The main legal point established in the judgment is the court's invocation of Article 226 to address larger issues affecting citizens' rights and impleading relevant government bodies to take action against unethical practices in the pharmaceutical industry.

JUDGMENT :

N. Kirubakaran, J.

"CARTEL OF DOCTORS, PHARMA COMPANIES AND DIAGNOSTIC LABS IS FLEECING THE PATIENTS"

India is a thickly populated country and the population is more than 130 Crores. It is reported that about 50 million patients take treatment from one million doctors in each day in India. The medical facilities available in India are equally compared to foreign countries. Even though foreign patients are coming down to India, especially to Chennai to take treatment, quality medical treatment is not provided to poor and rural people. Indian Pharmaceutical Sector supplies over 50 percent of global demand for various vaccines; 40 percent of generic demand in the U.S and 25 percent of all medicines in U.K. India contributes the second largest share of pharmaceutical and biotech workforce in the world. India's pharmaceutical sector was valued at US$ 33 million in 2017. India's domestic pharmaceutical market turnover is Rs.1,29,015 Crores in 2018, whereas in 2017, it was 1,16,389 Crores.

2. It is complained that drugs are overpriced and unnecessary drugs are being prescribed by a section of medical practitioners at the instance of pharmaceutical companies, apart from prescribing unnecessary tests, scans, X-Rays etc., for commission from diagnostic laboratories. It is being said that Medical Mafia is controlling the pharmaceutical field and they are responsible for overpricing of the drugs. For the purpose of promoting their drugs in the Market, it is being said that the companies are giving incentives such as providing hospitality and foreign trips to the doctors who prescribe their medicines to the patients without considering as to whether it is required or not. A study conducted by support for "Advocacy and Training to Health (SATHI)" states that big pharmaceutical companies bribe doctors through high value bribes such as smart phones, credit cards e-vouchers and even female companionship.

3. The medical companies are said to be overpricing the drugs over and above the maximum sale price fixed by the Government. Thus the patients are compelled to pay more unnecessarily because of overpricing of the drugs or prescription of unnecessary drugs to the patients at the instance of the drug companies. Overpricing of drugs is prohibited by Section 3 of the Drug (Price Control) Order, 1995. National Pharmaceutical Pricing Authority constituted by the Central Government is the body to implement the provisions of Drug (Price Control) Order, 1995. Though a voluntary code viz., Uniform Code for Pharmaceutical Marketing Practices is in force, the mechanism is stated to be powerless to take action.

4. Taking note of the fact that a section of doctors are receiving gifts, travel facilities, hospitality, cash, monetary grants from the pharmaceutical companies for prescribing their drugs, by virtue of notification dated 14.12.2009, Medical Council of India inserted regulation 6.8.1 in Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002 and another clause 6.8.1 (b) on 01.02.2016. The said regulation is usefully extracted hereunder:-

“6.8. Code of conduct for doctors in their relationship with pharmaceutical and allied health sector industry"

The Section 6.8.1(b) shall be substituted in terms of Notification published on 01.02.2016 in Gazette of India, as under:-

(b) Travel Facilities : A medical practitioner shall not accept any travel Facility inside the country or outside, including rail, road, air, ship, cruise tickets, paid vacation, etc. from any pharmaceutical or allied healthcare industry or their representatives for self and family members for vacation or for attending conferences, seminars, workshops, CME Programme, etc. as a delegate.

(iii)Action to be taken by the Council for violation of Section 6.8, as amended vide notification dated 10/12/2009, shall be prescribed by further amending the Section