Presentation on Key Findings of BRCC Project - Gujarat

1. Presentation on Key Findings of BRCC Project - Gujarat Presentation on key findings of BRCC-Gujarat

2. 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 Presentation on key findings of BRCC-Gujarat

3. 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. Presentation on key findings of BRCC-Gujarat

4. 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. Presentation on key findings of BRCC-Gujarat

5. 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. Presentation on key findings of BRCC-Gujarat

6. Sample Size Specification Pharmaceutical Companies Presentation on key findings of BRCC-Gujarat

7. 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. Presentation on key findings of BRCC-Gujarat

8. 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. Presentation on key findings of BRCC-Gujarat

9. 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 Presentation on key findings of BRCC-Gujarat

10. Sample Size Specification Private Hopsitals Presentation on key findings of BRCC-Gujarat

11. Environment Related Findings in Private Hospitals • 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 department Presentation on key findings of BRCC-Gujarat

12. 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 by these regulations Presentation on key findings of BRCC-Gujarat

13. 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. Presentation on key findings of BRCC-Gujarat

14. Finding from Prescription Analysis Presentation on key findings of BRCC-Gujarat

15. 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 BRCC-Gujarat