Opinion of Healthcare Providers towards the Implementation of Ethical Criteria for Drug Promotion under the Rational Drug Use Program: Case Study of a Province in the Northeastern Region

Abstract

Objective: To study the implementation and opinions of healthcare providers on the implementation of the Ethical Criteria for Drug Promotion (ECDP), problems and restrictions under the rational drug use (RDU) policy in a province in the Northeastern region. Methods: This research was a qualitative study collecting the data by analyzing relevant documents and in-depth interviews with 15 key informants comprising of 12 pharmacists and 3 physicians. Two physician informants were hospital directors involving in the implementation of RDU project. One physician had experience in the implementation ECDP. The data were collected from April–June 2018. Content analysis was used to analyze the data. Results: Self-assessment based on RDU indicators revealed all hospitals met the criteria. Key informants viewed that they were able to comply with the ECDP under the RDU programs, but there was no systematic procedure for the issues. Among 7 issues related to the ECDP, there was only one criteria that most hospitals could systematically adopted, i.e., accountability and transparency in procurement of medicines. The other criteria not able to adopt systematically included 1) monitoring the drugs with an unusually high prescribing rates within in hospitals, 2) receiving gifts from pharmaceutical companies. 3) specification of time and location for meeting with drug representatives, 4) receiving drug samples, 5) attending meetings or seminars organized by pharmaceutical companies, and 6) organizing academic conferences supported by pharmaceutical companies. Conclusion: Implementation of the ECDP under the RDU project mirrors the implementation of the Ethical Criteria for Purchasing, Procurement and Promotion of drugs and Medical Supplies B.E. 2557, issued by Ministry of Public Health. Both criteria adoption was on voluntary basis. Relevant authorities such as Ministry of Public Health should play a role in establishing clear guidelines and monitoring system to strictly supervise the compliance to the ECDP health care especially in large hospitals where more activities on drug promotion take place, compared to the smaller ones.