A few weeks back, a vigilant member of Indian
Academy of Pediatrics noted that M/s Sanofi Pasteur, a vaccine
manufacturer, was distributing printout and wall charts which had
altered/misrepresented the Indian Academy of Pediatrics Immunization
timetable 2012 (recommendations of the IAP Committee on Immunization
(IAPCOI))[1]. The said chart was titled ‘IAP Immunization Table
2012’ with a footnote mentioning that the same was adapted from the
IAPCOI recommendations [1]. The ‘tailored’ chart displayed Influenza
vaccine as a routine childhood vaccine recommended by IAP at 6 and 7
months of age, whereas the IAPCOI recommends this vaccine only for
identified high-risk groups. This covert attempt to promote their
product by misrepresentation/distortion of facts is a serious
ethical misadventure that should be viewed as nothing less than
"felony." In addition, they had committed a copyright violation by
reproducing the contents published in Indian Pediatrics with
no prior permission of the journal or of the body issuing
recommendations. The Academy duly issued a show-cause notice to the
firm. In response (in an email correspondence), Sanofi
representative asserted that "… it indeed was an inadvertent error
and not a deliberate attempt to gain commercial mileage." They
further stated that "we sincerely and unconditionally regret this
mistake and apologize for any inconvenience caused because of this
to the members of the Indian Academy of Pediatrics…" Since then,
Sanofi has recalled all the (mis)printed material sent for
distribution. However, the question remains… Are we willing to sweep
under the carpet serious ethical misadventures by accepting
statements of inadvertent errors and apology issued by the industry?
The phenomenon of misrepresentation of research
by the drug industry for their benefit is global. A systematic
review on the quality of pharmaceutical advertisements in medical
journals that included 24 articles (each article reviewing 4-24
journals) from 26 countries concluded that quality of journal
advertising is not what is desirable [2]. Pharmaceutical companies
do need support of academic bodies for their existence, but does the
academia need them for survival? This is where the ethical line has
to be drawn. Our overdependence on industry to run our own affairs
will continue to encourage the industry to repeat these misdemeanors
in future too. And we will continue to lament our incapability to
deal with them effectively. There should be a limit to our
dependence on pharmaceutical companies. We should not forget that
they are here to market their products and not for partnering us to
support our philanthropic agenda. There must be a ‘code of conduct’
on which the academia-industry relationship must subsist.
Taking note of various media reports, the
Department of Pharmaceuticals, Government of India, initiated
discussions with the Pharmaceutical industry, on the issue of code
of ethics. Organisation of Pharmaceutical Producers of India (OPPI)
and Indian Drug Manufacturers’ Association along with Confederation
of Indian Pharmaceutical Industry (CIPI), and other organizations
have worked out the ‘Uniform Code of Pharmaceutical Marketing
Practices’ for Indian Pharmaceutical industry [3]. Considering that
marketing expense of top 50 drug manufacturers is Rs 5340 crore an
year (for a sale of 28769 crore) [4], it is high time that the
voluntary ‘code’ comes as a regulation. It may not be able to solve
all the ills but shall definitely act as a deterrent for those
hell-bent on selling their products at any cost! Simultaneously,
there is a need to empower the budding physicians with the art of
analysing the promotional material in a most critical manner based
on evidence based medicine. Practitioners need to take charge of
updating their knowledge themselves. The information fed by the
pharmaceutical industry needs to be seen, smelled, tasted, and
scrutinised for its content; before digesting it finally!
1. Indian Academy of Pediatrics Committee on
Immunization (IAPCOI). Consensus Recommendations on Immunization and
IAP Immunization Timetable 2012. Indian Pediatr. 2012;49:549-64.
2. Othman N, Vitry A, Roughead EE. Quality of
pharma-ceutical advertisements in medical journals: a systematic
review. PLoS One. 2009;4:e6350.
3. Code of Marketing Practices for Indian
Pharmaceutical Industry. From: http://pharmaceuticals.gov.in/uniform
code.pdf. Accessed 23 August, 2012.
4. Das S. Govt to codify ethics for pharma companies next week.
The Financial Express. From: http://www.financial
express.com/printer/news/976413. Accessed 23 August, 2012.
