Transcript Business Responsibility in the Pharmaceutical & Private Healthcare

Gunjan
Organisaton
for Community
Development
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 Basic information about the state
 Basic information about the project
 Pharmaceutical Industry
 Environmental aspect
 Marketing and distribution aspect
 Private Health care facility
 Environmental aspect
 Marketing and distribution aspect
 Concluding remarks
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 Industrilisation in Himachal initiated in and around 2000-2001
 Himachal is a fertile land to establish industry as there are no. of
incentives to industries
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Tax incentives and exemptions
Investment subsidies and other incentives
Availability of finance at cost-effective terms
Incentives for foreign direct investment, (FDI)
Profitability of the industry
Physical and social infrastructure
Condition of physical infrastructure such as power, water, roads, etc.
 Information infrastructure such as telecom, IT etc.
 Social infrastructure such as educational and medical facilities
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Most of the Pharma industries shifted from Gujrat to Himachal and
around 200 pharma
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Focused districts
• Solan
• Baddi
• Barodiwala
• Shimla
• Kangra
• Dharmsala
• Palampur
• Sirmaur
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 Pharmaceutical Sector
 Private Healthcare Sector
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 Pharmaceutical companies:
District
Bulk Drug
Formulation Drug
Solan
13
308
Sirmaur
02
86
 Private Health care facilities:
District
No
bed
1-10
11-20
21-30
31-40
41-50
75
100
Solan
23
25
5
2
1
1
0
0
Shimla
8
14
6
0
2
0
0
0
Sirmour
4
4
5
0
0
1
0
1
Kangra
49
33
7
1
2
1
0
0
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Particulars
S. N.
Sample Size
First Phase
1.
Pharmaceutical Firms
51
2.
Private Hospitals
40
3.
Medical Representatives
55
4.
Prescription Collection
250
Second Phase
5.
Medical Rep. Association, Chemist Association, Private Hospital
Association, Pharmaceutical industry Association, Bio Medical Waste
Entity
Third Phase
6.
Pollution Control Board, Department of Health and Family welfare, Food
and Drug Controller, Community
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Firms:
 Pharmaceutical firms
 Private health care hospitals
Sectoral Associations:
 Pharma association
 Private hospital Association
 MR association
 Chemist Association
 State level business chambers
Regulators/Government Agencies:
 Government healthcare machinery
 State Pollution Control Board
 Municipal corporations
Other:
 Consumers
 Communities
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 Industry:
 Though industries are aware that air, water and pollution through
hazardous waste is being done by the industries and there are
strict regulations for pollution control by Government, Industries
are not self regulated.
 Many industries were penalized for not following the norms in
last five years.
 Though 50% industries are outsourcing the job, only 30% out of
those 50% are ensuring that outsourced industries are following
pollution norms or not.
 None of the firms is aware about the National Voluntary
Guidelines on Social Environmental and Economic
Responsibilities of Business (NVGs)
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 Association:
 Associations are not proactive and not even conducting
meetings on related issues
 Firms expect handholding from the associations and
government
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Government :
 Pollution Control board is proactive and initiated the process of
establishing environment cell in large and medium scale
industries.
 Board is conducting visits on regular basis and also trying to
enhance the awareness level of staff on environment related
issues
 Suggestions:
 Pharma collectives can play an important role to generate
awareness and ensure adherence
 Strong environmental cell can establish innovative changes
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Industry:
 80% firms sponsored events and 20% don’t have policy or
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don’t know about it.
Benefit of sponsoring spreads the knowledge and products of
the company which enhances the trade.
Though gifts are being asked by doctors but it has not been
accepted officially.
Less than one third companies are aware about Code of
Medical Ethics Regulations, 2002 (MCI)
75% industries are unaware about Uniform Code for
Pharmaceutical Marketing Practices
All companies employ MRs on incentives and are not ready
to pay them fixed salary.
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 75% Industries acknowledge that there are certain ethical concerns
relating to the ‘Incentive Structure' associated with the interplays among
different actors involved with marketing and distribution chain of drugs
Associations:
Pharma Association:
 As per company’s representatives, Pharma association has not discussed
or raised issues against the incentive process or thought about the
alternative methods.
 There is no evident mechanisms within the association to monitor the
marketing strategy of member firms.
MR Association:
 Asking about the factors contributed to the present incentives regime in
Pharmaceutical industry 66% voted for weak regulation and 33% for
business strategy of pharma industry
 People are not comfortable with the existing chain of marketing and
distributions of drugs and find responsible nexus of both for the same.
 Association has not met with any body for any issues:
State Medical Council, State /Local Branch of Indian Medical Association, State Local Level
Pharma Sectors Collective
 State /Local Level Industry Collective State/Local Drugs Control Administration
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Private Hospitals
 Bio medical waste is being managed by the hired
agencies but no one has verified or visited to verify the
process.
 Only 12.5% hospitals could tell the composition of the
waste and 42% institution’s staff as taken any training
BMW management.
 55% hospitals send BMW management report to SPCB
 Training of the staff and the agency is required to
improve bio waste management
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Private Hospitals
Associations:
 Associations are not proactive and has a base of 70-75
members
 Though gap in BMW management is evident but
association has not taken any step in this regard.
 Association has never conducted joint meeting of
BMW agencies and members to resolve the issues
faced by both.
 Association has never discussed environmental issues
with members or any government agency.
 Association does not get any copy of the report sent to
government from members on BMW
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Private Hospitals
 Though 80% hospitals are aware about Code of Medical
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Ethics Regulations, 2002 but 72.5% has no mechanism in
place to ascertain if in-house and/or empanelled doctors
abide by these Regulations
More than 50% are not aware of the Uniform Code for
Pharmaceutical Marketing Practices (UCPMP)
60% hospital don’t have guideline on Rational Use of
Drugs.
Though 60% hospital agreed on prescription audit but once
it is started by our organisation, hospitals objected and did
manhandling at two places.
80% hospitals either conduct diagnostic test in their own
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labs or prescribe it to some specific diagnostic centre.
Private Hospitals
 80% doctors denied to comment on some of the
determinants of unethical behavior in private
healthcare in the State.
Associations:
 No one is aware on National Voluntary Guidelines on
Social, Environmental and Economic Responsibilities of
Business.
 No guidelines have been developed so far for the member
hospitals to ensure responsible conduct from their part.
 Association never meet any of the agencies except once or
twice with IMA and do not conduct regular meetings of the
members.
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 Sectoral associations in both pharma and health care
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is a weak link in the state.
Regulatory bodies need to be proactive to address
marketing and distribution related issues.
There is lack of coordination with in the sector and
with other agencies.
There is an immense need of capacity building of all
agencies on different rules and regulations and cross
cutting issues.
State Pollution Control Board has played a proactive
role in the state.
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