The Indian government has recently enforced a ban on medical representatives (MRs) from directly meeting with doctors in All India Institute of Medical Sciences (AIIMS) and other hospitals run by the central government. This directive, issued by the Directorate General of Health Services (DGHS) under the Ministry of Health and Family Welfare, aims to curb unethical practices, maintain the professional environment of hospitals, and ensure doctors prioritize patient care over promotional activities. The order, dated May 28, 2025, instructs the heads of all institutions to implement the ban strictly and ensure compliance.
The core objective of this ban is to prevent any undue influence from pharmaceutical and medical technology companies on doctors, which could potentially compromise patient care. It has been a common practice for MRs to visit doctors, provide educational materials and drug samples, and even be present during operations where their products are used. Concerns have been raised that such direct interactions could lead to a "pharma-doctor nexus," where doctors might be swayed to prescribe certain medications or products due to gifts, sponsored travels, or other incentives. This can result in the overuse of expensive or unnecessary medications, increasing healthcare costs and potentially undermining the quality of care.
Under the new directive, hospitals are instructed to ensure that MRs are not permitted on the premises. Instead, if MRs need to share information about new treatments, investigations, or procedures, they are encouraged to do so through digital channels such as email or other virtual platforms. This move aims to ensure that doctors receive necessary information about medical advancements without being subjected to direct promotional pressure. The government believes that this will help maintain a transparent and ethical environment where clinical decisions are driven by patient needs rather than commercial interests.
The Indian Medical Association (IMA) has acknowledged the need for regulation of MR activities but has expressed reservations about a complete ban. Some argue that MRs play a crucial role in keeping doctors informed about the latest developments in the pharmaceutical industry. They suggest that instead of an outright ban, a more regulated approach should be adopted, focusing on curbing unethical practices such as gifting and sponsored travel while still allowing MRs to provide valuable information.
This ban is part of a broader effort by the government to regulate marketing practices in the pharmaceutical sector. The government already has a policy in place called the Uniform Code for Pharmaceutical Marketing Practices, which aims to prevent unethical practices. A revised version of these guidelines, released last year, allows pharmaceutical companies to conduct continued medical education workshops and provide research grants, provided these activities are carried out transparently. The current ban on MRs in government hospitals is a further step in this direction, aimed at creating a more transparent and ethical healthcare environment.
Hospitals have been directed to submit compliance reports to the DGHS, detailing the measures they have taken to enforce the ban. This will help the government monitor the implementation of the directive and ensure that hospitals are adhering to the new guidelines. The long-term impact of this ban remains to be seen, but it is expected to reduce the influence of pharmaceutical companies on doctors, promote more clinically driven prescribing practices, and ultimately benefit patient care in government hospitals.
