For the wellbeing of women or for pharmaceutical enrichment?

When a woman receives her doctor´s prescription for a contraceptive pill, sometimes it is determined by the interests and connections of the gynecologist with the pharmaceutical industry. This means that the doctor´s election of one pill instead of the other is not always related to the specific characteristics and needs of the patient, it´s also an economic interest.

The way the pharmaceutical industry sets off connections with the doctors is with the use of medical visitors. Each one of them is in charge of a specific area of the city where they work, and they should visit ten doctors and three pharmacies per day on average.

In medical visiting, they try to convince the doctors of prescribing their pills. First by telling them about the advantages of the product in comparison to other pills on the market, then showing the research that they have done, and at the end with presents or special offers (trips, continuing education courses, or financing a medical congress).  

“The doctors who are usually visited and receive little presents (notebooks, pens, calendars, bags) are the ones who prescribe more. However, it's more difficult to have access to a congress outside the country, the vacancies for these events are for the doctors that prescribe the most for the same pharmaceutical laboratory”, says a medical visitor (requested to stay anonymous).  

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After the medical visit, the doctors choose a pill for the patient, then they need to have in mind the Medical Eligibility Criteria for contraceptive use of the World Health Organization. Nevertheless, there are some other factors that may influence the decision. “In a complete formula there´s always the active principle, though, I privilege some commercial laboratories because they are the ones that stay in contact with the physicians”, says a gynecologist who decided to stay anonymous.

The third step of this process is the pharmacy. The way the pharmaceutical laboratories realize which doctors are making prescriptions is with a system inside the pharmacies named Close Up. When the woman goes to buy her pills she shows her doctor´s formula to the pharmacologist and, “they take a picture of the formula and then it goes to a database where the pharmaceutical laboratories can figure out who´s helping the competition, and who´s prescribing for them”, as it is said by Emilena Castro (ex- medical visitor).

Although in that moment the woman has the pills in her hands without knowing the motivation behind her doctor´s decision, this doesn´t mean that the doctors are just interested in money. “The congresses are really expensive and require a lot of sacrifices, that´s why there are some advantages to the laboratories' sponsorships. Neither the State nor the companies where we work are going to help us, thus the only way of updating our knowledge and doing medical research it´s financing everything by ourselves or a pharmaceutical sponsorship if we can´t afford the expenses”, says Nestor Balcázar, a gynecologist.

Not all doctor´s prescriptions are motivated by their economic interests with the pharmaceutical industry, but it´s a possibility that implies ethical issues. Have women been prescribed because of their health or is there another reason?