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SA Marketing Code of Practice. Steve Speller. What are health products?. Substances that have the potential to:- do good do harm. Code of Marketing Practice. Why is it needed in South Africa ?
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SA Marketing Code of Practice Steve Speller
What are health products? Substances that have the potential to:- do good do harm
Code of Marketing Practice Why is it needed in South Africa? To Protect Consumers
Code of Marketing Practice The complexity of three types of consumers People Animals Healthcare Professionals Direct Indirect Indirect Direct
As suppliers of health care products what do we try to do to customers ? Inform Them? Influence Them?
Off label promotion ... Incentive schemes Selective use of clinical trial information... Hospitality practices....
Pharma industry in the news • Polish Newsweek: Pharmaceutical corporations spend millions of dollars on presents for the doctors who prescribe their patented medicines. When buying medicines, we have to pay not only for our health, but also for costly gifts. • Milan(Reuters): Italian police are investigating a unit of a pharma company for allegedly offering illegal incentives to doctors and medical staff to prescribe its drugs • British Medical Journal May: Who pays for the pizza? Re-defining the relationships between doctors and drug companies.
Obligations for all..... • A Code of Practice for the marketing of healthcare products is required to provide a basis for the ethical marketing of health products • Requirement for reliable scientific information to be available to health care practitioners and patients/consumers • To enhance the rationale use of health products and fair competition in their marketing • Preserve the independence of the decisions taken by healthcare professionals
Fundamental Principle Code of Marketing Practice self regulation
A long journey AGM March 12 constitution signed
Scope of the Code • The Code is a collaborative effort by various sub-sectors in the marketing of health products • Builds on the experiences and principles endorsed by these sub-sectors • Code has been established after many years of consultation: at first, only ethical products were regulated by the Code but now, many categories of products included • Innovative medicines • Generics • Veterinary medicines • OTC products • Medical devices • Laboratory diagnostics
Current Trade Associations subscribing to the Code • PIASA: Pharmaceutical Industry Association of South Africa • NAPM: National Association of Pharmaceutical manufacturers • IMSA: Innovative Medicines South Africa • SMASA: Self-Medication Manufacturers Association of South Africa • PHARMISA: Pharmaceuticals made in South Africa • SAAHA: South African Animal Health Association • SAMED: South African Medical Device Industry Association • SALDA: South African Laboratory Diagnostics Association Support for the initiative and enforcement: • Pharmaceutical Wholesalers and Distributers • Pharmaceutical Society of Southern Africa
Who is the Code Applicable to? • licence holders, their agents, contractors, third party distributors /marketers and/or contracted events organisers • any member of medical, dental, pharmacy, nursing or allied health professions • any seller of health products who may prescribe, purchase, supply, administer, loan or lease a health product or recommend the use thereof • is not applicable to wholesalers, distributors (excluding distributors of medical devices) and logistics companies except to the extent that they may influence the demand for health products Note: Logistics service providers forum and PSSA has endorsed the Code
What the Code does not cover? • 18A: “bonus system, rebate system or any other incentives scheme” • 18B: Sampling • 22G: Pricing, dispensing fees, logistics fee Proposal to DoH: Gaps on legislation SA Marketing Code (27-09-2011)
Scope of the Code - Replace ASA appendix A & H - Guidelines
Part A: ACTIVITIES TO HCP’S: APPLICABLE TO ALL HEALTH PRODUCTS SA Marketing Code (27-09-2011)
Healthcare Sales Reps(C15) • Training • Interviews / access to HCP: • No inducements • No fees paid • No donations to charities or in lieu of hospitality • Mislead as to company identity • No inconvenience • Report AE • PI provided for new products and then afterwards should be available on request
Interactions with HCP (C17) • Hospitality, venue of meeting • Scientific and educational • Hospitality secondary to meeting • Appropriate venue* • Modest – not more the HCP would pay for themself • No spouse or other guest • Reasonable honorarium for speaker • Local CPD – reasonable travel to HCP outside major cities • Overseas congress / speakers Business class travel only for incoming and outgoing faculty members (i.e. HCPs presenting at congress, educational events or local CPD accredited events). • Selection of attendees should be transparent and open to scrutiny • Payment to congress or organisers not HCP unless proof of payment • No recreational or sporting activities allowed
Interactions with HCP (C17) Other matters: • No standalone social or sporting events • Consultancy services • Genuine service • Declaration by HCP • Written agreements • Honararium – fair market value and relate to activity performed • Can’t pay for room rentals
Inducements(*)C18 • No gifts, rebates to HCP to induce use of products • Gifts / promotional items • Inexpensive and value of R 300 (medical devices cap of R 2500 / practise or institution) • Educational and scientific benefit patient / practice • No cash or equivalent • No personal use • Scientific medical reference books, journals, anatomical models : • For individual practising HCP or practises, < R 2 500 incl of VAT/year • For training or academic institutions, < R 10 000 incl of VAT/year • The value of medical devices should not exceed R300 inclusive of VAT / per item with a cap of R 2500 / practise or institution • Promo items can be branded with company or product logo • Cultural gifts – not allowed by SAMED / SALDA (*) Subjectto company / corporate policies
Other activities (C18) • Competition (C18.5) • Based on medical / product knowledge • Prize relevant to practice • The maximum is R 2 000 • If prize is congress sponsorship – cover conference fees, accommodation and travel for the winner only. • Donations / grants to HCP (C18.6) • Supporting healthcare or research • Documented • Not inducement • Not paid to HCP • Corporate Social Responsibility (C18.7) • Support a charitable organizations • charitable contributions are not for marketing • Not an incentive to prescribe any health product
MCA Structure Code Technical Advisory Committee Appointed by Board Appointed by EO for specific complaint
Overall: Key MCA objectives • Awareness of the Code: • General roles and responsibilities of the MCA Industry healthcare groups Government: health and CPA ASA HCPs Allied medical professionals Patients Consumers • Training of all Industry stakeholders on the content of the Code Internal and external providers: must get our certification Paper based E based Getting certification • Implementation of the Code: Self regulation Legislated environment • Enforcement and sanctions
Complaint Process No resolution No resolution Breach of Act 101, legal mechanisms
Is it having an impact? • Yes BUT early days • Still lots to do re appointment of Executive Officer finalisation of training and certification process regulations influence healthcare professionals
Still required.... • The Medicines and Related Substances Control Act 101, 1965 will be the vehicle for the Code enforcement • Via Regulation 18 C of Act 101, 1965 • Desire of the Associations to have the Code enforced by law • Working with the DoH to seek approval of proposed wording for the update of the Regulations
Conclusions • Years of dedication of the Marketing Code Steering Committee to develop a new Code • Marketing Code Authority is now established • Procedures are defined to formalise the Authority • With new Associations being added to the existing groups, the Constitution will be signed by all Associations • Essential to have fair and balanced promotion of medicines for both Healthcare professionals and patients • Essential to retain the self regulatory status of the Code in line with other highly functional international Codes
Annual General Meeting • 12th September • 9am – 11.45am • Cedar Park Hotel 120 Western Service Road Woodmead • Guest Speaker – Dr AnbanPillay