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Pharmaceutical drug promotion: how it is being practiced in India?

The pharmaceutical industries (PI) throughout the World are heavily involved in aggressive drug promotions, with a clear aim to change the prescribing habits of physicians and to encourage the self-medication of patients. Broadly, drug promotion refers to all the informational and persuasive activities of the PI, the effect of which is to induce prescription, supply, purchase, and use of medicinal drugs. It includes the activities of medical representatives, drug advertisements to physicians, provision of gifts and samples, drug package inserts, direct-to-consumer advertisements, periodicals, telemarketing, holding of conferences, symposium and scientific meetings, sponsoring of medical education and conduct of promotional trials. The PI has the right to promote its products, but it should do so in a fair, accurate, and ethical manner. The promotional claims need to be reliable, truthful, informative, balanced, up-to-date, and capable of substantiation in good taste. However, now a days, whilst the promotional methods have become very sophisticated and effective, it was found that while promoting their products, the PI does not adhere to these ethical principles. Hence, in most situations, these lead to irrational use of drugs. This unfortunate situation could be tackled only by the multiple prong strategy involving government, PI, doctors, medical associations and consumers. The government is required to formulate some guidelines in addition to developing their own code. The doctors and consumers are required to be educated on the promotional practices and abuses committed by the PI and different ways to tackle those. Various medical and consumer groups should also intervene to improve the scenario of promotion.

Advertising↗

[The competences of doctors and apothecaries in relation to the prescription or medicines according to the analysis of ordinances from 1796].

The tasks and duties of apothecaries were perfectly outlined and regulated by the Real Tribunal de Protomedicato (Royal Tribunal of the Protomedicate) as well as the Real Colegio de Boticarios (Royal College or Apothecaries). However, when the Real Colegio de Medicina de Madrid (Madrid Royal College of Medicine) was set up, this institution began to take over certain responsabilities which, until then, had been regulated and controlled by a series of instutions such as the Royal Colleges. This was clear interferences in the privated affairs of these institutions in the presumible aim of newly centralizing power in one medical centre as had occurred throughout history. In any case, professional Colleges began to spring up and clearly define the frontiers between the three branches of health care. They also began to dictate deontological standards both in the professional terrain and between professionals and society in general.

Ethics, Medical↗

[Not Available].

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Drug Therapy↗

[The analects of Hajime Hoshi (No. 3) - philosophy of Hoshi].

Hajime Hoshi was the founder of Hoshi Pharmaceutical Company and Hoshi University. He made one of the biggest pharmaceutical companies in Japan in the early 20th century, and furthermore was a journalist, member of the Diet, educator, and also a writer. With such a checkered career, he had an attractive and invincible philosophy. As well as his most import philosophy "kindness first" described in the previous paper, "cooperation first" also had weight in his thought. In the Creed of the Hoshi Pharmaceutical Company, he said "self-reliance should go hand-in-hand with cooperation. Cooperation is an essential requisite in all successful enterprises." "Cooperation is an order of the god, and leads directly to progress." "Cooperation is construction, but noncooperation is destruction." Besides the thought "cooperation first," a part of his profound aphorism is described below. "Patience produces everything and conquers everything." "Success is proportioned to the degree of patience." "Success or failure is determined not at the end, but at the start of an enterprise. A well-conceived plan is the mother of success." "Train your mind. Man's brains become the more fertile and keen, the more they are used." "The is no limit to improvement and invention. We should never relax our endeavor to improve and invent." "Smile! Smile! Do your work with a smile on your face. Conquer difficulty and discontent with smiles." "Yesterday's impossibility is today's possibility. Today's impossibility is tomorrow's possibility."

Commerce↗

The ethics of post-marketing surveillance of therapeutic agents.

Trials of new therapies have strict codes of conduct which expect the highest of ethical practice. Local ethics committees review protocols, patient information, consent. National research councils delineate guidelines for minimum standards regarding subjects in such trials. Once medications enter the market place, there is less definition of minimal codes of conduct. Clinical trials are designed to meet regulatory demands to access commercial markets. Prior to marketing, there is a usual drug trial exposure of less than 5,000 individuals which diminishes identification of rare adverse events. Australian case law has found negligence for not warning of a 1:14,000 risk of sympathetic ophthalmia and more recently, in Chappel v Hart, even a speculative risk was grounds for negligence. Recent reports of serious adverse events for conditions such as epilepsy or depression resulted in companies appearing to expend considerable effort to suppress concern rather than to seriously investigate these complications in the post marketing period. This paper will explore such cases and discuss approaches to improve post marketing surveillance and patient protection.

Adverse Drug Reaction Reporting Systems↗

Therapeutic horizons--the human genome.

The sequence of many genes has been conserved during evolution, offering insights into gene function and new opportunities for research in pharmacology and drug development. The many ethical issues surrounding genetics have the potent tial to halt the genomic revolution unless society strives to understand and resolve these issues. Advances in pharmacogenomics hold significant promise for improved health care, such as by enabling clinicians to select the optimal medications and dosages for individual patients.

Ethics, Pharmacy↗