[e-drug] please be a little moderate.... (4)

["Chandra Gulhati" <seeemgee@yahoo.co.uk>]

E-DRUG: please be a little moderate.... (4)
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dear E-druggers,

As a clinician who has worked both in the West (UK, Belgium) and a developing country (India), I can understand the feelings of Dr. Frighi and others who are devoted to the welfare of their patients.

However Society forms its opinion based on collective experience and evidence. How does one explain the following facts?

1. Eleven drugs (such as metamizole, droperidol, cisapride) internationally banned or discarded are being prescribed by doctors in India even when safer and far more efficacious alternatives are available?
No doubt that drug regulator has failed in his duty but why should doctors patronise such products. It is certainly not because of ignorance. The list of such discarded drugs is listed in MIMS INDIA each month, has been reproduced by several newspapers with huge circulations and has been a subject of discussion on several TV programmes. Doctors patronise because they are patronised by producers.

2. Due to non-application of product patent in India so far, each molecule has several branded formulations. Our study has shown that more expensive brands (some times 600% more than equivalents) sell far more than less expensive brands even when the producers have equivalent credibility. This happens because producers use excessive profits to give incentives to doctors. Naturally doctors accept such favours; otherwise the sales will not go up.

3. Doctors are involved in large-scale manufacturers sponsored drug trials without mandatory regulatory approval and even more important without proper, valid, informed consent from poor, illiterate, female subjects. Examples: Letrozole use in infertility, erythromycin pallets use for contraception, just to give two recent examples. Why do they do so?

I am not suggesting that all doctors receive incentives but many do. No wonder Indian medical profession today is one of the least respected professions.

Dr. Chandra M. Gulhati
Editor, MIMS INDIA
(Monthly Index of Medical Specialities)
e-mail: indianmims@yahoo.co.in
seeemgee@yahoo.co.uk