Shut up and take your medicine

What happens in the world of pharmaceuticals is none of our business, because we allow it to stay that way

I don’t have much respect for doctors. This isn’t because I don’t need them, obviously, because we all do at some point or another. My lack of respect stems from an inability to treat them as anything other than specialists, the way I treat a mechanic fixing my car or an electrician changing my apartment’s wiring. They treat an ailment and I pay them for their expertise. There’s nothing more to it. I struggle with this ridiculous habit of treating them like demigods simply because they chose to study the human body while the rest of us didn’t.

We look upon doctors as magical beings, often ignoring the fact that they know almost nothing beyond the body. A shockingly large number of them don’t know about the body either but get away with it because we are a densely populated nation where human lives are little more than statistics. It’s also why doctors get away with the blatant disrespect they show to most patients, treating their time as unimportant, safe in the knowledge that patients will wait because they have no choice.

I suppose I would respect them a little more if I thought of them as scrupulous beings, and if every doctor’s office had fewer medical representatives shuffling in and out like coke dealers at a rave party. 

We’ve all seen them: young men in smart formals, suitcases in hand, cutting into visiting hours to hawk the latest drug, and walking out leaving behind all kinds of pharmaceutical swag. It’s why the offices of so many doctors are nothing more than blank canvases for the advertisement of some tonic, tablet, or syrup.

A couple of years ago, an analysis by the non-profit journalism collective ProPublica revealed that doctors in the United States receiving money from pharmaceutical companies prescribed their drugs more heavily than doctors without those financial ties. More than one in five doctors who prescribed OxyContin—the now reviled drug, blamed for an opioid crisis that has consumed North America—had a promotional interaction with its manufacturer.

What do pharmaceutical companies offer doctors in India? What do they promise them in exchange for a prescription? How do you know why one specific brand of medicine is prescribed to you over another? Ailments like diabetes or asthma spawn thousands of cures. Why do we know so little about why generic pills have multiple manufacturers and are sold at radically different prices?

In February this year, a report on the Finance Bill showed that pharmaceutical companies could no longer claim the cost of various freebies as business deductions. Apparently, those deductions involved foreign trips provided to doctors. Think about that for a minute. There must have been enough doctors being bribed with freebies and foreign trips for the taxation department to step in.

A doctor that is morally bankrupt enough to accept a free family holiday is one with no qualms about prescribing one drug over another, irrespective of whether it is good for a patient or not. A simple Google search shows the kind of gifts doctors are routinely offered. Whether or not they accept them determines what they prescribe to their patients and, inevitably, what those patients must pay to be cured.

Here’s another question we should all be asking ourselves a lot more but never do: why do prices for generic drugs vary as widely as they do, based solely on a brand? Who decides when the cost of a particular drug must be capped, if at all? Look at the price of vaccines before and during the COVID-19 pandemic and ask yourself why manufacturers could magically halve the prices when they felt like it. 
Doesn’t it imply that vaccines could have been sold at those prices from the start, and weren’t simply because companies put profit margins over people’s lives?

It is easy for pharmaceutical companies to brush off criticism by talking about how they are businesses and need to be run like any other business. That response holds little water when there are lives at stake, more so in a country as poor as ours where millions still have no access to medical aid of any kind.

The fact that we know almost nothing about what government oversight exists, if at all, is why our public healthcare standards are as appalling as they have always been. It’s also why the government gently nudges us towards private healthcare at every opportunity, because of how complicit it is in what should be treated as a crime.

When he isn’t ranting about all things Mumbai, Lindsay Pereira can be almost sweet. He tweets @lindsaypereira
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The views expressed in this column are the individual’s and don’t represent those of the paper.

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