E-DRUG: Industry Control over Information
-----------------------------------------
There was a report in the Jakarta Kompas daily on 31 August in
Indonesian headlined: Pharmaceutical Affairs Bad because Information
Controlled by Industry. It reported on a recent seminar "Tricks for
Rational Provision of Drugs to the Public in Time of Crisis", and
particularly focussed on comments by a pharmacology expert at the
Medical Faculty of the University of Indonesia (the premier Indonesian
university), Prof dr Iwan Darmansyah.
Iwan is quoted as saying that the condition of drugs and pharmaceutical
affairs in Indonesia is bad [the Indonesian word used is rather stronger,
and could be translated as 'stinks'!), because medical information is not
controlled by the government but by the pharmaceutical industry. Besides
this, the National Drug Policy determined by the government does not run
well. Iwan went on to note that the problem does not just lie in high
prices. "Rational prescription means using the minimal amount of drugs,
with essential drugs preferably generics. For example, patients with
hypertension should be given anti-hypertension drugs, and they don't need
additional anti-cholesterol, vitamins and other unnecessary [drugs].'
According to Iwan, this irrationality is because information about the
benefits and methods of use of drugs is not provided by the government.
As a result, doctors have to use information provided by the
pharmaceutical industry in prescribing.
Unfortunately, such information is often diverted [the Indonesian word
used is rather stronger, more like 'corrupted'] for the self-interest of
the industry, so that they can sell as much as possible. Iwan noted that
the information provided in IMS (Index Medical Speciality) is misleading.
This is because the indications are too broad, side effects are not
included and doses are too high and can kill. The reason is that the
information in IMS originates from the factory.
The report goes on to lambast the government for failing [I won't provide
all the gory details]. Iwan concludes by recalling that a consultant from
WHO in a survey of the medical drug situation in Indonesia in 1989 told
him that the situation in Indonesia was the worst in the world.
I was rather surprised at the strength of the criticism of the IMS --
particularly that the doses are inflated to dangerous levels to help sell
drugs. Is this true? Surely the doses in the IMS must represent those on
the (approved?) package inserts?
I haven't translated the whole article and what I have done is 'quick and
dirty', but if a more complete and polished version would be helpful, I
could attempt to provide.
Chris
Chris W. Green
Jakarta, Indonesia
Tel: +62-21 846-3029 Fax: +62-21 846-1247
Email: chrisg@rad.net.id
--
Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'.
Mail administrative requests to `majordomo@usa.healthnet.org'.
For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.