New Delhi: The Department of Pharmaceuticals replaced its earlier code regulating relations between pharmaceutical companies and doctors with a new one on Tuesday (March 12).
Known as the ‘Uniform Code of Pharmaceutical Marketing Practices’ (UCPMP), the notification doesn’t stipulate that the code is mandatory.
The Department of Pharmaceuticals works under the Union chemicals and fertilisers ministry.
The code’s latest version, like its previous one, says that pharmaceutical companies must not bribe doctors in any form or even arrange for their travel facilities in exchange for the healthcare professionals promoting or excessively prescribing a particular drug.
That is why the code is crucial to curb unethical practices that pharmaceutical companies undertake in connivance with doctors.
Much of the criticism that the previous version of the code, which was notified in December 2014, attracted was related to its voluntary nature. There was no legal backing to its provisions and it therefore remained toothless.
There has been a long-pending demand of various health activists to make it mandatory. Even the 2017-18 annual report of the Department of Pharmaceuticals insisted on making it mandatory.
While the government has now removed the word ‘voluntary’ from the code, which was there in the previous version, it has stopped short of making it mandatory. It has now merely ‘requested’ the pharmaceutical companies’ associations to see to it that the code is ‘implemented’.
The 2024 version of the UCPMP says, “All associations are requested to constitute an Ethics Committee for Pharmaceutical Marketing Practices (ECPMP), set up a dedicated UCPMP portal on their website, and take further necessary steps towards implementation of this Code.
On the other hand, the 2017-18 annual report of the Department of Pharmaceuticals had noted:
“Uniform Code For Pharmaceuticals Marketing Practices (UCPMP) for Pharmaceutical as well as Medical Device Industry is being implemented w.e.f. 1.1.2015. The implementation of the UCPMP has been reviewed in consultation of [with] all the stakeholders including NGOs/Civil Societies and it was felt that in order to implement it more effectively, it would be desirable to make it mandatory.”
The report even went on to say that the Department of pharmaceuticals was working with the legal affairs department with the intention of making the code mandatory.
However, the government later changed its stand. In a Supreme Court hearing in 2022, the government said it was not of the view that the code should be made mandatory. It told the court that the code in its previous form – voluntary – was “adequate”.
Also read: Union Govt Flips Stance, Tells SC ‘Don’t Push for Mandatory Rules to Curb Pharma-Doctor Nexus’
Whither punishment?
Even if the code hasn’t become mandatory, what punishment does it stipulate if a pharmaceutical company is indeed found bribing a doctor?
The punishment, in this version of the code, as in the previous one, remains the same.
The maximum that a pharma company concerned can face is that it would be removed from the association of the pharmaceutical companies of which it is a member. There is no penalty or scope of any other action against the company except it losing membership of the association that it is part of.
This reporter had filed RTI applications in 2019 to ask the Department of Pharmaceuticals whether it was aware if even this mild punishment had been meted out to any company.
The department specifically named 20 pharma companies in the reply and said it was aware that they had violated the code.
On being asked about the action taken against them, it said their names had been forwarded to the pharmaceuticals associations – namely, the India Pharmaceutical Association (IPA) to take ‘action’ against all the firms charged with malpractice between 2015 and 2016, and to the Indian Drug Manufacturers’ Association (IDMA) as per UCPMP provisions.
The previous version of the code – as the current one – said that whenever pharma associations take an action, they should put it in the public domain through their respective websites.
When in a follow-up RTI query, it was asked if the Department of Pharmaceuticals was aware of the punishment – the pharma company being removed from the association – the reply stayed silent.
And what if the pharmaceutical company concerned is not a member of any of the associations in the first place? One of the 20 pharma companies named as violators in an RTI response was actually not part of any association.
The code was silent in the previous version. This time, an amendment has been made.
It says:
“In case of companies, who are not members of any Association, or member of more than one Association, the complaint should ordinarily be handled by the Pharma Industry Association to whom the complainant has addressed the complaint; and where necessary, it will seek guidance from the Department of Pharmaceuticals.”
Doctors, on the other hand, if found being bribed by the pharma companies, can be punished as per another code of ethics published by the National Medical Commission (NMC).
Last year, the NMC revised its set of ethics and said doctors, besides facing suspension of their licence to practise if a violation was established, could also be asked to pay a monetary penalty.
The NMC code of ethics also barred doctors from attending conferences of healthcare professionals sponsored by pharma companies.
However, under pressure from the Indian Medical Association and other groups, the government put its revised ethics under abeyance. In doing so, it reverted to the 2002 code for doctors, which said the state medical commissions could only suspend doctors’ licenses for a period it thought was necessary.
Also, it did not bar doctors from attending a pharma company-sponsored conference, which the now-abandoned code of last year had done.
Key provisions of the UCPMP
Some of the key provisions of the UCPMP remain the same in the current version as well.
It states that the companies should not extend travel facilities inside or outside the country to healthcare professionals or their family members for attending medical conferences. It also bars companies from extending any hospitality, including hotel accommodation, to doctors attending medical conferences.
However, despite these provisions being there in the 2014 code as well, there have been many instances of them being violated.
In 2015, Amitava Guha, who is associated with the Jan Swasthya Abhiyan, submitted proofs of a pharma company sponsoring trips to Vancouver for 13 doctors, paying the hotel bills of 258 doctors for attending a diabetes conference in Chennai, giving six doctors cash for a pleasure trip to Australia and paying up to Rs 3 lakh each to 58 doctors.
He had reported many other violations as well.
There is no record of how many of these doctors got punished by the NMC – if indeed they were – and how many pharma companies faced removal from the associations they were part of, as a punishment prescribed under the UCPMP’s 2014 version.
The current version of the UCPMP also explicitly states that no gift should be offered for the personal benefit of any healthcare professional or their family members by any pharmaceutical company.
The new version also has a section on the organisation of medical conferences.
These conferences have been a bone of contention because they are many a time organised by pharmaceutical companies, allegedly as quid pro quo on the part of doctors.
In the course of organising these conferences, pharma companies incur huge expenditures.
The code does allow them to continue organising these conferences but prohibits them from doing so in foreign countries.
The code also says that a pharmaceutical company organising such conferences should upload the details of its expenditure on its website so that it can be “subjected to independent, random, or risk-based audit”.
Non-adherence to any of these provisions could attract punishment for pharma firms as stated above.
This story was updated at 7:30 pm on March 15.
