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Drugmakers'spending on doctors raises medicine prices

BIDS study says; manufacturers deny the claim

Star Business Report
Medicine prices are high in Bangladesh as drug-makers have to spend big to convince doctors to prescribe their products, a new study finds.
Sometimes, drug manufacturers even send the full families of doctors abroad to spend holidays or to attend a big seminar, according to the study presented at the two-day BIDS Research Almanac 2019.
The Bangladesh Institute of Development Studies (BIDS) organised the event to discuss the findings of different researchers at the Hotel Lakeshore in Dhaka.
Drug-makers sometimes give gifts to doctors or transfer a big amount of funds to doctors' accounts so that they feel encouraged to recommend their medicines, said Nazneen Ahmed, senior research
fellow of the BIDS.
The prices of medicines go up in the domestic market when pharmaceuticals companies include the sums spent for the gifts in their cost of production, she said.
She spoke while presenting a paper on "Pharmaceutical industry of Bangladesh: prospects and challenges."
Contacted, SM Shafiuzzaman, secretarygeneral of the Bangladesh Association of Pharmaceutical Industries (BAPI), said they do give pens to physicians, but the items do not fuel the prices of medicines.
"For example, if you go to a doctor's chamber and see that there is no fan and if a Tk 1,200 fan is given, will the prices of medicine rise?"
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He said medical representatives visit doctors with samples of newly introduced drugs. "If we give a pen with the samples will the prices of medicines increase?" he questioned.
On sending full family of doctors abroad, Shafiuzzaman said: "This is not based on facts," he told The Daily Star.
He said there are expenses involved if spouses and children of doctors are sent abroad.
"How many medicines a doctor can prescribe? All companies visit a doctor and have you ever seen a doctor prescribing medicines for a single company?"
He said it would be correct if the researchers can give authentic references. "Otherwise, it is not correct."
The BAPI secretary-general also said the prices of drugs are cheaper in Bangladesh than any other country.
The prices of drugs of the same generic group of different companies vary in Bangladesh and the patients have to spend more to buy high-priced medicines while following doctors' prescription, Nazneen said.
For instance, the price of a tablet of one company is Tk 5 but the consumers purchase the same tablet at Tk 15 of another company although both tablets are under the same generic group, she said.
The patients do not verify the prices and
generic groups, she said.
Monzur Hossain, senior research fellow of the BIDS, said the research found that garment factory workers now feel safe at their workplaces after the improvement in compliance following the recommendations of the Accord, the Alliance and a national initiative.
Hossain shared the information in a paper on the "Impact of compliance on RMG industry in Bangladesh".
"We did not find any significant impact of compliance on labour productivity, total output, market access of firms and on crisis like labour unrest, accidents and injuries faced by firms after the remediation work from 2013 to 2018."
Higher investment on fire safety compared to the total cost of the firm leaves negative impact on labour productivity and total output, he showed in the paper.
The findings, however, showed that compliance or remediation measures have positive effect on workers' perceptions on building safety, fire safety and electrical safety at workplace.
Another paper was presented on "A macro model of the Bangladesh economy" that aimed to construct a model to be used to update the input-output table and assess the effects of different interventions in the short- and long-run period.
After the Rana Plaza building collapse, a lot of
electrical, fire and structural safety improvements have taken place in the garment factories, the researchers said.
However, at the same time the prices of garment items did not increase; rather in some cases the prices fell to some extent, they said.
Selim Raihan, executive director of the South Asian Network on Economic Modeling, said in many factories compliances exist in papers only, not in reality.
"Compliance cannot be a choice in the factories - it's a must to run the business,” he said.
Prof Raihan also shed light on the quality of Bangladeshi drugs. He said Thai doctors prescribe one paracetamol tablet for fever, but in Bangladesh it needs two paracetamols.
One Thai paracetamol is enough to cure fever, but two tablets are needed in Bangladesh only because of a lack of quality, he said.
Khondaker Golam Moazzem, research director of the Centre for Policy Dialogue, said there is a slowdown in demand for apparel items globally.
As a result, the prices of garment items declined to some extent not only in Bangladesh, but also all around the globe, Moazzem said.
He said it should be investigated whether big pharmaceuticals companies are manipulating the drug prices in the local market as 10 large firms control over 70 percent of the market.