Saudi Gazette report DAMMAM — Pharmaceutical companies are employing many tactics to promote their products with doctors and pharmacies. These companies are competing for a share of the SR13 billion pharmaceutical market in the Kingdom, which is expanding at an annual rate of 10.2 percent, according to a report in Al-Riyadh newspaper. Some pharmacists dispense medicines that is different from what the doctor has prescribed, claiming that what has been prescribed is not available. However, they really want to promote medicines from certain pharmaceutical companies for a commission, and they are helped by a complete absence of regulations. The Saudi Food and Drugs Authority (SFDA) has issued many laws for dispensing medicines but they are not implemented. Dr. Ayman Al-Mesailhi, consultant dermatologist, said doctors should respect their profession and the oath they have taken upon graduation. They should not be lured by pharmaceutical companies to promote their products, he said. Medicines have side effects that can be dangerous to patients if they are not taken under a doctor's care, he said. Some medicines may even be life-threatening. This is especially true for antibiotics and medicines for chronic diseases. He said some pharmaceutical companies offer incentives to pharmacists to dispense their products to patients. These incentives can reach 20 percent of the medicine price, in addition to other incentives like free air tickets. Some patients ask their doctor whether they can use an alternative medicine offered to them by their pharmacists, but the majority do not. Some medicines may be similar in composition, but have different side effects if taken with other medication. Hasan Fayoumi, sales executive of a large pharmaceutical company, said the company imposes on them a monthly sales target. This puts them under continuous pressure as they are paid mainly in commission. He said that his company offers many incentives in the form of air tickets, free trips, gifts, and gift cards redeemable in stores, in addition to monetary commission. His company has a department that follows up with clients and offers them incentives to increase sales. Husain Al-Najjar, a pharmacist at King Fahd University Hospital in Al-Khobar, said there is no problem in changing the medication as long as the patient consults with his doctor. He warned against using alternative medication that is different in composition from a patient's usual prescription as it may cause complications. Dr. Abdullah Al-Joudi, consultant of family and community medicine at Dammam University and supervisor of the Society of Family and Community Medicine in the Eastern Province, said any medicine has a particular substance and any alternative prescription should have the same composition. He said the doctor prescribes a medicine based on clinical examinations and because he knows the patient and his or her medical history. He is the only one that can prescribe a medicine, while a pharmacist does not know what a patient needs. He said patients should be educated and strict laws for dispensing medicine should be implemented. He added the SFDA is the only body that can and must deal with such issues. He said the misuse of antibiotics produces bacteria that are resistant to the medicine. This forces doctors to use stronger antibiotics to defeat the bacteria, while harming the patient unnecessarily. He said SFDA regulations are very competent, but they are not strictly followed. Dr. Ibrahim Al-Hafez, executive manager of the "Know Your Medicine" exhibition at Dammam University, said some medicines have the same composition but are different in their commercial names. He said medication alternatives should first be approved by the doctor, since he only knows the patient's history.
