Doctors accepting freebies such as gifts and foreign jaunts from pharmaceutical companies will now be punished, based on the value of gifts received. The punishment will range from a censure for gifts of up to Rs 5,000 to deletion of the errant doctor’s name from the state or national medical register for a period of one year or more for freebies valued more than Rs 1 lakh.
The Medical Council of India (MCI) is set to notify the new ethical guidelines under the Indian Medical Council (Professional Conduct, Etiquette and Ethics) (Amendment) Regulations, 2015. For the first time, these guidelines will define punishment for errant doctors based on the value of favours or freebies received from pharma companies.
While the Indian Medical Council Regulations, 2009 bar doctors from receiving freebies, the punishment, if caught, is now subject to the discretion of either the central or the state councils’ ethics committee. A voluntary code of conduct for pharmaceutical companies came into effect from January 2015. It was to be reviewed a few months later to decide whether it should instead be made mandatory. The review is still pending.
As per the new ethics guidelines any doctor accepting gifts, travel facilities, hospitality, cash or monetary grants worth Rs 5,000 to Rs 10,000 from a pharma company would see his/her name removed from the national or state medical register for three months. Nobody can practice medicine without registration with either the state medical council or the central council. If the value of the freebies is between Rs 10,000 and Rs 50,000 the penalty would go up to six months, and for those priced Rs 50,000 to Rs 1 lakh, the errant doctor’s name would remain struck off the register for a year.
For free gifts amounting to more than Rs 1 lakh the period would be more than a year, subject to the discretion of the ethics committee. Repeat offenders under all slabs would be punished on a case to case basis, depending on the gravity of the offence.
An alleged nexus between some pharmaceutical companies and unscrupulous doctors is widely recognised as one of the key reasons behind rising drug prices, although companies maintain that the margins are to account for research and development work. In reality, cost of the freebies to doctors are usually worked into the marketing cost of drugs. As a result, drugs priced higher containing the same molecules often tend to be the market leaders.
But one of the worst kept secrets of the industry is that the code is flagrantly violated. Some time back, the MCI ethics committee had summoned 326 doctors from Maharashtra for accepting gifts, including jewellery and flats, apart from the more usual gift of foreign jaunts.
The new guidelines lay down that medical practitioners may carry out research work funded by pharma companies, provided they ensure that the research proposals have all the necessary clearances, it fulfills the legal requirements, the funding is publicly disclosed, and proper care and facilities are provided to volunteers. Any contravention for the first time will merit a censure but repeat for offenders names would be struck off the medical registers for a period depending on the gravity of the violation.
According to norms, a doctor cannot also endorse any medical product unless it is to present the results of an efficacy or other study done in an appropriate scientific body or journal. Not doing so for the first time would result in a censure; a second offence would mean deletion of his/her name from the medical register.
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