Bitter Pills:Medicines & The Third World Poor | Page 72

prescription pad. One company executive says candidly: "All salesmen are biased
in that they talk about the virtues of the drug they are selling and cannot be expected
to extol the virtues of somebody else's product." " " In recognition of these
difficulties, the British industry's code of practice recommends to member
companies that information must be "accurate, balanced and must not mislead
either directly or by implication". " : i
In Britain manufacturers operate a system of self-policing within the guidelines
of their voluntary code, which one industry source has described as "virtually
monastic in its strictures". "•'' But the Government also monitors advertising
standards and has the legal powers to take action against offending
companies. " 4 | It also keeps doctors supplied with more objective drug
information, particularly on cost-effective prescribing - an element frequently
played down by sales promotion.
Very few Third World governments are in a position to control promotional
activities, much less foot the bill for providing objective drug information. The
problems created by this information vacuum are set out graphically by an Indian
pharmacologist and WHO consultant. "Once our doctors pass out of medical
college and set up practice, they are cut off from the world of pharmacology.
Only those who are interested enough and find the time will keep themselves abreast
of the latest developments in medical therapeutics - and these form a very small
minority. The others are thus .... vulnerable to glib medical representatives ...
This situation is quite different from that in developed countries like the US and
UK, where there are well organised services rendering a constant flow of
information about drugs to prescribing doctors. Thus we have a gaping lacuna
in our country and most firms take full advantgage of it." " 5 |
Companies employ a variety of sales promotion tactics, including sponsorship
of medical meetings, advertising in journals and prescribing guides, and direct
advertising to the public. Among the key target groups in ensuring market success
are doctors, drug retailers and government officials. The "Marketing Plan 1980
( - 1982)" of E. Merck in Bangladesh includes all three as central to its marketing
strategies. Its authors propose "To maintain very good relation with Government
officials in Health and Commerce Ministry to guarantee importability of our
products"." 61 Chemists are an important target group because according to the
marketing plan 80% of Merck's products are distributed through wholesalers and
retailers, and over-the-counter sales without a doctor's prescription make up a
large percentage of total sales. Strategies proposed to distribute Merck products
include: "To take sales goods during up-country trips and make direct sale to
chemist on cash base." " 7 |
Merck's sales force apparently already covers a quarter of the country's doctors.
But the Marketing Plan includes as a strategy: "To create more demand of our
products by the way of effective promotion through better doctor selection." " S|
(our emphasis) The Marketing Plan also indicates that in 1978 the company's
"average sales proceeds per man per year" were 22 times greater than his average
cost to the company. (l9)
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