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Healthy Skepticism Library item: 2965

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: Journal Article

Lall S, Bibile S.
The political economy of controlling transnationals: the pharmaceutical industry in Sri Lanka, 1972-1976.
Int J Health Serv 1978; 8:(2):299-328


Abstract:

(Limited to parts of article dealing with promotion.) After the establishment of the State Pharmaceuticals Corporation in Sri Lanka, promotion virtually disappeared for drugs that it imported. With the disappearance of promotion, the distribution of free samples, hospitality and visits by sales representatives practically stopped. According to the Pharmaceutical Manufacturers Association (U.S.) this led to problems that the information function on drug research and applicablility performed by drug companies through their sales representatives was eliminated. To counter this “information gap”, the SPC started publishing and distributing two quarterlies of objective prescribing information.

This paper describes the experience of Sri Lanka in reforming the structure of production, importation, and distribution of pharmaceuticals in the period 1972-1976. It highlights the actions and reactions of transnational pharmaceutical corporations to these reforms, and traces the achievements and problems of the State Pharmaceuticals Corporation which was set up to implement the reforms. The roles of political leadership in regulating the power of drug transnationals, and of the medical profession in resisting reform, seem to be of crucial significance. Developing countries wishing to lower the present high cost of drug delivery must proceed with great care and immense caution, since complex problems of quality control, bioequivalence, medical acceptance, and consumer reeducation are involved.

Keywords:
*analysis/Sri Lanka/State Pharmaceuticals Corporation/developing countries/sales representatives/ATTITUDES REGARDING PROMOTION: INDUSTRY/PROMOTION AND HEALTH NEEDS: PROMOTION IN DEVELOPING COUNTRIES/PROMOTIONAL TECHNIQUES: DETAILING Drug Industry* Humans National Health Programs/economics* National Health Programs/organization & administration Pharmaceutical Preparations/supply & distribution* Politics Public Policy Sri Lanka

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909