Concern over drug industry involvement at India's 'health camps'

December 02, 2015

Pharmaceutical sales representatives are screening people in India in return for prescriptions for their products, finds a special report published by The BMJ today.

Free 'health camps' for poor people in India have grown popular, writes author Frederik Joelving, a journalist based in Denmark.

Local residents are invited to the camps that may include medical testing done by drug representatives or technicians, he explains. Some camps take place at temples or schools near slum areas and tend to attract hundreds of visitors, while smaller 'patient camps' can be at a hospital or in the waiting room of a doctor's office.

The BMJ has evidence that unlicensed employees from several Indian drug firms and from the Indian arms of Abbott, Bayer, GlaxoSmithKline, Roche, and Sanofi have tested patients at health camps.

The Medical Council of India says the practice is unauthorised and that only a registered medical practitioner can perform screening and diagnostic tests.

Likewise, for doctors to prescribe specific products in return for testing services from a drug company is not only 'totally unethical,' said K L Sharma, joint secretary at the Ministry of Health and Family Welfare; it also violates MCI regulations.

Cipla acknowledged that its employees test patients, reports Joelving. A Roche spokesperson said that Roche Diabetes Care India donates testing supplies to diabetes education camps but added that "people with diabetes who attend the camp test on their own, after having signed a written consent."

Ransom D'Souza, a GlaxoSmithKline India spokesperson, said: "Our sales representatives are not permitted to perform tests on patients in India" and added that GSK "at no point in time" has "sought prescriptions from [healthcare professionals] in reciprocation and that last year the company removed individual sales targets for its representatives."

But Pinaki Dutt, a GSK sales rep from Bankura, West Bengal, told Joelving in 2013 that he and his colleagues were required by 'company policy' to do blood sugar tests at regular health camps.

"This kind of behavior can actually lead to harm to patients -- overdiagnosis, misclassification [of healthy people as sick], iatrogenic harm of drugs," Glyn Elwyn, a primary care clinician-researcher at The Dartmouth Center for Health Care Delivery Science in Hanover, New Hampshire, USA, told The BMJ.

The Indian subsidiaries of Abbott Laboratories have been particularly active in the push for screening, says Joelving, with each of the company's business divisions organizing health camps.

In 2011 alone, the company says it screened more than 240,000 people for thyroid disorders. Meanwhile, sales of its flagship product Thyronorm (thyroxine) raced ahead of cheaper competitors in India.

"I would call it market penetration with a label of corporate social responsibility," said Hans Hogerzeil, a professor of global health at Groningen University in the Netherlands and until 2011 director for essential medicines and pharmaceutical policies at the World Health Organization.

Abbott told The BMJ: "Health camps must not be supported in exchange for an explicit or implicit understanding to purchase, order, recommend, prescribe or provide favourable treatment to any Abbott products."

But an Abbott rep who does screening at diabetes camps said that his services are an investment in the doctor and have nothing to do with charity. "The only objective is the business transaction," said the rep, who spoke on condition of anonymity from fear of losing his job.

Finally, Leena Menghaney, a lawyer and India manager of Médecins Sans Frontières' Access Campaign, said: "This is nothing but selling privatised health care, whether it's medicines or diagnostics," adding that she discourages her family from going to the camps.


Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to