Physicians share a very strong and unusual relationships with medical representatives (MR). Medical representative is essentially a catalyst who conveys knowledge on most recent trends in medical diagnostic and treatment to the physician population. However, medical representatives are being treated only as sales personals, but in reality they are channel for conveying information to medical fraternity.
The physicians in India are increasingly showing their disinterest in meeting medical representatives. As per survey, 70% of Indian doctors from all major fields do not want clinical interactions with medical representatives. About 53% of doctors do not think that MRs add any value to their medical practice. But, over 80% doctors still want to interact with pharma companies through online channels for product information and other proprietary knowledge.
There are many things which should be considered to make the relationship between physician and MRs better and useful. These are discussed as below:
Doctors accepting drug samples from medical representatives
Most general practitioners (GPs) say they only accept drug samples to use as emergency medication during night calls. If the samples are used only in this way, it would be acceptable for doctors to receive them. Doctors must store the samples in line with their marketing authorisations and must make sure that all relevant safety and quality measures are in place to maintain the safety, quality and effectiveness of the drugs.
Doctors accepting gifts & hospitality from pharmaceutical, medical devices or other commercial companies
The doctors should not accept gifts and hospitality from any pharmaceutical, medical devices or other commercial companies. However, doctors can accept reasonable fees for any work they do as part of a contractual arrangement with a commercial company.
Doctors should be aware that commercial companies may use even low-value promotional items to try and influence prescribing and treatment decisions. The 2007 Regulations mention that the physicians may accept reasonable hospitality and gifts from pharmaceutical, medical devices or other commercial companies as long as this happens at sales promotion or other professional or scientific events and as long as the level of hospitality is limited to the main purpose of the event.
REGULATIONS SAY "You are advised not to accept gifts (including hospitality) from pharmaceutical, medical devices or other commercial enterprises. This does not preclude the payment of reasonable fees. You should be aware that even low value promotional materials are offered by commercial enterprises with the intention of influencing prescribing and treatment decisions."
The reasoning for the Medical Council’s advice to doctors is because of the risk that the doctor’s professional judgement might be affected by accepting gifts or hospitality. Doctors have a professional obligation to obey the Medical Council’s guidance.
Doctors attending promotional/sponsered educational meeting
A ‘promotional meeting’ is a meeting held by a pharmaceutical, medical devices or other commercial company to teach physicians about a particular new drug or device. In general, promotional meetings do not give objective educational information and doctors should not use them for continuing professional development (CPD) points unless the event has been approved by a professional body.
Physicians should not rely solely on promotional literature from pharmaceutical companies for information about particular drugs and to seek independent, evidence-based sources of information on the benefits and risks before prescribing.
A ‘sponsored educational meeting’ is a professional educational meeting or conference sponsored in whole or in part by commercial companies. Pharmaceutical, medical devices and other commercial companies have changed the type of sponsored meetings they hold and the emphasis is now on medical education.
The Medical Council advises doctors not to accept direct hospitality from such pharmaceutical or medical devices companies, so that their professional judgement is not affected by the hospitality.
The Medical Council accepts that payment of travel and accommodation expenses for doctors to attend meetings, either as participants or speakers, supports the aim of continuing professional development. However, these payments should go through unrestricted Education and Development Funds made available by the sponsoring company to the institution which is hosting the meeting or the conference organiser. Unrestricted Education and Development Funds are not linked or controlled by the organisations that contribute to them and healthcare institutions can choose to spend the funds any way they see fit.
Physicians charging fee for medical representatives visit
As per regulation, the medical sales representatives must not use any incentive or use such means for an interview with a doctor. They must not pay in any form for access to a healthcare professional. It is likely that the Medical Council would view the charging of fees for visits by sales representatives as wrong.
Guidelines & regulations dealing with doctors' interaction with pharmaceutical & medical device companies
The Medical Council’s Guide, the 2007 Regulations and the Code of Marketing Practice all set out the recommended codes of conduct relating to your dealings with pharmaceutical and medical device companies. As a doctor, it is one's duty and responsibility to be familiar with the latest guidelines and regulations in this area. The guide says that your main responsibility is to act in the best interests of your patient. You should not be influenced by any personal consideration.
Doctors accepting sponsorship from pharmaceutical & medical device companies
Doctors have a responsibility to make sure their work is not influenced in any way as a result of sponsorship or any other relationship with a pharmaceutical, medical devices or other commercial company. Doctors should tell patients, employers and other institutions where they see or treat patients about the relationship. If the relationship involves medical research, the doctor must make sure that the relationship does not influence the study, design or interpretation of any research data or affect the research or education in any way. The doctor should also tell the relevant ethics committee about the relationship.
In general, educational sponsorship or funding from commercial companies should go through unrestricted Education and Development Funds. The funding should be managed without influence from the commercial company.
Right sources to keep-up-to-date with developments in medication and device safety
Being a physician you should not rely solely on promotional literature distributed by pharmaceutical companies for information about particular drugs or medical devices. Instead, you should seek independent evidencebased sources of information on the benefits and risks of all medication and medical devices before prescribing.