Welcome to India, the Land of the Drug Reps

Two dozen young men and women toting backpacks and brochures mill around cardiologist P.L. Tiwari’s office in Bombay Hospital, waiting up to 90 minutes for an opportunity to see him. They aren’t there for checkups. They want to persuade the Mumbai doctor to prescribe their employers’ brands of prescription drugs. Tiwari, who sees about 50 patients a day, says he’s so inundated by sales representatives that he tries to limit their visits to Friday nights. “They often come pleading to me, asking me to prescribe their company’s drugs,” he says. “I only give them 20 seconds or a minute. You can’t stop your consultation to entertain them.”

Rising incomes and surging rates of heart disease, diabetes, and cancer have resulted in 14 percent annual growth of pharmaceutical sales in India since 2005. Due to the nation’s ban on prescription-drug advertising and local prohibitions on pharmacists substituting one maker’s pills for those of another, pharma companies view expanding their sales forces as the best way to grab a larger slice of the $12 billion Indian drug market.