Frederik Joelving of Reuters Health went to India to report:
“Sales representatives for Abbott Laboratories Inc’s Indian subsidiaries know what it takes to get a doctor to prescribe the drugs they market: a coffee maker, perhaps, or some cookware, or maybe a vacuum cleaner.
These are among the many gifts for doctors listed in an Abbott sales-strategy guide for the second quarter of 2011…
In interviews with Reuters, dozens of doctors, drug reps and other healthcare insiders said domestic and multinational drug makers routinely shower Indian doctors with gifts, posh junkets abroad, and cash payments disguised as consultancy or other types of fees.
“Indian CRM,” or customer-relationship management, is what industry insiders call this system of inducements. None of the doctors or reps who described their participation in this trade would speak on the record. Under Indian law, doctors are prohibited from accepting cash, gifts or travel from drug companies. Still, enforcement is rare, and drug makers may lavish gifts on doctors with impunity, though their home countries may punish the practice.
In a country where doctors often make less than $10,000 a year, it can be an effective strategy.
“Somebody is doing something for you,” says a Delhi-based cardiologist. “Obviously you will want to return the favor.” He says he prescribes more drugs from companies that provide gifts and send him on paid vacations to Thailand, Hong Kong and elsewhere. One of those companies, he says, is the India-based Ranbaxy unit of Japan’s Daiichi Sankyo Co.
“We do not sponsor vacations for doctors,” a Ranbaxy spokesperson said. “We are viewed as a scientifically and academically orientated company and our promotional activities are built around academics and science.”
In response to questions from Reuters, Chicago-based Abbott said that it complies with local laws and regulations in India. It added that company policy forbids employees to “offer or give a sponsorship, gift, meal or entertainment in exchange for an explicit or implicit agreement that Abbott Products will be used, purchased, ordered, recommended or prescribed or that Abbott or any Abbott products will receive any favorable treatment.”
SO MANY CHOICES
The Indian market is particularly vulnerable to corruption because of the intense competition here. Until 2005, India flouted drug patents, refusing to rein in domestic copycats of Big Pharma’s blockbusters. Brands proliferated. Today, an Indian doctor can choose from among 224 registered brands of the cholesterol-lowering drug atorvastatin, sold by Pfizer Inc as Lipitor in the U.S. and elsewhere.”
And on his Cardiobrief blog, Larry Husten published two noteworthy pieces recently: