way that drug companies try to influence
the doctor's prescription. There are other ways too such as giving away gifts,
drug samples, sponsorship of conferences etc. Drug companies spend huge amounts
of money on drug promotion to doctors. The result is that the consumer is
burdened when he buys the drug. In the year 2002, almost $21 bn was spent by
drug companies on drug promotion in the </SPAN></STRONG></SPAN></B><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">US</SPAN></STRONG><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"> . In
developing countries like </SPAN></STRONG><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">India</SPAN></STRONG><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">
medical representatives are frequently the only source of information on
medicines. </SPAN></STRONG><STRONG><SPAN
style="FONT-WEIGHT: normal; FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"><SPAN></SPAN></SPAN></STRONG><B><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"><BR><BR><STRONG><SPAN
style="FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">If drug promotion
leads to better prescribing, more scientific use of medicines or improved
cost-effectiveness then there would be no concern. But on the contrary heavy
promotion of new drugs leads to widespread prescribing and use before the safety
profile of these products is fully understood. </SPAN></STRONG></SPAN></B></P>
<P><B><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"><BR><STRONG><SPAN
style="FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">Newer and more
expensive medicines displace older, less costly ones without evidence of an
improvement in outcome. </SPAN></STRONG><BR><BR><STRONG><SPAN
style="FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">Both WHO and NGO have
been expressing concern about inappropriate drug promotion. At the 1977
Roundtable on WHO's Ethical Criteria for Medicinal Drug Promotion there was
agreement that inappropriate promotion of medicinal drugs remains a major public
health problem both in developing and developed countries. The only difference
is that in a developing country like </SPAN></STRONG></SPAN></B><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">India</SPAN></STRONG><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"> the
consumer has to pay through his nose and end up in debt just to pay drug bills.
</SPAN></STRONG><B><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"><BR><BR><STRONG><SPAN
style="FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">Attempts to control
drug promotion have largely been unsuccessful because of the reliance on a
combination of voluntary codes adopted by industry associations and medical
organisations. </SPAN></STRONG><BR><BR><STRONG><SPAN
style="FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">On the surface,
voluntary self-regulatory codes from the pharmaceutical industry may look like a
sensible approach to controlling promotional activities of companies; and
lacking government-industry adversaries. </SPAN></STRONG><BR><BR><STRONG><SPAN
style="FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">In a highly
competitive industry, the desire of individual companies to prevent competitors
from getting an edge could be harnessed to serve the public interest through a
regime of voluntary self-regulation run by a trade association.
</SPAN></STRONG></SPAN></B><STRONG><SPAN
style="FONT-WEIGHT: normal; FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"><SPAN></SPAN></SPAN></STRONG><B><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"><BR><BR><STRONG><SPAN
style="FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">In order to control
promotion, government regulation, training of students, media exposure of
abusive promotion, provision of reliable exposure to non-commercial medical
information to medical doctors and the public are useful. Unfortunately none of
these exists in </SPAN></STRONG></SPAN></B><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial">India</SPAN></STRONG><STRONG><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: Verdana; mso-bidi-font-family: Arial"> .
</SPAN></STRONG></P></BODY></HTML>