Tuesday Aug 06, 2019
It’s 10PM in Karachi. Dr K is getting ready for his unprecedented assignment. Before leaving home, he wants to make sure everything is ready. Tonight, he has to make a big offer to a renowned doctor. The physician in question is Dr U. He is a senior consultant in some prestigious hospitals and also runs a personal clinic in an affluent area.
The offer is not about a joint venture to establish a hospital. It’s about a matter that both of them don’t want to discuss in public. But it will bring luxury to Dr U and result in the professional growth of young Dr K. The meeting is set at 10:35 as Dr U doesn’t see any patient after 10:30.
Carrying his briefcase, Dr K reached the clinic well in time. In the lobby, he saw a few medical representatives waiting for their turn. He waved his hand at them. And, warmly chatted with the staff. Meanwhile, the receptionist informed the physician. Giving them a strange look, one of the representatives whispered something. But, Dr K could only hear that ‘we should be like those who knock doors only to find the doctors waiting’. In no time, Dr K was called in.
Picking up his bag, Dr K kept thinking about the days when he was studying at Sindh Medical College. He had always dreamt of becoming a physician. Specialization in cancer treatment was his goal. But, after house job, financial pressures shattered his dreams. He started working in the Emergency for a local hospital but it didn’t pay much. Later, he tried luck by opening a clinic in his house. Even that needed time to establish.
To quick fix the mess, he reluctantly joined a multinational pharmaceutical firm as a product specialist. In a few years, he excelled in promotional practices that the company undertook in line with the International Federation of Pharmaceutical Manufacturers & Associations code of ethics.
Dr K’s transition to a local company became even more rewarding. Here, as a Manager, he supervises representatives in the whole province. Top consultants respect him for in-depth knowledge of the product and grip of human physiology and anatomy.
The aspiring Dr has undertaken the task of almost doubling the market share in the assigned territory. For him, the sky is the limit. To earn a commission, he has learnt novel ways of luring medical fraternity. Meeting Dr U is on the same line.
With a broad smile on his face, Dr U welcomed him in. Dr K found him a bit more open than ever. He felt even comfortable. Unlike past visits, when the consultant would cut short greetings to quickly listen to him about the product, Dr U started talking about how Dr K was managing life challenges.
Finding him relaxed, the senior doctor brought him close to the topic. At the same time, he informed the receptionist not to send any staff member in.
With his articulate style, Dr K linked the challenges of life to the offer of the night. Mentioning historic inflation, price hike and additional taxes, the manager explained the damaging effect on the pharma industry. In the same breath, he informed the senior consultant that to survive and increase market share, his company has devised a policy of helping the ones who reciprocate the gesture.
Taking a deep breath, Dr U admitted that it was the very reason to accept the offer. On that, Dr K opened his leather bag and presented him the unusually small but expensive gift pack. Dr U knew well what was inside the little box. He opened it up for his satisfaction.
Two glittering keys of a 1600 CC car were lying in the black leather box. The gifted car was ready in the showroom and the consultant could drive it home anytime tomorrow. He stretched his arms and took a yawn as Dr K took out documents to get them signed. y just having a glance, the consultant made his initials and put the box in the drawer. With that, the meeting was over. But, it’s the beginning of a long process.
Now onwards, the consultant can enjoy the brand new car and may own it eventually. The cost is within reach. He has to simply help Dr K achieve ambitious sales target. Failing which means losing the car early next month. After all, Dr U is only promised with an instalment plan. However immoral approach this may be, it’s a win-win situation for both.
As a matter of fact, the instalment plan is more effective. It makes it easier for the doctor and the respective company to observe check and balance. Over the last two decades, Dr K’s company has showered tens of thousands of doctors with gifts that matched their prescription power. But, this plan has always proved its worth.
Unfortunately, Dr K’s company is not the only one that makes such shadowy deals to dominate the market. You take any firm; it starts with offering a pen or a writing pad. Once the sales graph shows an upward trajectory, the doctors are invited to dinners, sent on foreign tours with families and promising ones get the whole clinic refurbished. Even one can have his Valima ceremony fully sponsored in a top restaurant.
Yet, only the top slot gets the crème. Consultants like Dr U are offered cars of various ranges and chosen ones can even get tuition fee of their kids paid no matter where they study in the world. The only problem, it’s paid semester by semester. This policy makes sure that the respective doctor’s pen never dried prescribing the product.
For most of the medical fraternity, it’s a matter of why prescribe medicine when there are a dozen alternates and sometimes even cheaper ones. Expensive drugs are beyond reach for many. Sending the patients to buy them means taking risk of losing them. To those who are in this field, accepting gifts means compensation.
For the company of Dr K and a few others, care, fairness, respect, and honesty are mere words. Behaving with integrity, no matter how challenging the circumstances, is a thing shelved in ‘Guiding Principle Folder’. Following the footsteps of many other companies, they have established hidden companies to remain apparently clean while crossing the red line. After all, dodging IFPMA is not easy.
Since January, IFPMA has banned even customary gift. Pen, posters, calendars, diaries and other goodies are no more allowed. A pen or notebook can be given but even that during a company-organized event. Scientific books, journals, and memory sticks that have no independent value can be presented. But, in a country like ours, an empty hand medical representative is least welcomed.
One of the top Pharmacological Executive Dr Asim Jamal reserved his comments about such practices by the local companies. But, he categorically said that in letter and spirit IFPMA code of ethics demands that there be no correlation with ethical promotion and business.
Immoral practices to promote their drugs is one thing. The other issue is we have failed to capitalize on the potential of exporting medicines to the West. It’s unfortunate that not a single MNC based in Pakistan is FDA qualified. The result is, we hover between $200-300 million worth of exports.
On the other hand, our neighbour, India is the third-largest pharma exporter in the world. It’s exporting medicines to amass around 20 billion dollars. She has raised its target from 11% to 15%. Even Bangladesh fetched a hundred million dollars in nine months. It’s around 35% increase.
The new challenge is devaluation as many pharma ingredients are imported from various countries. Making it for the local and overseas consumer means more expenditure. Dr Jamal believes there are practical ways to overcome this problem. According to him, whatever we produce, we need to be good at it. We need to ensure the highest quality standards and bank on our business and bank on our business and commercial acumen to penetrate export markets.
The government can provide the industry with some incentives to create as level a playing field as possible with India and other competitors. By taking four steps, he believes the government can maximise export potential.
Tax-free imports of raw material, only for export purpose, can be a good choice. Tax holidays on investing in plants and machinery will be also helpful. At the same time, facilitation in regulatory bodies visits to the country must be ensured. And, finally, the Drug Regulatory Authority of Pakistan should work closely with the Trade Development Authority.
In the last one year, there is hardly a sector that is not badly affected. Every step taken for strengthening the economy has only backfired.
It’s time the government focuses on increasing exports of every possible sector. For many reasons, the pharma industry can give it a much-needed boost. To turn this dream into a reality, the government must ensure local companies to follow international production standards. It should also ensure such companies to observe high moral codes.
A positive image of a country is not built by empty slogans. It is achieved by building trust. And, making the world ensured that you care.