Doctors' prescriptions

After reading an article titled Unfair collaboration responsible for soaring prices of drugs (Suara Pembaruan, June 26, 2001), I am sure that what was said by the chief of the Agency for Food and Drug Control (BPOM) Dr. H. Sampurno, MBA, is correct.

There are two ways with which a pharmaceutical company persuades (bribes) doctors to prescribe the drugs it produces. National pharmaceutical companies give something directly to the doctors while foreign pharmaceutical companies act with more sophistication. They will, for example, invite a doctor to attend a seminar abroad and pay for all of the expenses. Sometimes even the wife of the doctor will be invited. Well, they have the same motive only a different method.

There are many ways -- all quite sophisticated -- with which a national pharmaceutical company bribes a doctor. So sophisticated are these ways that there is practically no evidence of bribery.

Let's say a doctor has a lot of patients. The director of a pharmaceutical company may visit him and give him a TV, a refrigerator, a washing machine or other non-binding gifts. However, as the doctor feels indebted to the director for his kindness, he will prescribe drugs made by this particular pharmaceutical company. As this doctor offers a good potential for profit to the company, the director will go one step further by offering him an automobile worth hundreds of millions of rupiah.

When the deal is made, the doctor must sign a leasing agreement on the purchase of the automobile. Well, the director will pay the first installment and will do so with later installments provided the doctor prescribes drugs in quantities that meet the target set by the company. Otherwise, the doctor will have to pay the installments by himself.

Or, perhaps, the doctor will not be directly approached by the director. He will, instead, ask his wife to take the doctor's wife, let's say, to a jeweler's.

In a gathering with my former students, this story was strongly denied. One of them, a doctor, refuted my story, saying that he had never got such an offer from a pharmaceutical company. "Right you are," I snapped, "because you don't have many patients!"

Once I read a story in a newspaper that a doctor in Semarang filed a lawsuit against a pharmaceutical company for a breach of promise. The money he received was less than the amount his prescriptions were worth. This is always possible if a drug store replaces the drugs prescribed with generic drugs.

SUNARTO PRAWIROSUJANTO

Jakarta