E-drug: Reply from Dr Attaran to Dr Srinivas (cont'd)
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Dear Dr Srinivas,
Please do not hold back from contributing to the discussions on this
fantastic e-mail group. We are all entitled to our opinions, which
represent our experience and views and whether they reflect the
institutions we work in or not. Please continue contributing because
the discussion is enriched by the views from practitioners and
policymakers in developing countries.
I totally agree with you about doctors (and pharmacists) preferring to
prescribe, "new patented" drugs to old brand and generic equivalents.
There are many reasons for this, as any doctor (especially those of
us from developing countries), would very well know. Companies
advertising plays a major role in prescription all over the world but
especially in developing countries where impartial, objectives, and
scientific information is still scare in many settings. Personally, I
remember the days when impressive looking company
representatives gave us free samples and information on drugs and
diseases which we couldn't get from elsewhere. Scientific evidence
has shown that advertising plays are role in prescribing (see WHO
database on drug promotion). Studies have shown a direct link in
developed countries where doctors are presumed to be
well-informed. If advertising, in general, only succeeds with "dupe"
people, the whole advertising industry would have collapsed long time
ago.
Of course, as you rightly say, that is not to say patent is the cause of
prescribing habits. However, what you described, is the reality in
developing countries, where strong patent rules will soon be
implemented. I sincerely hope that the WHO proposed monitoring of
the impact of TRIPS include impact on prescribing, use of generics
and patented drugs, prices, as well as access to medicines in
general.
Mohga
Dr. Mohga Kamal Smith
Health policy advisor
Oxfam GB
Tel: + 44 (0) 1865 312290
Mobile: +44 (0) 777 62 55 884
E mail: mksmith@Oxfam.org.uk
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