SUBANG, Nov 1 — The pharmaceutical industry is the most ethical among various industries, while chemical and fertiliser industries have far worse practices, a group of Malaysian generic manufacturers said.
The Malaysian Organisation of Pharmaceutical Industries (MOPI), a 45-member association comprising mostly local generic drug makers, said the pharmaceutical industry had several codes of ethics, as well as other such codes within each company.
“I worked for 35 years, but in the pharma industry for 12 to 15 years, and I can tell you, among many other industries, the pharma industry is the most ethical industry,” MOPI president Billy Urudra told a seminar Wednesday on good governance for medicines that was jointly organised between the Ministry of Health (MOH), the Malaysian Pharmaceutical Society (MPS), the Malaysian Community Pharmacy Guild (MCPG), MOPI, the Pharmaceutical Association of Malaysia (PhAMA), and the Malaysian Association of Pharmaceutical Suppliers (MAPS).
He also pointed out that some government-linked companies (GLCs) in the pharmaceutical industry have already signed the Malaysian Anti-Corruption Commission’s (MACC) integrity pledge and instituted company policy against bribery and corruption.
According to Billy, PhAMA, which mostly represents multinational drug makers, established its code of ethics in 1978, while the ethics codes of MOPI and MAPS, which represents importers of generics, were drawn up in 2012 and 2013 respectively.
He also pointed out that MACC had found no evidence of corruption in the supply of medicines to MOH in its investigation on a whistleblower’s claim that three tender agents monopolised MOH’s total medicine tenders between 2013 and 2016, worth RM3.7 billion.
“It has put out this unnecessary and tarnished image of the industry,” Billy said.
The codes of ethics in the pharmaceutical industry, he said, cover various issues related to prescription drugs, such as promotional methods, patient confidentiality, and companies’ interactions with health care professionals, like what kind of accommodation and airfare can be provided to them.
Dr Ramli Zainal, senior director of MOH’s pharmaceutical services programme, said enforcement officers and government staff in logistics and pharmacy who deal with the procurement of drugs in hospitals are rotated every three to five years.
“If you look at government procurement, we have a very tight procedure. The Ministry of Finance (MOF) procedure is there. In terms of procedure it’s there, but still the element of human intervention might be there,” Dr Ramli told the seminar.
He added that MOH’s pharmaceutical programme was tightly regulated, with clear standard operating procedure (SOP) and several committees dealing with product registration.
MACC senior assistant commissioner Zakiah Hassan said public procurement was a high-risk area for corruption, noting that there is a “very high” number of cases involving public procurement in the health sector.
“We’re in the process of introducing a new law to deal with ‘ali baba’. The sale of any tenders, procurement, or contracts is an offence,” she told the seminar.
“We’ve brought this up to the government to make it an offence for any bidders to enter tenders but who ‘ali babakan’ the tenders and procurement,” she added, referring to rent seekers.
The government, Zakiah said, will also tighten laws to require companies bidding for government contracts to declare their “beneficial ownership”.
A survey on code of conduct run last May among drug distributors, wholesalers, importers, local and foreign manufacturers, and community pharmacies in Malaysia revealed that majority of companies surveyed did not have their own code of conduct, except for mostly foreign pharmaceutical manufacturers. Out of 211 respondents, only 73, or 35 per cent, had an official company policy that governs company staff’s interactions with external stakeholders and clients.
“Upstream industry players, such as distributors, manufacturers and importers, reported a higher proportion of companies with internal code of conduct,” PhAMA executive director Ewe Kheng Huat told the seminar.
“Foreign-based companies have a higher proportion of companies with internal code of conduct compared to local-based organisations.”
The activities covered in respondents’ codes of conduct included promotional activities, continuous medical education, and fees for services, among others, while the types of interactions covered were with contractors or suppliers, consumers, health care professionals, medical institutions, and patient organisations.
In general, Ewe said, most complaints about ethics in the pharmaceutical industry were related to ensuring proper and fair promotional materials.
Dr Hasenah Ali, director of the pharmacy policy and strategic planning under MOH’s pharmaceutical services programme, said the good governance in medicines (GGM) programme, which is under the Malaysian National Medicines Policy (MNMP), was launched by the World Health Organization (WHO) in 2004 to ensure the provision of safe, quality, effective, and affordable medicines within a best practice environment.
Malaysia was among the first few countries to join the initiative.
Malaysia’s GGM programme aims to strengthen the health system by promoting good governance in the pharmaceutical sector, to prevent corruption by identifying areas of vulnerability, to increase transparency and accountability in all processes related to the pharmaceutical sector, and to promote individual and institutional integrity.
Areas that are vulnerable to corruption in the pharmaceutical sector include medicines registration, promotion, and selection; licensing; inspections; and procurement.
“We plan to engage with other ministries to collaborate further on GGM initiatives, like the Ministry of Defence, Ministry of Education, Ministry of Finance, MACC, Malaysian Institute of Integrity, and Transparency International-Malaysia,” Dr Hasenah told the seminar.