DOCTORS OR BROKERS?

Dr. Prerna Kherajani

“Doctors are the Brokers for the pharmaceutical companies”. This is a statement that many of the professional medical practitioners are faced with on a day to day basis and it’s not unheard of to us either. Every day, in our family or friend circle we come across people making these statements to us – medical students. Newspaper articles, research studies, all claim doctors to be the intermediaries between the pharmaceutical companies and the patients.

But, how much truth lies in this statement is unknown to the common man and frankly to us medical students as well!

The COVID 19 Pandemic turned out to be a benediction for pharmaceutical companies as they flooded the market with new drugs to fight the deadly bug. Remdesivir and Tocilizumab vials were being sold at exorbitant prices when their role in fighting the virus didn’t even have substantial evidence. Fabiflu, Hydroxychloroquine, Ivermectin, Baricitinib were sold more than lozenges – and at premium rates! But how much can we blame a doctor for this? Those poor chaps were just trying to do all they could to save the patient’s life from this exotic disease!

In the past, we have seen multiple “Scams” being brought to light, one of the biggest being the “Cholesterol Vilification”. The ACC/AHA lowered the cut offs for normal Blood Cholesterol levels for the prescription of Statins in order to reduce the Cardiovascular disease related mortality. According to these cut offs around 40% of the population over the age of 50 years would have to be prescribed Statins! It was however seen that to achieve a small reduction in mortality, around 99.7% people would need to be on medication for 3 years to prevent just 1 heart attack! This was done without taking into consideration the various Adverse Drug effects of Statins. All this for Profit?

Similarly we have seen guidelines for the Blood Pressure and Normal Blood Glucose levels being changed umpteenth number of times!

Doctors in private practice are known to prescribe medicines using the brand names rather than the more economical generic ones, in order to receive remittance in kind- expensive gifts, vacations abroad, tickets to a game and to reap all the benefits of being the Ambassador for the pharmaceutical companies!

Despite all this, is it right to blame all the Doctors? Turns out that a lot of them are merely following the guidelines that are laid down by the standard organizations so as to safeguard the patients health, and some prescribe a particular brand as they see better results with it!

The topic of Doctors being Brokers for pharmaceutical companies has very subjective opinions. The oath of “Do No Harm” ties our hands and compels most of us at least to do what’s best for the patient.

References-

For Article-

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4684135/

For images-

https://pharmafield.co.uk/in_depth/access-matters-the-rise-of-the-payer-and-implications-for-pharma/

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