Doctor defends right to prescribe branded medicines - 15/9/2006

link to The Times

Doctor defends right to prescribe branded medicines
Massimo Farrugia

The suggestion that doctors should not be allowed to prescribe branded medicines goes against basic medical professional ethics, according to a private general practitioner and bioethicist.

Pierre Mallia, a former president of the Malta College of Family Doctors, told The Times yesterday he fully agrees that the decision on what medicines should be prescribed lies with doctors.

"Whoever came up with such the suggestion knows nothing about medical ethics.

No government or authority, anywhere in the world, can be expected to impose something like that on doctors. It is, and should always remain, at their professional discretion," he said.

A suggestion to amend the Medicines Act so that doctors would no longer be allowed to prescribe branded medicines was turned down by the government during talks with medicine agents earlier this week.

The Chamber of Small and Medium Enterprise (GRTU) claimed patients should not be forced to buy a branded product when they could get generic medicines - which imitate brands but are cheaper because they are patent free. But the government insisted that judgment should lie with doctors whose professional discretion should not be overruled by legislation.

The law states that pharmacists may offer an alternative brand or cheaper generic equivalents only if the doctor does not specify a particular branded product by writing "branded" or "" on the prescription.

Could it be that doctors' decisions are influenced by drug companies which sponsor them, as it is often rumoured?

"It is definitely illegal to receive commission, and if a doctor is caught doing something like that, he or she is brought before the Medical Council and would most probably be struck off the register. In 14 years, I have never come across such a case," Dr Mallia said.

Though drug companies do sponsor doctors' medical education, these are acceptable from an ethical point of view if they are regulated.

"Sponsors are difficult to come by after all, and the rumour that doctors prescribe brands because they benefit financially is a banal excuse. Any doctor would tell you that some generics are effective but others are just not good enough, which is why a doctor has no choice but to prescribe a branded medicine. After all, the ultimate consideration is always the patient's well-being," Dr Mallia said.

"It is an accepted truth that medicine and business are in symbiosis. One should be careful that the relationship does not become parasitic," Dr Mallia said, warning against decisions which may benefit retailers but are not necessarily in the interest of patients.

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