Executive Summary:

Despite constant advocacy around “patient centricity,” India’s healthcare ecosystem – from pharma to hospitals – continues to show deep structural gaps. Safety failures, unethical marketing practices, opaque pricing, and hospital-level exploitation still undermine patient trust. This article uses illustrative (not exhaustive) examples to show how these gaps persist, and where genuine patient-friendly efforts do exist.

When “Patient First” Breaks Down: 

1. Safety & Ethics Failures:

India’s recent crises show that patient safety is still vulnerable to systemic weaknesses.

One of many examples demonstrating quality lapses:

• In October 2025, India declared three pediatric cough syrups — Coldrif, Respifresh-TR, and ReLife — toxic and unsafe due to diethylene glycol (DEG) contamination linked to child deaths.
• The WHO issued global alerts after detecting dangerous DEG levels.
• State regulators admitted major inspection gaps, including unfilled drug-inspector vacancies.

This is one form of patient-unfriendly failure – but quality lapses have surfaced repeatedly in other categories of medicines too.

2. Unethical Marketing Practices — Still Alive Despite UCPMP 2024:

A representative example among many:

• The Department of Pharmaceuticals found AbbVie Healthcare India sponsored a luxury trip for 30 doctors to Paris/Monaco — a clear UCPMP violation.
• No meaningful penalties were disclosed, reinforcing that enforcement remains weak.

This case is merely one of many unethical influences still shaping prescribing behavior.

2.1 UCPMP 2024 Exists, but Enforcement is Toothless:

• The UCPMP 2024 code outlines strict ethical rules for pharma.
• But without statutory backing or punitive powers, the code’s deterrence remains limited.

This is just one sign of India’s “soft touch” regulatory culture.

3.. Hospitals & Doctors: Patient-Centric in Theory, Revenue-Centric in Practice:

Again, the following are illustrative examples, not isolated incidents.

3.1 Overbilling, Procedure Inflation & Revenue Targets

Numerous investigations and patient testimonies reveal:

• Corporate hospitals often impose internal monthly revenue targets on doctors.
• Unnecessary surgeries, implants, and prolonged hospital stays are pushed to meet business objectives.
• Vendor-tied implants and consumables result in inflated pricing for patients.

These patterns show a recurring conflict between patient welfare and institutional profit.

3.2 Diagnostic Overuse Driven by Referral Incentives

• Mandatory MRIs, CT scans or lab panels for non-critical conditions.
• Referral chains that reward doctors or hospitals for test volume.

These widespread practices worsen India’s already high out-of-pocket spending burden.

4. Pharma’s Patient-Friendly Efforts: Encouraging, but Limited in Scale:

Many pharma companies run genuinely helpful programs — but they serve only a fraction of patients.

Below are examples among many such programs, not an exhaustive list:

3.1 Roche India — Blue Tree Program

• Patient counselling, home-delivery support, and navigation for oncology patients.

3.2 Intas Foundation — National Patient Support Network

• Chronic and rare disease support across 27+ states and 100+ hospitals.

3.3 Sun Pharma — Patient Support for Palbociclib + Mobile Health Units

• Access initiatives plus rural MHUs serving underserved regions.

3.4 Pfizer India — PAP India App

• Digital enrolment for patient assistance programs.

3.5 Cipla — Breathefree Initiative

• Lung health education and inhaler-use training for asthma/COPD patients.

These initiatives demonstrate that patient-centricity is possible — yet remain limited in reach compared to the scale of India’s disease burden.

4. The Core Problem: Structural Incentives Aren’t Patient-Centric:

India’s healthcare suffers from a systemic incentives gap:

• Pharma is rewarded for sales, not health outcomes.
• Hospitals optimize for revenue, not evidence-based care.
• Regulators focus on paperwork, not rigorous inspection.
• Patients lack pricing transparency and grievance redress.
• Outcome reporting by pharma support programs is almost nonexistent.

Until incentives shift, “patient centricity” will continue to be a marketing phrase rather than a structural reality.

5. What Must Change:

For Pharma

• Publish measurable patient-outcome data from PAPs.
• Link marketing incentives to adherence, satisfaction, and patient outcomes — not prescription volume.
• Adopt independent audits for safety and access programs.

For Hospitals & Doctors

• Prohibit revenue-linked professional targets.
• Mandate transparent cost disclosures before treatment.
• Establish patient-rights cells with independent oversight.

For Regulators

• Give UCPMP statutory authority with real penalties.
• Fill all drug-inspector posts and accelerate surprise audits.
• Mandate public reporting of safety violations.

For Patients/Citizens

• Demand transparent bills, treatment rationale, and alternatives.
• Report overcharging and unethical promotions.

Conclusion:

India’s healthcare and pharma ecosystem will only become patient-friendly when safety, ethics, transparency, and accountability become non-negotiable pillars of the system — not optional CSR-style add-ons.

“Patient centricity” must shift from being a promotional narrative to becoming a structural design principle. Until then, the current contradiction will continue -loud advocacy, thin implementation, and uneven patient experiences.

— By: Tapan J. Ray

Author, commentator, and observer of life beyond the corporate corridors.

Disclaimer: The views/opinions expressed in this article are entirely my own, written in my individual and personal capacity. I do not represent any other person or organization for this opinion.

Key Sources:

1. Roche India — The Blue Tree Program (official): Roche India corporate page. Roche India+1
2. Intas Foundation — Patient Assistance Program (official): IntasFoundation.org. intasfoundation.org+1
3. Sun Pharma — Palbociclib launch & PAP (press release): Sun Pharma press/materials. Sun Pharmaceutical Industries+1
4. Pfizer PAP India — app and program (official): Pfizer India / Google Play listing / press. Google Play+1
5. Cipla — Breathefree (official): Breathefree / Cipla patient site. breathefree.com+1
6. Contaminated cough syrups & DEG child deaths (peer-review & Reuters coverage & WHO alert):PMC/NCBI article on Gambia incident (background), Reuters & WHO reports on 2025 India DEG incidents, BMJ coverage. BMJ+3PubMed Central+3Reuters+3
7. State FDA inspection capacity & audits (Times of India coverage post-syrup crisis): reporting on inspector vacancies and limited audits. The Times of India
8. AbbVie India foreign-trip investigation / DoP reprimand / related coverage: Times of India, New Indian Express and Economic Times coverage of the 30-doctor Paris/Monaco trip and ensuing probes. The Times of India+2The New Indian Express+2
9. UCPMP 2024 documentation & commentary (DoP / legal FAQs): Department of Pharmaceuticals UCPMP material and Cyril Shroff client alert. Also Supreme Court push to give UCPMP statutory force (LiveLaw). Cyril Amarchand Mangaldas+2Department of Pharmaceuticals+2
10. Academic/analysis on drug safety, DEG incidents & systemic failures: IJME, BMJ and other peer-reviewed commentaries on cough syrup poisoning, and reporting on systemic enforcement gaps. Indian Journal of Medical Ethics+1