Time has probably come for patients to appoint security guards when they go to the capital’s Birdem Hospital, the biggest healthcare facility for diabetic patients in the country.
Nilufar Begum, 48, has been coming to the Birdem Hospital every week for the last 10 years to check the sugar level in her blood. Last week also, she came to the hospital to get her regular sugar-level checkup and doctor’s consultation.
When she came out of the doctor’s chamber with a prescription in her hand, some of the representatives, who were not supposed be inside the hospital at that time of the day, gently wanted to see which drugs she had been prescribed.
But, what she could never expect was that some of the other representatives would try to snatch the prescription from her hand without caring to take permission.
“I have been coming to Birdem for 10 years. But I have never experienced such aggression before.” She said it was a habit that some of the representatives had grown very recently.
Patients say the representatives want to make sure that doctors prescribe the drugs manufactured by his or her company.
A few years ago, the hospital authorities imposed restrictions on the presence of medical representatives inside the hospital premises, which barred them from entering the hospital or the doctors’ chambers except for Saturdays, Mondays and Wednesdays – not before 1pm.
However, Nilufar said she had never seen the rule at work. For a year or so, no matter which time of the day it was, she had been seeing hundreds of medical representatives inside the hospital premises. She said they even entered the chambers when the doctors were in the middle of checking patients.
This correspondent has also seen scores of medical agents inside the hospital every day and almost around the clock.
They could be seen religiously noting down every drug listed in the prescriptions every time a patient came out of a consultant’s chamber.
Many other patients have also described similar predicaments associated with the aggression of the medical representatives.
The Dhaka Tribune has learnt that at least 600 representatives of 30 pharmaceutical companies regularly throng the Birdem hospital, although only two are allowed from each company. Patients say recently they have been seeing female representatives as well.
There are allegations that these representatives care little about rules because the doctors themselves privilege them. Many of the doctors allegedly get into secret dealings with drug makers. They prescribe the drugs manufactured by a certain company in exchange of hefty bribes.
The bribes generally take the form of expensive cars, mobile phones, television sets, refrigerators, air-conditioners, air tickets and hotel booking for foreign tours to attend international seminars.
Lutful Chowdhury, senior consultant of medicine of Apollo Hospitals in the capital, said the authorities there encourage doctors to write generic names of drug in the prescriptions.
He added that they get the medical representatives and chances of bribery out of the equation by not writing the name of any specific drug in the prescriptions.
The Birdem authorities are also apparently concerned about such bribery. Seeking anonymity a high-ranked official of the Diabetic Association of Bangladesh (Badas) said: “It is true that the environment of the hospital is having to suffer because of the aggressive marketing policy. This is totally unethical.”
Badas Joint Secretary Professor Dr Rashid-e-Mahbub said: “We have asked the pharmaceutical companies to not offer any sponsorship to the doctors directly.
We have asked them to forward the offer to the Birdem authority who would then select the doctors for the foreign tours.”
Birdem Director Brigadier General (retd) Shahidul Hoque Mollick said: “We are trying to control it [the unauthorised presence of medical representatives].”
However, Abdul Muktadir Chowdhury, secretary general of Bangladesh Association of Pharmaceutical Industries (BAPI), claimed that none of the companies were involved in the aggressive marketing.
Muktadir, who is also the managing director of Incepta Pharmaceuticals, said they offered sponsorships to the doctors from their obligation to develop the health sector.
He also claimed that the representatives who behave aggressively inside the hospital were not their employees. He suggested that the people from survey firms act in that way.
He further claimed that a pharmaceutical company would go bankrupt if it were to give such expensive presents to all doctors.