"Vedomosti": "Don’t come to the doctor"
Regional officials have begun implementing Vladimir Putin's instruction to ban representatives of pharmaceutical companies from hospitals and out-patient clinics. Without waiting for the requirement to be legalized, they tell pharmaceutical agents not to appear while physicians receive patients or just send them directly to the management.
Two weeks ago, Prime Minister Vladimir Putin demanded to ban "the so-called pharmaceutical agents from medical institutions." In fact these people are consultants working for pharmaceuticals producers and telling medical workers of their companies' products. However, they are not directly engaged in sales.
"Large pharmaceutical companies pay kickbacks to medical specialists for prescribing their drugs to patients!" Putin said, outraged, adding that they also pay for medical seminars and conferences, especially at seaside resorts.
The Federal Anti-Monopoly Service (FAS) is currently working on amendments regulating the activity of such consultants, said Timofei Nizhegorodtsev, head of the FAS department for social and trade issues. The Healthcare Ministry is also "considering legalising and regulating relations between drug producers and the medical community," the ministry spokesman said.
However, some of Russia's regions preferred not to wait for changes in legislation. Regional governments have already imposed their own limitations on the activity of pharmaceutical agents, a senior executive of a major pharmaceuticals company who also heads a professional association told Vedomosti.
On October 15, Valery Yelykomov, an Altai Territory official responsible for healthcare and pharmaceuticals, sent a letter to local hospitals and outpatient clinics recommending banning pharmaceutical agents from the institutions during the physicians' working hours without a permit of the hospital management. Vedomosti can confirm this information, as the editorial team has a copy of this letter.
The Krasnoyarsk Territory may soon introduce a similar limitation. Regional health ministry spokesperson Oksana Anikanova said the minister has instructed his staff to examine the relations between territorial and municipal medical centers and pharmaceutical agents. Moreover, according to Anikanova, medical workers themselves were telling officials that visits of pharmaceutical agents need to be restricted.
Specific medical institutions are introducing their own bans. A deputy chief medical officer at a Rostov clinic told reporters that the medical staff will be instructed at the next briefing to send pharmaceutical agents to the management instead of having them consult with practicing physicians directly. The decision was made by the clinic management following Putin's speech, not in response to a regional government order, she added.
"We insist that pharmaceutical producers abide by relevant ethical codes (adopted by major professional associations or by specific companies - Vedomosti)," said Zakhar Golant, deputy chairman of the St Petersburg committee on healthcare. He said there was no plan to send out instructions.
For example, the ethical code of the Association of International Pharmaceutical Manufacturers (AIPM) does not allow producers to offer doctors money or equivalent remuneration (such as gift certificates). Any gift should have something to do with their professional activities, such as reference books or professional journal subscriptions. Other gifts are only acceptable on specific occasions such as the New Year's, birthdays, March 8 or Medical Workers' Day.
A representative of the Moscow health department has not responded to Vedomosti's inquiry.
Drug producers fear that the ban on their agents' work will hinder the market. The restriction will hit hardest the promotion of drugs distributed upon a specialist's prescription, said David Melik-Guseinov, research director at the Pharmexpert market research centre.
"It will be virtually impossible to launch an innovative drug or a first generic version. Deprived of information on innovations, physicians will keep prescribing traditional drugs they are used to," a senior executive at a Russian pharmaceuticals company said. As for producers, they will find other ways to promote their drugs to replace the old practice, such as city or regional conferences which medics can visit during non-working hours, Melik-Guseinov adds.
Anastasia Lyubarskaya, Olga Morozova, Vera Bukina and Mikhail Rudnev contributed to this article.
