Drugmakers helping doctors stay relevant

Cardiologist Prahalad Rao*, attached to two private hospitals and a government hospital in Mumbai, has been “gifted” by a US-based pharma giant with the password to MD Consult, a medical website providing full-text reference journals. Rao can update his knowledge for free as the annual subscription of nearly Rs10,000 for the website will be borne by the drugmaker.

Diabetologist V Gandhi from a leading Bangalore corporate hospital attends at least 4-5 workshops across the country every year, aimed at enhancing doctor’s education.

The companies gain from the process, too, says Gandhi. According to him, medical representatives (MRs) surround doctors during lunch time with leaflets advertising the latest drugs from their companies. “MRs save time and energy travelling to our clinics promoting their drugs, as the workshops serve the purpose.”

In late 2008, a European suture and medical device maker held an education programme on nosocomial or hospital acquired infections for the nursing staff of a south Mumbai trust hospital. Besides a film on the company, the programme involved a quiz for the trainee nurses, with questions like who makes the best sutures and the answers obviously hinting at the company.

These are just a handful of examples of the latest trend in the pharmaceutical industry — continuing medical education (CME).
Due to increasing flak over gifting and receiving free cartons of alphonso mangoes, free trips to the Eiffel Tower and free music systems and laptops, a strategic shift is evolving in the doctor-drugmaker relationship, with CME becoming a safer haven to promote drugs and devices to doctors.

Drugmakers in India spend between 3-6% of their total turnover on CME, says the associate director of a professional services firm.

It is a subtle attempt at generating goodwill and creating a channel to market products under the guise of education, says CM Gulhati, editor of medical journal Monthly Index of Medical Specialties (MIMS).

However, drugmakers beg to differ. According to the MD of the Indian arm of a leading European MNC, CME is key for doctors to keep themselves abreast of the developments, and drugmakers have the resources to facilitate the same.

The chief operating officer of a Mumbai-based drugmaker goes a step ahead, saying it is the “duty” of companies to “empower” doctors through seminars and lectures. “We have a knowledge academy, which holds lectures for the medical fraternity on diabetes, cardiac ailments, etc. It has got nothing to do with our products.”

Then why would the company even spend for the lectures?
“There cannot be a CME programme by a drugmaker without indirect references to the products that it is marketing, or is likely to market, or at least the therapeutic areas it is involved in,” says Dharwad (Karnataka)-based ENT surgeon Gopal Dabade, who is also the co-convenor of All India Drug Action Network (AIDAN).

*Names of doctors have been changed, but incidents are real