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Healthy Skepticism Library item: 16976

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: news

Treerutkuarkul A
Companies accused of 'pushing' drugs: Doctors back efforts to regulate promotions
Bangkok Post 2009 Dec 15

Full text:

Over-prescription of pills and medicines by doctors under pressure from pharmaceutical companies is being condemned by senior doctors ahead of a national health assembly on the issue this week.

In some cases, drug sales representatives were criticised for wearing “inappropriate outfits” and offering gifts to secure orders.

Doctors say they are quite prepared to join any public sector moves to end unethical drug promotion to protect patients and cap soaring national health care costs and irrational drug use.

At a forum on ethical criteria for promoting medicines, physician Prasert Palittapongarnpim, of Chiang Rai’s Prachanukroh Hospital, said big pharmaceutical firms use many different methods to encourage doctors to prescribe their drugs.

They range from small gifts and stationery to lucrative luncheon lectures, seminar sponsorships and overseas trips.

Dr Prasert said he was once offered a huge sum of cash by a drug salesperson to change his drug order.

Some senior doctors also tell their medical students to buy drugs of smaller dosages so they can increase the size of their orders.

“I think sponsorships for medical education are unacceptable, unethical and should be changed,” he said. “It has an indirect impact on the national health care system and patients as a whole.”

Some doctors helped promote medical products by writing articles for health publications with big sponsorship logos of medical products, he said.

Sayomporn Sirinavin, a paediatrician at Ramathibodi Hospital, said she was once invited to attend academic training overseas.

But the trip ended with on-site visits with other doctors organised by drug companies.

The doctors agreed that agencies such as the Public Health Ministry and the Medical Council and representatives from drug companies should work together to regulate drug promotion and educate young doctors about being influenced by drug sales staff because of the adverse effects on patients and national health care costs. Last year, up to 40% of the 158.6 billion baht national healthcare budget was spent on drugs.

Medical experts believe the high figure partly resulted from unethical drug promotion schemes. Of the total amount of drugs purchased, 54.9 billion baht’s worth was allocated to 5 million people listed under the health care scheme for civil servants while the rest went to 57 million people under the universal health care scheme.

The disparity between the health care schemes for civil servants and national healthcare patients reflected the grey area of drug marketing and “unusual” drug use, said Niyada Kiatyingungsulee, manager of Chulalongkorn University’s project to monitor drug use and development.

According to the project, the value of retail drug sales in Thailand increased from 186 billion baht in 2005 to more than 200 billion baht this year.

Maureen Birmingham, the World Health Organisation’s representative in Thailand, said based on evidence collected from around the world, doctors were clearly influenced by drug promotions.

Manu Sawang-Jaeng, of the Pharmaceutical Research and Manufacturing Association’s (PReMA) subcommittee on sales and marketing ethics, said he was trying to solve complaints about sales staff wearing inappropriate outfits to meet doctors and offering free gifts.

He said standard uniforms were being suggested.

Mr Manu claimed the problems were not the fault of major drug companies which are members of PReMA.

Amphon Jindawattana of the National Health Commission said the over-prescribing of drugs would be a major topic of the 2nd National Health Assembly to be held over the next few days.


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