[Jaguar]

I know that we are going OT, but I remember seeing a BBC documentary on fake drugs being manufactured by small companies in India. The owner claimed on hidden camera that he could fake any drug along with any kind of packaging and holograms. And he would put small quantities of the original drug mixed with either paracetamol or chalk powder based on what the buyer is willing to pay. The sad part is that, the BIG drug companies whose drugs were being faked are not willing to take any action, cause that would mean recalling all their products from the market to verify.

[vivekiny2k]

Originally Posted by Gansan

This is very serious, if true. And it is available in metros too. My son was prescribed Moxikind tablets by the paed very recently. The infection did not go down as expected, and he then had to take a course of Mahaceff injections.

I will avoid this company's medications henceforth.

I am not aware of the company name, but I personally heard somebody in lucknow years back about sponsoring a toyota qualis to doctors. He is a medical representative for a pharma company and just keeps paying the EMI on the car. And he was not a lone case.

[archat68]

Originally Posted by vivekiny2k

I am not aware of the company name, but I personally heard somebody in lucknow years back about sponsoring a toyota qualis to doctors. He is a medical representative for a pharma company and just keeps paying the EMI on the car. And he was not a lone case.

This is a very common practice. I know a renowned Gastroenterologist in Kolkata who got a Maruti Zen from Glaxo (yes - a MNC) for prescribing Zinetac tablets in 1990's (it was launched then).

[rkg]

Among Indian pharma companies ranbaxy, cipla, reddy's are fine. no problem.

it is very easy to start pharma( like tablest/capsules etc, actually these are called formulations) company. Buy the bulk drug from any of the above and a tablet /capsule making machine. you are in the market.

the above companies are also the manufacturers of the drugs not like many small guys.

It costs a lot to manufacture drugs.

Dr Reddy's is one the largest bulk drug manufacturer on the world

many biggies also buy the drug from others and make tablets and sell ( statin's like atorva used for cholesterol control- Biocon is the world's largest manufacturer. almost all the biggies buy the statins from Biocon and make their own formulations)

[jaysmokesleaves]

The medical profession is no longer the noble profession it used to be in the old days, though we occassionally(rare) come across a few noblemen in the profession.

The doctor is no different from a mechanic. He is expecting returns on his investments. Especially that on his education and his clinic etc. The hospital is a larger more organised racket, especially if you have mediclaim / health insurance.

So you do with your doctor what you do when you are not satisfied with your mechanic. You take your bunch of papers and your ailing vehicle(your body) and find another possibly competent one that rips you off a lot less while providing equal or better treatment than the one you just dumped.

Doctors may feel offended by such a stance by a patient like me, but I wouldnt care less, when its my body thats on the line.

[DocG]

Originally Posted by archat68

Don't agree. Do you know that most of the MNC pharmaceutical companies in India do not have their own manufacturing unit. They get their medicines manufactured by smaller companies under loan licence and markets them. MNC companies charge more because of their brand name and also due to the fact if they are the innovator of the drug they had spent a lot in R&D.

Take the example of Glivac (Imatinib Mesylate) an medicine used to treat leukemia. The drug was innovated by Novartis who marketed the drug and the cost to a patient for a month's supply of drug was about 1L in the year 2002. Then indian companies like Sun Pharma and NAtco Pharma started to market the drug in India at a much much lower cost of Rs. 15K for a month's supply of drug. The difference in price is due to the cost incurred by Novartis in developing the drug which Indian didn't have to. But quality of renowned Indian companies do not suffer - they are as good as MNCs.

So, take medicines manufactured by renowned Indian companies like Cipla, Ranbaxy (no more Indian), Sun, Dr. Reddy's, Torrent etc. without any fear of lower quality. I can vouch for this since I work in Indian Regulatory Authority for Pharmaceuticals.

Dear sir, I understand your position, and that you have extensive experience in the field. I don't mean to question you or call you out, but I have a faint idea about what's going on in the sector. My father due to his line of work has very close ties with owners, CEOs, MDs, heads of R&D and QC in all the big pharma cos in Asia. Therefore I'm always kept in the know about the latest happenings in the industry, apart from cool factory tours, and boring dinners etc.

Amongst Indian pharmas I recommend Sun, Cipla, Glenmark, Orchid and Dr. Reddy's.

The less said about Ranbaxy the better. I'm sure you know about the resignation of the last head of QC, and the reason why he submitted his papers.

I understand the cost that goes into drug development and that MNCs who heavily invest in this need to make their money, but having been around the industry for this long I've noticed that most of the large MNCs never drop the ball in terms of standards. The Indian companies though keep having a back and forth.

Originally Posted by archat68

This is a very common practice. I know a renowned Gastroenterologist in Kolkata who got a Maruti Zen from Glaxo (yes - a MNC) for prescribing Zinetac tablets in 1990's (it was launched then).

I can pretty much vouch for none of this happening anymore from GSK. The current CEO is an unbelievable leader and ensures that his company maintains a strong code of ethics.

But since people are on the topic, I can fill you in on more details of free stuff. I know doctors who are amongst the top few in their specialities, and they earn very good money. But at the same time, you can go into their home and find a LCD/Plasma with a pharma label on it. Tata Sky box with a pharma label on it. Refridgerator, microwave, cooking range, laptops, desktops, mp3 players, iPhones and blackberrys, portable DVD players, home theaters etc etc...I have once seen a Jaccuzi with branding on it , and my favorite, all expense paid trips for you and your family to a destination of your choice!

Oh and all these things can be seen in the home of docs who earn crores a year, yeah crores!

BUT

At the same time there are many docs who abide by their priciples and refuse to accept such gratuities. I have met and heard about a lot of people from this lot too.

[Thad E Ginathom]

How about accepting the freebees (well... if it's going...) but making sure that one never prescribes anything that is not in the interest of one's patient. Is there room for that? Is it possible?

[rsjaurr]

Originally Posted by Thad E Ginathom

How about accepting the freebees (well... if it's going...) but making sure that one never prescribes anything that is not in the interest of one's patient. Is there room for that? Is it possible?

well this is what majority of doctors are doing contrary to popular belief.
More than 90% docotors are working in central/state govt. hospitals,dispensaries(like me),charitable hospitals,small nursing hospitals owned by themselves or others,small clinics on OPD basis and very few are working in really big hospitals.

So a doctor working in a smaller/remote inaccessible hospital/dispensary is not visited by any MR or very rarely if at all they visit.And what freebees they give to doctors,any guess?Usually its a samll writing pad/few tablets of painkillers or a set of some kitchen utensils costing about couple of hundred bucks.And you guys think doctor will just fall these gift?

Very very few docotors get expensive gifts like LCD tv etc.Usually these doctors have their own hospitals or are working in big hospitals e.g/ which are attached with medical colleges.Now these expensive gifts are offered by big reputed pharma companies and not be some cheap drug making ones though there are some exceptions.So clearly a doctor is not doing any harm to his patient by buying low quality drugs.

I dont buy it that someone knew a doc who was gifted a innova or his every household thing came from a pharma company.These companies cant afford that too.Moreover information often becomes exaggerated when it flows through mutiple heads.

If at all this is happening then most probably the beneficiary will be owner of very big hospital who promises to buy large amount of drugs at once.this makes everyone happy because pharma company officials meet/exceed their target and owner gets a free car/expensive gift which he wouldn't have got otherwise.Price of those drungs will still be same whether deal is done or not because MRP will be same before/after the deal.
Also the owners of these big hospitals are not doctors as they dont have that much money to built these hospitals like Apollo/Escorts/Fortis.
This is what you call markeeting and not greed.
Dont we get one soap extra if we buy 3 or 100ml conditioner with 1L of shampoo which we wont get if we buy 500ml!!!!

What all i have been trying to say is that most of docs are not doing what many of you had said in your previous posts.Very small percentage id indeed doing it but their number too small to paint all doctors with same colour.
Bad fishes are everywhere be it politics,med. profession,software industries,defense etc,its just a question which sector has least no. of these rotten fishes.I do however believe that my profession is one of cleanest if not the cleanest of all departments/sectors/fields we have in India.The experience of working for 11rs in govt hospitals/dispensaries give me the reason to say this.

we are just soft targets for almost everyone.Earlier it was criminals,IAS officers,police,politics,media and even public but it seems now that the so called 'educated' class is also after for no apparent reason.Suddenly we are (along with allopathy) 2nd most ridiculed people here on t-bhp after politicians.
Why i am saying is that the person who started this thread did it without verifying the facts 1st though later he came to know that its the price of drug which cost him that much.Now its not the fault of doctor if the medicine is that pricy and ow the discussion is more on pharma companies and pricing for which the title of thread has no relevence.

[Thad E Ginathom]

Most of the docs I see, even the more expensive ones, are working in independent clinics. They write a prescription, the patient chooses the pharmacy, there is no direct benefit to the doctor for prescribing one drug or another. Of course, as in other countries, the doc is still going to be targeted by advertising and inducements.

I am sorry that you feel ridiculed. It is no easy task to become a doctor in the first place, and I will always have some respect for that achievement.

We are free to choose allopathy or some other system of treatment. My experience is that there is a much more level playing field in India regarding this as (assuming one can afford to pay for healthcare art all), not only is a range of practitioners easily available, but there is cross fertilisation too, with allopaths being prepared to say, "this is something aurveda is good with", or prescribing homeopathic medicine.

In my home country there is still a prejudice, in the profession, against "alternative" therapies, and their practitioners are often as expensive to consult as a private hospital consultant. I used to pay over Rs3,500 to spend an hour with my homeopath in UK (and she was not one of the most expensive). Even allowing for the difference in the economies, this is still a huge amount of money.

[KITE RUNNER]

Originally Posted by rsjaurr

So a doctor working in a smaller/remote inaccessible hospital/dispensary is not visited by any MR or very rarely if at all they visit.And what freebees they give to doctors,any guess?Usually its a samll writing pad/few tablets of painkillers or a set of some kitchen utensils costing about couple of hundred bucks.And you guys think doctor will just fall these gift?

Very very few docotors get expensive gifts like LCD tv etc.Usually these doctors have their own hospitals or are working in big hospitals e.g/ which are attached with medical colleges.Now these expensive gifts are offered by big reputed pharma companies and not be some cheap drug making ones though there are some exceptions.So clearly a doctor is not doing any harm to his patient by buying low quality drugs.

I dont buy it that someone knew a doc who was gifted a innova or his every household thing came from a pharma company.These companies cant afford that too.Moreover information often becomes exaggerated when it flows through mutiple heads.

If at all this is happening then most probably the beneficiary will be owner of very big hospital who promises to buy large amount of drugs at once.this makes everyone happy because pharma company officials meet/exceed their target and owner gets a free car/expensive gift which he wouldn't have got otherwise.Price of those drungs will still be same whether deal is done or not because MRP will be same before/after the deal.
Also the owners of these big hospitals are not doctors as they dont have that much money to built these hospitals like Apollo/Escorts/Fortis.
This is what you call markeeting and not greed.
Dont we get one soap extra if we buy 3 or 100ml conditioner with 1L of shampoo which we wont get if we buy 500ml!!!!

What all i have been trying to say is that most of docs are not doing what many of you had said in your previous posts.Very small percentage id indeed doing it but their number too small to paint all doctors with same colour.
Bad fishes are everywhere be it politics,med. profession,software industries,defense etc,its just a question which sector has least no. of these rotten fishes.I do however believe that my profession is one of cleanest if not the cleanest of all departments/sectors/fields we have in India.The experience of working for 11rs in govt hospitals/dispensaries give me the reason to say this.

we are just soft targets for almost everyone.Earlier it was criminals,IAS officers,police,politics,media and even public but it seems now that the so called 'educated' class is also after for no apparent reason.Suddenly we are (along with allopathy) 2nd most ridiculed people here on t-bhp after politicians.
Why i am saying is that the person who started this thread did it without verifying the facts 1st though later he came to know that its the price of drug which cost him that much.Now its not the fault of doctor if the medicine is that pricy and ow the discussion is more on pharma companies and pricing for which the title of thread has no relevence.

You have said it correctly, fully agree with you.

Bad elements are every where, in every field, but only a minority.

[benbsb29]

Originally Posted by Spitfire

My close friends wife who delivered in Manipal Hospital Bangalore ran a bill of 1.5 lakhs last month. And it was a normal delivery. Talk about being ripped. The profession is slowly sleeping away to being ignoble.

Manipal Hospital has made big money out of this habit, and they still continue unabated. I have reached the conclusion that unless the problem is a rare one, or this happens to be the last resort, one should avoid Manipal Hospital.

Their habit of inflating bills has become so severe that the medical insurance provider with which my company has a tieup has banned any cashless transactions with the hospital and one should go the re-imbursement way in processing such a claim. Such bills are thoroughly scrutinized, and many a time its the claimant who ends up weeping thanks to the hospital's exhorbitant charges.

Originally Posted by ntomer

I had a very similar experience in Kailash Hospital, Noida. My mom underwent a cataract operation there; she is insured by Oriental Insurance and the whole procedure was cashless.

They gave me a stack of papers, with the paper I needed to sign on top. When I tried to see the papers, the person almost panicked and told me that all the bills are same and no need to recheck. This made me suspicious and I checked the bills thoroughly; and found that the bill had been inflated to 44K and the TPA too had approved the amount. They charged us for a delux suite, while my mom never left the pre-OT ward.

Tell me about it. The initial arrangement between the hospital and the insurance provider (Mediclaim) was made for a standard non-A/C room in my wife's case. Since the weather in Kerala suddenly changed for the worse and it was getting really hot, we decided to upgrade to an A/C room the same day of the arrangement. However, despite all my efforts in trying to talk sense into them, they flatly refused saying if there was to be a change, i cannot avail cashless and will need to pay from my own pocket. We decided to put up with the heat problem since it was only a matter of a few days. Later, on seeing a rough estimate of the bill i realized that the amount which the hospital was actually claming from Mediclaim was almost close to that of an A/C room! Imagine the profit the fellows made! They could have atleast paid heed to our requests, for God's sake!

This incident made me realize that there is a nexus between hospital, TPA and insurance company personnel, which is bleeding the insurer dry.

[jkdas]

Originally Posted by greenhorn

heh, my manager was telling me recently, his dad had some operation, cost 3.5L. the medical insurance covered only 50K, so he had to shell out 3L. Only later he found out that the insurer got a 10% discount, which was not passed onto him, so the insurer effectively paid only about 15K.

Medical Insurance ripping people off is a global phenomenon, I think even in the US

Wait! how much was he insured for? Its 1lac or 2lac by default. Confirm and revert.

[frequentflyer]

The profession of medicine has also become a business - unfortunate but true. the General practitioner is known to take kick backs from private hospitals and some corporate hospitals to admit patients. Doctors get freebies from pharma companies too for prescribing their drugs..Consultants advise unnecessary procedures, tests and surgeries. There are good doctors too but you will find him if you find a relation in your family who knows him. So a doctor of some sort is required in your family to advise and re check what is being prescribed to you. The kind of medical ethics practised in India are called the 'cottage' industry kind. There is no third party. One doctor gives advice to operate and he himself is the direct financial beneficiary of his advice. This needs to be remedied by education and the alert patient. The GP who was the Ombudsman once upon a time is not playing this role any longer. This is because he is paid abysmally low fees by his patients. Imagine being an MBBS and getting 50 rupees per patient. If you see fifty patients a day after ten years of practice also you monthly income will not go beyond 65000. Can you buy a house, educate your children , go to a restaurant or a vacation in any city with this income with a family of four plus parents? Medical colleges are charging donations contrary to the SC ruling of no capitation fees. But is there a mechanism by which capitation fees will not be charged. We have systemic problems. The personal morals and ethics and knowledge of the doctor you visit are the final determinant on whether you will get the right advice.

[redeff]

Or you do a simple thingy. Engage a lawyer ( Remember me if you wish to try this, it would be a good start to my career ) and let him rip you off for a smaller amount without putting your body on the line!! Vengeance will be yours!!

[PatienceWins]

Originally Posted by benbsb29

Manipal Hospital has made big money out of this habit, and they still continue unabated. I have reached the conclusion that unless the problem is a rare one, or this happens to be the last resort, one should avoid Manipal Hospital.

Their habit of inflating bills has become so severe that the medical insurance provider with which my company has a tieup has banned any cashless transactions with the hospital and one should go the re-imbursement way in processing such a claim. Such bills are thoroughly scrutinized, and many a time its the claimant who ends up weeping thanks to the hospital's exhorbitant charges.

Received this forward today. The general feedback about manipal seems to be very bad.

I am Ravikumar. I would like to get one of the incident happened this
weekend to ur notice. One of my co-brother met with an bike accident and expired on Friday night. (A BMTC bus came on the wrong side and hit him).
This accident happened around 6.30 PM near whitefield and initially he got admitted to a hospital called Vydehi near whitefield. Later it was proposed by Vydehi doctors to take him to either Nimhans or Manipal. So we took him to Manipal around 8.00 PM since NIMHANS is very far and also by considering traffic at that time. To reach even Manipal it took too much time, Most of the delay caused because of Heavvy Traffic in airport road.
As soon as we took him to the Manipal hospital doctors said his state is very critical and 95 % he is out. Still they said they will do CT-Scanning and then they can clearly confirm the status. Then around 10.30 PM they arranged for CT-Scanning (Too much of delay). Soon after the CT-Scanning one of the doctor reported his BRAIN is damaged, 2 kidney's and small liver also was damaged for which he needs to be operated for a head surgery and a stomach surgery, during the operation he may die also or at any moment he may die.
Soon after they took him to ICU instead of taking him to Operation Theatre. There was around 1hr delay in answering us back from this point. They didnt allow any of us to see him when he was in ICU untill we demanded and shouted on them. When we demanded and asked them to discharge so that we will take him to NIMHANS, Then the answer from them was they will operate immediately but we need to Admit and pay around 2 lack Rs. Since we didnt have that much of cash and also we doubted on whether he is still alive or simply these doctors playing a game..., But still ince they demanded around 2 lack rupees for the operation before they start it, I went ahead to fill up the forms and pay money immediately with using credit card,
But when our uncle had a look at him in ICU noticed that he is already dead (this was around 11.30 PM). Then immediately he asked me to not to make any payment.
We went to doctor in-charge and asked (when we shouted) about his status and chances of he being saved. Doctor infomred that chances are less than 1 percent, then only we realized that MANIPAL Administration guys playing a game, and trying to fool us to collect some money in the name of operations to operate a deadbody !!!
We took it seriously and tried to contact TV9 on the same day but could not get the contact numbers..., Since we were strong enough to fight back on Manipal Hospital they agreed that he is dead and asked us to pay Rs. 30,000 to release dead body.
As we know they didnt give any treatment other than doing a CT-Scan and keeping the deadbody in ICU fr 2 Hrs... We shouted on them and demanded to release the deadbody with CT-Scan charges only. Finally we were able to fight and take the body with out paying any money as they were trying to cheat us.
Some how we escaped from being paid for dummy operations being planned by Manipal Doctors. But if it was some other innocent poor people they would have ended up with paying full money and cheated by MANIPAL.
The whole idea behind my writeup is : we all know MANIPAL is one of the big and well known Hospital in bangalore. Manipal stands among the best 10 hospitals in India. But these people cheat innocent people by collecting huge money to operate even deadbody!!! and try to fool as if they are going to save the patient. I request you all to forward this mail to all your friends and inform every one on how BIG Private Hopspitals can cheat ... and to Beaware of these...