Presentation on Key Findings of
BRCC Project - Gujarat
16-07-2016
Presentation on key findings of BRCCGujarat
1
Overview of Pharma Sector in Gujarat
• Started the journey by setting up India’s 2nd domestic
Pharmaceutical unit in 1907 (Sarabhai Chemicals)
• Total value of Gujarati Pharma is 4.3 billion USD (215000
Crore INR)
• 42 % of total Indian Pharma turnover
• 35 to 40 % share in total pharma production in India
• 22 % of total export of the country
• 60000 employment in the sector
• Approximate 3533 manufacturing units
• 40 % of Indian Pharma machinery production
• 37 pharma academic institution have 2375 students intake
16-07-2016
Presentation on key findings of BRCCGujarat
2
Overview of Healthcare Sector
• The growth in private healthcare started picking up
since the 1990s
• The total number of private health units in the State is
roughly around 30000 including both private and
public units.
• All hospitals (Public & Private) are covered for BMW
collection by 18 approved agencies.
• Gujarat has become a hub of medical tourism after
Vibrant Gujarat Summit.
• World-Class healthcare and cost effective service are
the key strengths of Gujarati Health Sector.
16-07-2016
Presentation on key findings of BRCCGujarat
3
Status of Business Responsibility in Both the
Sector
• Regular and systematic CSR policy is not in place in most of
firms. But it doesn’t mean that CSR is not done entirely.
• Very low awareness on NVGs, UCPMP etc. among all visited
Pharmaceutical Companies as well as Private Hospitals.
• Most of respondents believe that they need not to have
Dedicated Environment Department with the philosophy of
“Pharma is not polluting industry”.
• Code of Medical Ethics Regulation is acceptable instrument for
both the sectors. Only 5 out of 100 has taken some initiative to
comply this guideline.
• No Association nor Government department has any guideline
to abide doctors by this regulations.
16-07-2016
Presentation on key findings of BRCCGujarat
4
Status of Business Responsibility in Both the
Sector
• Almost 65 % hospitals have in-house guideline for providing
optimal healthcare services.
• Majority of hospitals maintain record of patients’ satisfaction.
And they all think it should be mandatory.
• Gifts and Incentives are the Medicines for the selling of
Medicines.
• No associations have any guideline to stop the Nexus between
Pharma Firm and Private Hospitals.
• There is commission for C&FA, Discount for Distributors,
Commission for Retailer, schemes at every stage of supply chain
of pharma but there is not concessional for consumers.
16-07-2016
Presentation on key findings of BRCCGujarat
5
Sample Size Specification
Pharmaceutical Companies
Sr. Name of Districts
No.
No.
Sampl
e Size
Nature of Firm
Formula
tion
Bulk
1
Ahmedabad
48
41
9
2
Vadodara (Baroda)
21
14
7
3
Bharuch
18
3
15
4
Valsad
13
6
7
100
64
36
Total
16-07-2016
Presentation on key findings of BRCCGujarat
Small
Mediu
m
Large
48
26
26
6
Environment Related Findings in Pharma
Sector
• Water and Hazardous waste are ranked as higher
pollution in pharma firms by most of respondents.
• No GMP compliance results into more environmental
hazards according to 51 %.
• Financial constraint is the major problems for GMP
compliance for most of firms.
• More than 50 % firms put this environmental issue in
their boardroom meeting.
• Only 40 % firms have dedicated environment
Department.
16-07-2016
Presentation on key findings of BRCCGujarat
7
Environment Related Findings in Pharma
Sector
• 72 % of firms expect different regulatory mechanism for
small, medium and large as well as bulk and formulation
units.
• 80 % firms have not received any type of assistance for
environmental issues and environment related
infrastructure.
• 76 % have not CSR Policy in place and 88 % does not
know anything about NVG.
16-07-2016
Presentation on key findings of BRCCGujarat
8
Marketing & Distribution Related Findings in
Pharmaceutical Companies
• 50 % respondents sponsor seminar/workshop for
doctors for raising their sales target.
• Almost all formulation companies accept that doctors
ask for gift/incentives from MRs while detailing the
medicines.
• They all say this is a bad conduct from the part of
doctors. Half of them say it is a usual practice and the
rest says that it is to survive in the sector.
• “We have no other way to sell our products” according
to majority respondents.
• 90 % of companies with MRs do not will to fix the
remuneration of their MRs
16-07-2016
Presentation on key findings of BRCCGujarat
9
Sample Size Specification
Private Hopsitals
Sr.
No.
Name of Districts
No.
Sample
Size
1
Ahmedabad
64
2
Vadodara (Baroda)
20
3
Bharuch
09
4
Valsad
07
Total
16-07-2016
Nature of Hospitals
Up to 30
Beds
30 to 100
Beds
100 +
Beds
37
48
15
100
Presentation on key findings of BRCCGujarat
10
Environment Related Findings in Private
Hospitals
Particulars
UP to
30-100 100+ Total
30 Beds Beds
Beds
Bio-Medical Waste Management
by service provider
37
48
15
100 %
Awareness about BMWM Rules
36
48
15
100 %
Reporting about BMWM to
supervisory body
21
33
13
67 %
Lack of awareness among staff
10
21
06
37 %
• Majority of respondents said that we get “No Support” from Health
Department, SPCB and Service Provider as well. All of them expect
support related training from all the stakeholders.
• Lack of skilled and dedicated BMW staff is the major problem in managing
BMW according to government
Presentationdepartment
on key findings of BRCC16-07-2016
Gujarat
11
Social Responsibility in Private Hospitals
• 58 % hospitals have CSR policy in place. While 42 %
has not such policy. Most of them are small
hospitals.
• 85 % respondents do not know about NVGs. And 73
% are not aware of UCPMP.
• Around 85 hospitals want that their interaction with
various authorities and associations should be
improved.
• There is no hospital association in Gujarat.
• 78 % hospitals are aware of Code of Medical Ethics
Regulations, but 58
hospitals’ doctors are not abided
Presentation on key findings of BRCC16-07-2016
12
by these regulations Gujarat
Marketing & Distribution Related Findings
• Most of hospitals have not any mechanism to guide
doctors on medical prescriptions.
• Around 60 % hospitals are not abided by Guideline on
RUD. Doctors of 80 % hospitals are free to prescribe on
their own discretion.
• Almost half of respondents have STP Guideline.
• Many of respondents acknowledge the nexus between
pharma and hospitals.
• Incentives and commercial motivation of doctors as
well as weak regulatory framework are the main
reasons behind unethical practices in the sector.
16-07-2016
Presentation on key findings of BRCCGujarat
13
Finding from Prescription Analysis
Collection of Prescription
302
No. of Hospitals
20
Auditable Prescription
297
98.34 %
Prescription with doctors’ name
172
57.91 %
Prescription with details of patient’s name, age and
gender
42
14.14 %
Drug doses and duration were not written
238
80.13 %
Medical registration no. was mentioned
12
4%
Prescriptions were illegible
249
83.83 %
Prescription with diagnosis mentioned
48
16.16 %
Rational Prescription
20
41.66 %
Irrational Prescription on the basis of STP and ELM
28
58.33 %
16-07-2016
Presentation on key findings of BRCCGujarat
14
Recommendations
• More and formal involvement of private sector should be
in the process of decision making.
• Taking up of a much pro-active role by the
associations/collectives as regulators of ethical practices
and advocacy platforms.
• Effective implementation of the regulations and
strengthening/capacity building of the regulatory bodies.
• Regular mechanism of identifying good practices and
recognizing the same, and setting it up as models for
others to follow.
• Incentives for good practices and disincentives for
deviation.
Presentation on key findings of BRCC16-07-2016
Gujarat
15