off record
Shaukat Ali Jawaid

Rational pharmacotherapy
for cancer patients


Speaking at the Pakistan Society of Clinical Oncology conference held at CPSP campus in Karachi recently Dr. Shahid Hameed consultant oncologist urged the oncologists to prescribe cost effective economically priced cancer therapy. He was of the view that by doing so, we can treat a much larger number of patients rather than spending huge amount of money on few expensive anti-cancer drugs.

Dr. Shahid Hameed is a noted clinical oncologist who had served at Shaukat Khanum Memorial Cancer Hospital & Research Center at Lahore for many years before returning back to serve in United States. As such he is fully aware of the ground realities here as well.When the conference organizers and leaders of these specialty organizations ask for millions of rupees donations for holding such conferences and other activities most often at Five Star Hotels, those who oblige them, then also influence their prescribing practices. In return the oncologists are also willing to oblige them for these favour hence they prescribeexpensive drugs rather than cost effective therapy.

In a country where we have miserably failed due to incompetence and inefficiency of the government to have an Essential Drugs List for the public healthcare facilities, where unethical medical practice by physicians and unethical marketing practices by the pharmaceutical trade and industry goes on un-checked because of lack of proper monitoring and accountability, what else can we expect. In the end it is the poor patients who suffer and have to pay for all this in the shape of high cost of drugs. Healthcare professionals in general and their leadership in particular, instead of being a part of the solution has become part of the problem. Since most of them come from affluent society, they have neither seen poverty nor they are aware of the fact how the poor patients continue to suffer. In many cases failure for compliance with the prescribed therapy is due to high cost of drugs which a vast majority of the people find unaffordable. To quote Prof. Khawaja Saadiq Husain an eminent physician and former President of CPSP, Principal of King Edward Medical College, the CC virus (commercialization and corruption) has afflicted the members of the medical profession. Hence it was high time that they are reminded to uphold professional ethics in their practices. Whenever Prof. Kh. Saadiq Hussain gets a chance to speak at some meeting, he has always tried to speak on these issues.

Lt-Gen. Mahmud Ahmad Akhtar former Surgeon General of Pakistan Army who has special interest in clinical pharmacology has been fighting for the cause of having an Essential Drugs List for the country and a Hospital Formularybut without much success because of corrupt elements in the health bureaucracy and the medical profession. However, it is heartening to note that there are still some conscious people in the medical profession like Dr. Shahid Hameed who do speak out on these issues advocating rational prescribing and cost effective therapy. May be it will have some effect some day and the government functionaries will wake up from deep slumber or someone may go to the Supreme Court of Pakistan and ask the judiciary to help in checking  these unethical practices. Whenever the political leadership and government fails to discharge its duties, it is the honorable members of the higher judiciary which has always come to the people’s rescue. Guidelines on Physicians interaction with Pharma Trade and Industry prepared by the National Bioethics Committee which covers most of these issues are at present gathering dust somewhere in the government because no one seems to be interested in its implementation.

Tail Piece: Brains like Hearts go where they are appreciated.

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