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Nearly 100,000 medical and sales representatives—whose key function is to convince doctors to prescribe the drugs of their respective pharmaceutical companies in India—are venting their spleen at their employers.

They are triggered allegedly by the immense pressure to keep up with ever-increasing drug-sales targets and other marketing practices of drugmakers. 

So, on 4 November, a high-level committee appointed by the Supreme Court of India started its first round of consultations to look into various problems in the sector.

The panel was formed following a public interest litigation (PIL) filed in 2021 by the Federation of Medical and Sales Representatives’ Associations of India (FMRAI)—the trade union representing the sales and promotion employees of most domestic and international pharma companies in India.

These medical representatives are aggrieved over the delay in the legalisation of the Uniform Code for Pharmaceuticals Marketing Practices ( UCPMP UCPMP Department of Pharmaceuticals Uniform Code of Pharmaceuticals Marketing Practices Read more ). Ironically, nearly seven years ago, the government admitted that there was an urgent need to do so.

VK Paul, a doctor and member of the government think-tank Niti Aayog, who chairs the committee, heard out appeals made by industry bodies, such as the Indian Drug Manufacturers’ Association (IDMA) and the Organisation of Pharmaceutical Producers of India (OPPI).

The discussions primarily revolved around two demands: relaxing norms related to the distribution of freebies (up to a particular value) to doctors and facilitating Continuous Medical Education (CME) programmes for them, according to people who attended the meeting. The UCPMP considers giving gifts and monetary benefits to doctors as unethical practices. 

“Such demands by the industry are in direct contrast to why the committee was formed in the first place. It opposes patient welfare and leads to bias in prescribing drugs from certain brands,” said Malini Aisola, the co-convenor of All India Drug Action Network (AIDAN), an independent network of several nonprofits working to improve the rational use of medicines.

And then, there is the issue of rising marketing spending. For instance, Dr Reddy’s Laboratories’ marketing expenses rose 27% in the year ended March 2022 to Rs 980 crore (US$120 million). In the same year, Zydus Lifesciences spent Rs 541 crore (US$66.5 million) in marketing expenses—a 2% drop from the previous year—but the total commission given to sales reps rose by 28% to Rs 146 crore (US$18 million). 

Top seven pharma companies have spent Rs 34,187 crore (US$4.2 billion) over the past eight years in marketing, making drugs expensive. Sales promotion expenses constitute 20% of the drugs’ cost

Supreme Court PIL

Naturally, the drug-sales targets have only gone up over the years.

AUTHOR

Maitri Porecha

Maitri writes about everything health for The Ken. For close to 10 years now, she has navigated hospital corridors in her search for a good story. In a past life, when she was not a journalist, she used to teach French at her neighbourhood school. Also an avid fan of forensics, she is always up for decoding mysteries in her free time.

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