Patients’ Needs or Physicians’ Wants?
Pharmaceutical marketers the world over and emerging markets such as India in particular are facing a dilemma. Patients’ Needs or Physician’s wants? This is not to say that they are ignoring patient’s needs because there is noway that any one in healthcare industry can afford to that. Patients’ needs are of paramount importance. That is the very purpose of their existence. The raison d’être.
The dilemma is regarding which one is a priority? Who takes precedence over whom?
Patients’ needs are a given. They are taken for granted. Patients’ needs are minimal. What does a patient need or expect from a healthcare provider? Efficacy, safety or tolerability, convenience, compliance, economy and availability. These are simple, minimal needs. The characteristic feature of pharmaceutical marketing is that a patient (the consumer) cannot choose the product to cure him because of the complexity of the product and the consequent knowledge that is needed to make a right decision. He, therefore, depends on the physician (the intermediate customer) for getting well and for making the right choices for him. The physician is the decision maker. Isn’t the decision maker more important everywhere, be it in healthcare, on the job, and in life itself?
Physicians’ needs too are similar. The patients’ wellbeing and welfare. That is like the basic physiological needs in a way. Once the basic needs are met, they have wants. In branded-generic markets, where proliferation is the order of the day and where there is little or no differentiation between products, the decision criteria shifts to what-is-there-for-me-in-it.
When the criteria to choose depends on the principle of reciprocity, you will want to return the favor. The favor of prescribing the products of the company that is doing something for you. A Delhi-based cardiologist (requiring anonymity) in an interview with Reuters, said that he prescribes more drugs from the companies that provide gifts and send him on paid vacations to Thailand, Hong Kong and elsewhere. He is rather the rule than an exception.
There are written codes of conduct and ethical guidelines by the professional bodies representing the physician and industry communities in most parts of the world. A written code is only as good as one’s intention to keep it.
One of the main reasons for the ever-increasing brand proliferation at least in India is regulatory environment, which acts as a breeding ground for brands. You don’t have to have a manufacturing facility that is WHO GMP certified or Schedule M-complaint to market your brands. Anyone can market his own branded generic versions of off-patent pharmaceutical formulations under loan-license. There are even some specialist physicians who are integrating forward into getting their own branded generics manufactured in smaller quantities for captive consumption. All this is happening because you can market pharmaceutical formulations without owning a factory ever. Unless this is changed to having a WHO GMP certified manufacturing facility or building one within a certain period, say for example within five years mandatory for marketing generic formulations, the rate of proliferation cannot be checked. Neither good manufacturing practices can be assured.
The second major reason is MCI’s lack of control over its members. It is rather a paper tiger. If the MCI takes a determined step to implement its well articulated code of conduct and ethical guidelines, the healthcare environment can become healthy and robust again. No doubt, it is the drug industry that does the inducing, but the decision is in physicians’ hands and minds, isn’t it? They can definitely say No. Just because Oscar Wilde once said that the best way of resisting a temptation is to yield, one does not have to yield!
Until then the question remains: Patients’ Needs or Physicians’ Wants?