CCP recommends PMDC, NCH and Pemra to frame guidelines curbing deceptive marketing practices
The Competition Commission of Pakistan (CCP) has recommended Pakistan Medical and Dental Council (PMDC), National Council for Homeopathy (NCH), and Pakistan Electronic Media Regulatory Authority (Pemra) to chalk out guidelines regarding the advertisements/marketing practices by medicinal and healthcare service providers to check deceptive marketing practices.
In an order issued by the CCP here on Thursday, the commission gave these recommendations in a case of deceptive marketing practices by a homeopathic practitioner Mian Liaquat Ali of Liaquat Hospital, Lahore. The order was passed by a CCP bench comprising Ms Vadiyya Khalil, the Chairperson, Dr Joseph Wilson, Dr Shahzad Ansar, and Ikram Ul Haque Qureshi, Members.
The CCP stated in the order that the guidelines must mention that the advertisements should be accurate and should not contain false claims or misrepresentations of material fact; must not create false or unjustified expectations; must make necessary disclosure if its absence would render the advertisement misleading; and, must have a reasonable basis regarding the claims.
The CCP further stated that in an era when health providers have begun to market their services aggressively, deceptive healthcare advertising poses significant risks to the public. Fraudulent claims may entice consumers to undergo costly, ineffective, and even more importantly, dangerous medical procedures, which cannot be ignored.
The CCP initiated an inquiry against Dr Mian Liaquat Ali of Liaquat Hospital Lahore after receiving complaints that he was allegedly involved in deceptive marketing practices through television commercial in violation of Section 10 of the Competition Act, 2010. CCP also contacted Pakistan Medical and Dental Council and College of Surgeons and Physicians in this regard.
CCP inquiry revealed that in his TV commercials, Liaquat Ali called himself a “Doctor” instead of “Homeopathic Doctor”; claimed to cure diseases like Hepatitis A, B and C, sugar, obesity, dandruff, and vitiligo or phulbehri; assured guaranteed birth of son through his treatment, and also offered treatment to people via telephone. All of his claims without having reasonable basis were in violation of section 10 of the Act. Based on these findings, show cause notice was issued to him.
During the hearings, Liaquat Ali’s lawyer assured the Commission of making suitable alteration in the TV commercial of his client to address CCP’s concerns, but no such action was taken. On 16 January 2015, the CCP issued an interim order in the matter directing the homeopathic doctor to immediately stop his deceptive TV commercial deceiving the masses through his absolute claims.
After concluding its proceedings in the case, the CCP has issued an order disposing off the show cause notice issued to Al Haj Mian Liaquat Ali after he stopped airing TV commercials on all channels, filed a satisfactory written commitment with the Commission that they would comply with the statement made them during the hearing and filed a compliance report as per the directions of the Commission.
According to the recommendations of the CCP, the statutory role of the PMDC is suggested to be revised for inclusion of the authority to issue licensed authorisation for establishment and operation of private healthcare facilities. Separate guidelines need to be formulated for sole proprietors and corporate entities. Competence and impartiality of the PMDC’s Board and staff will need to be ensured.
In order to improve private healthcare system in Pakistan, CCP has recommended revisiting health policy regulation. From a competition standpoint, increased regulation of markets is generally considered an unhealthy restraint on market forces. However, in certain instances, especially in sectors prone to market failures, appropriate regulatory mechanisms can improve outcomes by setting rules of the game and guiding behaviour. Therefore, the policy-makers need to revisit health policy with reference to role of the private sector. It is in the environment of a failing public health care system and lack of regulation that the private health sector evolved in the first place. Thus advocating for regulation of the private health sector becomes questionable. It remains for the government to ensure that such a regulatory mechanism be introduced that does not constrain the growth of the private health sector, but in fact aids its operations and promotes competition. The private health sector needs to be looked at as a solution to the problem, rather than the problem.
The CCP said that the organisational model of a majority of private sector facilities is sole-proprietorship or partnership-based. There are no constraints involved in establishing a private health clinic except investment capability of the owner. The present situation necessitates stipulation of quality and professional standards for establishment of private healthcare facilities. This is also necessary to check the deceptive marketing practices of quacks and unqualified doctors.
The health care sector is prone to information asymmetries. Suppliers of services may extract premiums owing to the fact that patients are ill-informed about medical treatment and costs. Since no treatment can be 100 percent effective, a doctor’s efforts and expertise remain unverifiable. One of the significant findings is the absence of a comprehensive and well-managed information and data system that could provide updated and detailed statistics regarding private healthcare facilities. Therefore, availability of objective information on the quality and cost of services is a pre-requisite for a competitive and well-functioning healthcare market. In the present set-up, the CCP has suggested PMDC be mandated with maintaining a centralised data base of all the healthcare enterprises at the federal as well as provincial level. The data base maintained shall need to be updated at regular intervals. Access to consumers through an appropriate mechanism shall also need to be ensured. Cognisance of the fact that a health facility’s history shall be in public domain will align incentives for doctors to exert maximum effort and compete on the basis of objective criteria.
We recommend that a separate database with specific proprietary information should also be maintained, with limited access, for the purposes of regulation and enforcement. Establishment of an autonomous information regime, assessing and reporting upon the cost and quality of available health facilities, can facilitate consumers in making informed choices. It will also help establish a competitive environment in the private healthcare market, CCP recommendations added.