retentionofemployeespharmaceuticalindustryprojectreportmbamarkting-120614004929-phpapp01

Retention of employees in pharmaceutical industry

Executive Summary

The pharmaceutical industry spends billions of dollars annually on gifts to physicians often these gifts consist of items that are designed to enhance patient care (e.g., anatomical oodles) or learning (e.g., textbooks), but gifts may also be of a more personal nature (e.g., vent tickets). Serious ethical concerns have been raised that gifts from the pharmaceutical industry to individual health care professionals risk compromising health care providers professional objectivity and integrity, and/or undermining their fundamental ethical commitment to putting the interests of patients first. This report discusses the special nature of gift relationships, examines why gifts to health care professionals from the pharmaceutical industry may be ethically problematic, and reviews professional ethical guidelines and legal standards regarding acceptance of gifts.Project report on :- Retention of employees in pharmaceutical industryObjectives:

1. To study on Employee satisfactions level in NRI vision care pvt. Ltd.in delhi.2. To know job satisfaction level existing employee in industry.

3. To Know the authority and responsibility of the industry.

4. To know the relationship between company and employeeResearch Methodology:Data Source : Primary Data (Field Survey)

Secondary data-Internet

Area of Research : Delhi Research approach : Survey method

Research Instrument : Questionnaire

Sample Plan : Personal Interview

.Sampling method : SPSS student version software

Sample size : 100 Respondents

Findings: In company the coordination is very good between the employees and management. In the company the employee satisfaction with there job. The mutual coordination between the members in company.

The rewards systems are in the company is very piece rate system

The company has giving equal wages to the employee.

The company recognition of sincere efforts to motivate the employee in organization.

The present working condition is very good in NRI vision care chemical industry. The employees have facing problem with decision making process to progress there company.

Suggestions:

The company has focus on giving extra security to employee in inside the organization

The company having aware of exact goals of there industry. To motivate employee the company having giving extra benefit to improve Working condition in company.

CONCLUSION: Assessment of overall performance of the pharmaceutical firms, as perceived by research sample, was relatively high;, only learning/ growth/ innovation dimension got an assessment below high level. Performance measures which were assessed a little below high level were:

Resources acquisition and utilization

Employees satisfaction

attracting new customers

introducing new policies, strategies, etc

Only one performance indicator was below the mean of the scale (3); that was development of new production methods.

Research findings indicated rather strong positive relationship between Employee and organization performance at NRI vision care chemical firms.

Introduction: NRI Vision Care Pvt. Ltd. is one of the fastest growing companies in India dealing in ophthalmic, ENT & other departments. Mr. Narendra Yadav, Managing Director of NRI Vision Care Pvt. Ltd. started this company in 1998.

Mr. Yadav has a background of almost 17 years in the field in various aspects of marketing of these drugs. Within a short span of 17 years the company has achieved enormous growth countrywide. NRI Vision Care Pvt. Ltd. is rapidly emerging as the market leader in the industry with the successful launches of a series of high technology solutions and drugs for diseases such as glaucoma, dry eye and various other eye-infections and inflammations along with various nasal disorders, ear diseases, gynaecological infections, macular degeneration, anaemia, dyspepsia etc.

The vision of the company is to position among the Top Brands in the Drug Industry in the very near future. NRI Vision Care Pvt. Ltd. has a team of more than 100 dedicated field force and managers at every level to help and assist the daily activities of field force and thus help in achieving the desired targets, without compromising on trust, moral ethics & quality of the manufactured drugs.

With the hard work of all NRI Vision Cares family members we are well known in some of our countrys renowned hospitals like AIIMS, Safdarjung Hospital, RML Hospital, Guru Nanak Eye Centre, DDU Hospital and major medical institutes of North India to name a few and with the above mentioned vision in our mind we will reach greater heights in the next 5 years.

Turnover

2012-2013 Rs 3,26,05,896(three Crore twenty six lakhs five thousand eight hundred and

ninety six)

2013-2014 Rs 6,70,72,596(six Crore seventy lakhs seventy two thousand five hundred and

ninety six)

Locations

We are currently operational in Delhi, Haryana, Uttar Pradesh, Himachal Pradesh, Rajasthan, Jammu &

Kashmir, Uttaranchal, Bihar & PunjabOGANISATIOZATION PROFILE: Health care professionals who prescribe pharmaceutical products base their prescription decisions on many factors including effectiveness, safety, and cost. In an effort to influence practitioners prescribing practices, the pharmaceutical industry employs diverse marketing and promotional strategies, among them offers of free drug samples, educational materials, meals, and other forms of gifts. These efforts are both intensive and expensive. In 2001 the drug industry spent more than $16 billion on visits to physicians offices. In the last five years the number of pharmaceutical company sales representatives in the U.S. has increased from 42,000 to 88,000.1 Some 80% of physicians report having been offered cash or gifts from pharmaceutical industry representatives.2 Many physicians meet with pharmaceutical industry representatives four or more times per month.3 Serious ethical concerns have been raised about these contacts between the pharmaceutical industry and individual health care professionals, especially when gifts are involved.4-9 The practice of accepting gifts from pharmaceutical industry representatives risks compromising health care providers professional objectivity and integrity, and undermining their fundamental ethical commitment to putting the interests of patients first. Gift incentives to participate in continuing professional education programs are the wrong incentives for health care professionals and trainees, who should be independently motivated to participate in lifelong learning.7 And there are economic consequences when the costs of gifts are passed along to patients, health care institutions, and third-party payers in the form of higher prices for drugs. Escalating drug costs may ultimately result in limitations on access to care. Federal regulations (at 5 CFR, Part 2635) establish standards for conduct in relation to gifts for all federal employees. But anecdotal reports from the field indicate that beyond these mandated thresholds, local facilities policies about accepting gifts from the pharmaceutical industry vary widely within VHA. To address this state of affairs, new national policy limits the access representatives of the pharmaceutical industry may have to facilities and staff.* This national guidance provides a foundation for the development of more uniform local policies throughout the system. This report by the VHA National Ethics Committee examines the values at stake in relationships between practitioners and the pharmaceutical industry from the perspective of health care ethics. Its goal is to clarify the philosophical and professional concerns that underlie regulations and policy in this area. The report addresses gifts provided to individual health care professionals by representatives of the pharmaceutical industry. Often these gifts consist of items that are designed to enhance patient care (e.g., reflex hammers, anatomical models) or learning (e.g., meals at educational events, textbooks), but gifts may also be of a more personal nature (e.g., organizers, event tickets). The promotional nature of gifts may be subtle or obvious, depending on, for example, whether a sponsor or product name is prominently displayed. For this report gifts are distinguished from purely promotional items that have no intrinsic value to the recipient (e.g., product brochures) and from compensation for professional work (e.g., honoraria). The report discusses the definition of gifts, examines why gifts to health care professionals from the pharmaceutical industry may be ethically problematic in the health care setting, and reviews professional ethical guidelines and legal standards regarding acceptance of gifts. It offers practical recommendations to guide ethical policy within VHA. Although the analysis and recommendations offered here were developed specifically in reference to gifts from pharmaceutical representatives, they apply equally to gifts from representatives of medical manufacturers Gifts provided to institutions are beyond the scope of this report.* What Is a Gift? Webster defines a gift as: something bestowed voluntarily and without compensation.12 Although this definition captures our casual understanding of a gift as something given with no expectation that the recipient will reciprocate, it misses much of the social aspect of gifts that make gifts from pharmaceutical representatives to health care professionals ethically challenging. Gifts have deep and sometimes contradictory cultural meanings.13 Unlike contracts, in which parties set out clear, explicit expectations, gifts place people in binding personal relationships that generate vague, open-ended moral obligations. The importance of a gift lies in the personal relationship it generates, sustains, and signifies.14 Why Are Gifts Ethically Problematic? Because gifts create relationships, health care professionals acceptance of gifts from the pharmaceutical industry can be ethically problematic in several ways. Accepting gifts risks undermining trust. It may bias clinicians judgments about the relative merits of different medications. And it may affect prescribing patterns in ways that increase costs and adversely affect access to care. Undermining Patient & Public Trust. Health care professionals fiduciary, or trust-based, relationship with patients requires that practitioners explain the reasons for treatment decisions and disclose any potential conflicts of interest, including the influence of gifts. One study asked patients and physicians to rate how appropriate it would be for a physician to accept gifts (ranging from pens to trips) from the pharmaceutical industry, and whether they thought accepting gifts would influence the physicians behavior.15 With the exception of drug samples, the patients considered gifts to be more influential than did the physicians. Almost half of the patients who participated had not been aware that physicians received gifts from pharmaceutical companiesand of those, 24% said that this new knowledge changed their perception of the medical profession. Similarly, a telephone survey of patients found that although 82% of respondents were aware that physicians received office-use gifts from the pharmaceutical industry, only about one-third were aware that physicians received personal gifts.16 Forty-two percent believed that personal gifts adversely affect both the cost and the quality of health care. On the basis of such data, the American College of Physicians has concluded that [a] significant number of patients believe that industry gifts bias their physicians prescribing practices and ultimately drive up medical costs.17 Public awareness that health care professionals accept gifts from pharmaceutical representatives may undermine trust in the profession and lead to a perceived loss of professional integrity. VHA is a public agency and public service is considered a public trust. Consequently, the public rightly hold VHA to a higher ethical standard than they do private companies. As federal employees, health professionals appointed to VHA have an obligation to ensure that citizens can have completeEquipmentMocnosCapacity

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MicropulveriserSS 316311 plates

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D. M. WATER PLANT70 M3Ion Exchange

CHARTER OF THE EMPLOYEE DEVELOPMENT AND RETENTION COMMITTEE OF MEDICIS PHARMACEUTICAL CORPORATION:This Employee Development and Retention Committee Charter was adopted by the Board of Directors (the Board) of Medicis Pharmaceutical Corporation (the Company) on July 9, 2006.

I. PurposeThe purpose of the Employee Development and Retention Committee (the Committee) of the Board of the Company is to review and provide guidance concerning the recruiting, hiring, training, promotion and retention of employees and managers.

In addition to the powers and responsibilities expressly delegated to the Committee in this Charter, the Committee may exercise any other powers and carry out any other responsibilities delegated to it by the Board from time to time consistent with the Companys bylaws. The powers and responsibilities delegated by the Board to the Committee in this Charter or otherwise shall be exercised and carried out by the Committee as it deems appropriate without requirement of Board approval, and any decision made by the Committee (including any decision to exercise or refrain from exercising any of the powers delegated to the Committee hereunder) shall be at the Committees sole discretion. While acting within the scope of the powers and responsibilities delegated to it, the Committee shall have and may exercise all the powers and authority of the Board. To the fullest extent permitted by law, the Committee shall have the power to determine which matters are within the scope of the powers and responsibilities delegated to it.

II. MembershipThe Board will appoint the members of the Committee. There will be a minimum of two members of the Committee. Each member of the Committee will be a non-management member of the Board.

III. Meetings and ProceduresThe Chairperson (or in his or her absence, a member designated by the Chairperson) shall preside at each meeting of the Committee and set the agendas for Committee meetings. The Committee shall have the authority to establish its own rules and procedures for notice and conduct of its meetings so long as they are not inconsistent with any provisions of the Companys bylaws that are applicable to the Committee.

The Committee shall meet at least one time per year and more frequently as the Committee deems necessary or desirable.

All non-management directors who are not members of the Committee may attend and observe meetings of the Committee, but shall not participate in any discussion or deliberation unless invited to do so by the Committee, and in any event shall not be entitled to vote. The Committee may, at its discretion, include in its meetings members of the Companys management, any personnel employed or retained by the Company or any other persons whose presence the Committee believes to be necessary or appropriate. Notwithstanding the foregoing, the Committee may also exclude from its meetings any persons it deems appropriate.

The Committee shall have the sole authority, as it deems appropriate, to retain and/or replace, as needed, any independent counsel, consultants and other outside experts or advisors as the Committee believes to be necessary or appropriate. The Committee may also utilize the services of the Companys regular legal counsel or other advisors to the Company. The Company shall provide for appropriate funding, as determined by the Committee in its sole discretion, for payment of compensation to any such persons retained by the Committee.

The Chair shall report to the Board following meetings of the Committee and as otherwise requested by the Chairman of the Board.

IV. Duties and Responsibilities1. The Committee shall, at least annually, review the employee recruitment, hiring, development, promotion and retention policies of the Company.

2. Through an interactive process with the Companys senior management and its Human Resources Department, provide oversight and guidance on issues including but not limited to employee recruiting, hiring & promotions, training & development, employee relations, work-life issues, diversity, inclusion issues, retention practices, and similar matters with the goal of increasing employee retention and satisfaction.

3. To address specific issues or problems relating to employee relations and retention that may arise with the objective of identifying which procedures or policies need be enhanced, changed or discarded and to ensure that senior management has a timely and reasonable action plan to address the issue or problem.

4. The Committee shall evaluate its own performance on an annual basis, including its compliance with this Charter, and provide any written material with respect to such evaluation to the Board, including any recommendations for changes in procedures or policies governing the Committee. The Committee shall conduct such evaluation and review in such manner as it deems appropriate. The Committee shall review and reassess this Charter at least annually and submit any recommended changes to the Board for its consideration.

V. Delegation of DutiesThe Committee may delegate its responsibilities under this Charter to a subcommittee comprised of one or more members of the Committee. The creation of such a subcommittee, as well as its purpose, will be reported to the Board of Directors. The Committee will also carry out such duties that may be delegated to it by the Board.Retinas-Employee Retention News: Retensa is proud to be the company keeping you current on employee retention trends , turnover tools, and talent management tactics.Feb: Department of Small Business Services Invites Retinas to Speak at Business Survival Conference of 175 attendees The NYC Department of Small Business Services Flatiron BID invites Chanson Hecht, employee specialist, to speak with conference attendees on workforce issues in an uncertain business environment. Real world scenarios and solutions will be addressed at the Feb 25th event, such as how to reduce employee costs without reducing productivity and what are the viable alternatives to layoffs. Organizational Development Network Invites Retensa to Diversity PanelJan Retensa consultant, Barbara Vigilante, was invited by the Organizational Development Network to take part in a panel on diversity and inclusion. Topics such as the role of diversity in talent management and leading practices in designing, promoting and implementing diversity initiatives will be discussed at the February 10th event.

Retensa presents the Top 10 "Biggest Quits" list of 2008 Retensa presents the fourth annual review of the most the most impact resignations of the year. 2008 was a year remembered for change. For some, change is welcome. For others, it casts uncertainty. Stability is the new currency, so this year's list of biggest

Retention Programs to Retain Pharmaceutical Employees:State of the Industry:

In the highly regulated Pharmaceutical Industry, jobs have become more stressful and complicated. Fierce competition has driven salaries higher and higher and benefits must be constantly improved. Although the Pharmaceutical Industry has lower turnover rates compared to other industries, the cost of turnover is much greater. With strict regulations and rigid timelines, a research specialist's resignation leaves your company with a delay in product development and a loss of talent. Additionally, when a pharmaceutical representative leaves, they take the client relationships with them. These stringent regulations leave employee actions vulnerable to repercussions from their boss, the government, and sometimes even the media making retaining talented employees invaluable.

How Can Retinas Help? In order to retain your employees and reduce turnover, a proactive approach is critical. Retensa can help your Pharmacy organization achieve these goals by constructing an employee retention strategy according to your company's strengths, weaknesses, budget, and goals. Recruiting, hiring, On Boarding, and training are especially important in the Pharmaceutical Industry. An analysis using our Emergent Employee Life Cycle can give you an accurate picture of what current processes are successful and which ones are not as effective as they could be. Retensa creates an action plan with clear recommendations for improvement based on these findings. We also use exit interviews and employee engagement surveys to learn why employees leave your company and what you can do to better retain them. Costumer focus: To Satisfy our customers' needs and expectations

ToMake commitments we fully understand and believe we can meet

ToMeet all commitments to customers on time

Performance Driven: ToVerify that our products and services meet agreed requirements

To Monitor, benchmark and continuously improve our business, products, services, organization and employees' performance

ToProvide best service backup for our customersCommitment to Quality:Quality values are internalized at every level of the organization. Our approach to communicating and implementing these values is one of encouragement, education and training rather than making policies. Ongoing education and individual support provide employees with the tools, confidence, and motivation they need to implement quality philosophy.

Through a quality training program, employees will learn, both the importance of quality and how to measure it and a commitment to continually improving the quality and reliability of NRI vision cares products and services. We work to offer a very low impurity profile in our products.About pharmaceutical promotion: General Practitioner in Willunga, a village 50 km south of Adelaide, South Australia paid one day per week. Lecturer in the Discipline of General Practice, University of Adelaide paid one day per week. My duties include developing a Treatment Decision Education Collaboration (TDEC)

National Institute of Clinical Studies (NICS) Fellow 2.5 days per week. My project is to develop a website to assist GPs to evaluate the usefulness of drug promotion compared to Therapeutic Guidelines.

Director, Healthy Skepticism Inc unpaid. Healthy Skepticism is an international non-profit organization with the main aim of improving health by reducing harm from misleading drug promotion. I am currently on a 23 city tour of Europe and the USA from April 20 June 25, 2008 with stops in these cities:

Helsinki, Manchester, Leeds, London, Oxford, Berlin, Verona, Glasgow, Belfast, Geneva, Lausanne, Madrid,Kln, Mainz, Washington, Boston / Pawtucket, Chicago, New York, Seattle, San Francisco / Davis, Hobart I am much obliged [old fashioned English for thank you] to my major sponsors:

IQWiG [German Institute for Quality and Efficiency in Health Care]

SSMI [Swiss Society of Internal Medicine]

Why is drug promotion a difficult topic?

Understanding drug promotion is not rocket science. It is a much more complicated and difficult topic. Understanding drug promotion requires understanding insights from many different fields of study. The more I learn from these any

fields the more I realize that I have much more to learn. The useful fields of study include:

Medicine and Pharmacy

Pharmacology, Epidemiology, Public Health, Evidence Based Medicine, Drug Evaluation,

Pharmacovigilance

Social sciences

Psychology, Economics, Sociology, Anthropology, Management, History, Politics, Communication Studies

Humanities

Logic, Ethics, Rhetoric, Epistemology, Linguistics, Semiotics, Literature, Art, Religion

Professions

Marketing, Public Relations, Education, Advocacy, Regulation Policing, Law, Accounting

Statistics

Because drug promotion is so complex this paper can only be a quick introduction covering only the tip of the iceberg. I will have to simplify many complex issues. I apologize for any misunderstandings or distortion that may result. The understanding of drug promotion is also complex and difficult for the following reasons:

The greatest obstacle to discovering the truth is being convinced that you already know it. Many doctors believe that they all ready know everything they need to know about drug promotion so they are not open to reconsidering their beliefs.

Peter Mansfield: Healthy Skepticism about pharmaceutical promotion page 2

Because we swim in a see of promotion we dont notice it, just like fish may not notice the water that they swim in.

The issues are not black and white.

The conclusions from psychological research about persuasion do not fit well with the current belief systems of many health professionals. Many reject these conclusions because they feel wrong or difficult to believe without assessing the strength of the evidence. This tendency of people to reject facts if they feel that they are implausible was known by the ancients. Plato who attributed the following quote to Socrates discussing sophistry: In courts of justice no attention is paid whatever to the truth all that matters is plausibility... both prosecution and defense positively suppress the facts in favour of probability, if the facts are improbable. Never mind the truth -- pursue probability through thick and thin in every kind of speech; the whole secret of the art of speaking lies in consistent adherence to this principle. (Plato, Phaedrus 272). Thucydides wrote that "When someone finds a conclusion agreeable, they accept it without argument, but when they finds it disagreeable,

they will bring against it all the forces of logic and reason." Modern psychologists call these tendencies

confirmation bias.

Many health professionals perceive any discussion of drug promotion to be a threat to their freedom to choose

for themselves what to do, including whether or not to accept gifts from drug companies. Psychological

research has found that threats to freedom often elicit reactance. Reactance is an emotional reaction against

threats to freedom or pressure to change. Reactance can cause people to adopt or strengthen views contrary to

what was intended.

What is promotion?

Promotion can be defined as persuasion with the aim or effect of increasing or decreasing the use, sales or acceptance of a product, service or idea. Promotion is a subset of marketing. The 3 other main components of marketing are: developing the product, pricing and distribution or placement. Thus the 4 Ps of marketing are: product, price, promotion and place. Promotion includes many methods: advertising, sales representatives, gifts, samples, sponsorship, public relations etc.

Do we think we are influenced?

Many studies around the world have found similar results to a study by Steinman et al (2001). When they asked young US physicians: How much influence do sales representatives have on your prescribing? the answers were: 61% none;38% a little and 1% a lot. It seems that the majority of us are confident that we are completely or nearly completely invulnerable to promotion. However we are not so confident about our colleagues. When asked How much influence do sales representatives have on other physicians prescribing? the answers were: 16% none; 33% a little and 51% a lot.1 have It is very common for humans to believe that they are at lower risk of harm than other people. Psychologists call this the illusion of unique invulnerability. Consequently if you think you not vulnerable to being misled by drug promotion you are in the majority. However, there is also evidence that this illusion increases vulnerability. Overconfidence increases vulnerability because it reduces the motivation to think carefully about persuasive messages so they are less likely to be rejected.2 One of the main reasons why doctors are overconfident is that they believe that their high intelligence is an adequate

protection. Recently, an Australian national GP leader for denied that doctors were be adversely influenced by drug promotion. His main justification for this denial was that: Doctors have the intelligence to evaluate information from a clearly biased source.3 However intelligence is a risk factor for overconfidence and overconfidence is the main risk factor for being vulnerable to misleading promotion. For example, a study of internet fraud has found that clever people are easier to con To do the bigger scams you need the victims to trust their own capabilities and experience A significant number of high-loss cases involved specialists such as psychiatrists, psychologists and neuro-surgeons.4

Are we influenced?

Pharmaceutical industry staff believe that drug promotion is effective because they see sales change soon after promotional activities occur. In 1964 advertising company executive Pierre Garai disclosed that: As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond Peter Mansfield: Healthy Skepticism about pharmaceutical promotion page 3

doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order.5

Pharmaceutical companies have a legal obligation to invest money only where it is most likely to provide the highest return on investment. In many countries they have been the most profitable of all industries for most of the past 100 years. They only invest in promotional activities where they have good reason to believe are likely to increase prices

and/or sales volumes. They would not invest in promotion if it did not work on average to provide high returns on investment. Drug companies spend huge amounts on promotion in most countries. They may spend more in the USA but that is the only country where reliable expenditure data is available. Pharmaceutical promotion in the United States in

2004 is as high as $57.5 billion Excluding direct-to-consumers advertising and promotion towards pharmacists, the industry spent around $61,000 in promotion per practicing physician As a percent of U.S. domestic sales of $ 235.4 billion, promotion consumes 24.4% of the sales dollar versus 13.4% for R&D.6 The following graph shows the volume of prescribing of drug A in a hospital in northern USA. The doctors in that

hospital were asked if they were influenced by drug promotion. They denied it. Initially the level of prescribing was low. It increased when the doctors received an invitation to an all expenses paid seminar about the drug in a resort in Florida. The level of prescribing dropped while the doctors were away at the seminar then increased even more after they got back.7 Perhaps the initial level of prescribing was too low and the post promotion level was more appropriate. The main point here is that doctors who believed that they were not influenced were in fact influenced. Observational evidence such as this study is not as conclusive as randomized controlled trials. However the industry has millions of sales graphs similar to this one.

Are we vulnerable to being misled?

I am a member of a team doing a systematic review of studies that have measured doctors exposure to promotion and measured the quality of prescribing and analyzed the relationship between those two measures. So far we have found 7

studies -

1. Andersen M, Kragstrup J, Sondergaard J. How conducting a clinical trial affects physicians' guideline adherence and drug preferences. JAMA. .

2. Aubrey L., Hensgen F., Sermet C. La diffusion de linnovation pharmaceutique en medicine liverale: revue dela literature et premiers resultants francais. Bulletin dinformation en economies de la sante. 3. Becker MH, Stolley PD, Lasagna L, McEvilla JD, Sloane LM. Differential education concerning therapeutics and resultant physician prescribing patterns. J Med Educ..

Peter Mansfield: Healthy Skepticism about pharmaceutical promotion page 4

4. Berings D, Blondeel L, Habra ken H. The effect of industry-independent drug information on the prescribing of benzodiazepines in general practice. Eur J Clin Pharmacology.

5. Haayer F. Rational prescribing and sources of information. 6. Muijrers PE, Grol RP, Sijbrandij J, Janknegt R, Knottnerus JA. Differences in prescribing between GPs: impact of the cooperation with pharmacists and impact of visits from pharmaceutical industry representatives. 7. Spingarn RW, Berlin JA, Strom BL. When pharmaceutical manufacturers' employees present grand rounds, what do residents remember? Acad Med. 1996 Jan;71(1):86-8.Of the 7 studies 4 found that exposure to promotion correlated with lower quality prescribing. Two studies found no correlation. This could mean that promotion is not effective all the time or perhaps there were effects that those 2 studies did not detect. One study found mixed effects. Exposure to promotion was associated with higher levels of prescribing for less common severe cases where the drug was appropriate (improving quality) but also higher levels of prescribing for more common less severe cases where the drug was inappropriate (decreasing quality). On the available evidence exposure to promotion can be associated with increased or decreased quality of prescribing. It may sometimes have no

effect, in which case it is just a waste of money. It appears that overall exposure to drug promotion may do more good than harm. There is not enough evidence of benefit to justify doctors investing their limited time in allowing themselves to be exposed to drug promotion. There is corruption in most professions including the medical profession. However that is not the main problem arising from drug promotion. The main problem is unintended bias. Social science research shows that even when individuals try to be objective their judgments are subject to an unconscious and unintentional self-serving bias.8

What percentage of promotion is potentially misleading?

The answer to this question depends on definition used. My definition is: Promotion is potentially misleading when it omits relevant information that is needed for good decisions or includes persuasion techniques that that have been

identified as potentially misleading in studies of logic, critical appraisal, psychology or rhetoric. These techniques ay be

used deliberately with intent to mislead or ay be used innocently by people who have been misled themselves. For 25 years I have been looking for an example of promotion that is not potentially misleading. The reason I want such an example is that I want to influence drug companies and praise is a more effective way to influence people than criticism.

However I have not been able to find any examples in Australia or any of the many other countries I have visited. Sometimes I have found advertisements that I initially think are ok but on loser examination I find that they had fooled me. I frequently ask audiences at the talks I give to send an example of promotion that is not potentially misleading butnone have been sent to me. If you see a good example please send it to me at [email protected]. It is still possible that some promotion is ok but I think the parentage must be very small. I conclude that the percentage of promotion is potentially misleading is likely to be near 100%.Overview of pharmaceutical:

Clinical research and development in the drug industry must be understood in the current political and economic context of medical neoliberalism (Fisher 2007a; forthcoming). In the US, neoliberalism is the guiding ideology behind economic policies that emphasize a reduction in social services provided by the state and an increase in the role of the private (for-profit) sector in the provision of social goods, such as health care, welfare, and education (Monahan 2006). Medical neoliberalism, in particular, is manifest in a consumer model of health characterized by an inequitable distribution of services according to who can pay for different kinds of care (Frank 2002). The pharmaceutical industry benefits from neoliberal forms of health care because un(der)insured populations in the US can be recruited as human subjects into clinical trials in exchange for limited, medical attention for the duration of studies (Fisher 2007b).5 In addition, many health care providers are looking for new ways to increase their revenue through a diversification of services (Gray 1993). In this climate, physicians become targeted as potential investigators on pharmaceutical studies (Pham et al. 2004). The resulting organization of clinical trials has important implications for relationships of trust in drug development. Pharmaceutical clinical trials are characterized as contract research. Unlike investigator-initiated research, those conducting pharmaceutical studies rarely have any role in defining the research questions, designing the protocols, or analyzing the results. Instead, scientists and researchers at pharmaceutical companies determine these elements of clinical trials, and clinicians are then hired to execute the protocols using their patients as subjects. Although physicians at academic medical centers and university hospitals confer legitimacy and prestige on pharmaceutical studies, the bulk of contract research is conducted in the private sector by physicians in private practices or for-profit, dedicated research centers.Conceptual framework:The concept of trust provides a useful lens for exploring relationships among pharmaceutical companies, clinicians (i.e., physicians and research coordinators), and human subjects engaged in drug development. In the majority of scholarship on trust in medicine, the focus is primarily trained on patients trust in their personal care providers, human subjects trust in the researchers or institutions conducting clinical trials, and citizens trust in their health care delivery systems (e.g., Mill man 1977; Mechanic 1996; Kao et al. 1998; ONeill 2002; Allsop 2006). Yet, for pharmaceutical clinical trials to operate effectively, clinicians must trust the pharmaceutical companies with which they are working and pharmaceutical companies must trust the clinicians and human subjects. With each of these relationships, trust is multifaceted and negotiated as individuals respond to their own and others institutional opportunities and constraints. Several modes of trust are critical for the success of clinical development. In the clinical trials industry as seen elsewhere, trust is necessary to ensure effective cooperation of all relevant actors and organizations (see Luhmann 1979; La Porta et al. 1997). One way of understanding this dynamic is to distinguish between how trust is constituted differently in individuals and institutions. This difference in types of trust is important because both levelsthe individual and institutionalcan shape the other, but each have unique implications, particularly if trust is misplaced (ONeill 2002). Specifically, trust in individuals may overemphasize those actors intentions and motives while obscuring the effects of how institutions structure (and limit) that trust (Shapiro 1987). For example, physicians conducting drug trials may indeed have the best interest of human subjects in mind, but nonetheless they have only limited jurisdiction over decision-making regarding subjects participation. Thus, subjects trust in those physicians may give them a false sense of confidence that their wellbeing is appropriately safeguarded. Examining trust at the level of individuals can ignore the myriad constraints that are placed on the range of individual actions and choices.confidence in the integrity of the federal government (5 CFR 2635.101; EO 12674). Whereas the public relies on legal enforcement mechanisms to assure that private health care organizations comply with relevant law and regulation, they expect public agencies and employees to adopt policies that not merely follow the rule of law but also promote its spirit by establishing goals of exemplary behavior as ethical standards. Acceptance of any type of gift from the pharmaceutical industry by VHA employees risks eroding public trust in VHA, possibly to a greater degree than would be the case for employees in private agencies. More importantly, the beneficiaries of government programsveterans, in the case of VHAare often more dependent on government services than are those who rely on private programs. This greater dependence gives rise to the governments obligation to adhere to a stricter ethical standard. Effects on Professional Relationships. Given the ways in which gift giving differs from entering into a contractual relationship, gifts from pharmaceutical representatives to health care professionals can blur the distinction between formal business exchanges and informal, interpersonal exchanges.13 The social experience of giving and receiving gifts affects the relationship between the two parties in complex and subtle ways. Anthropological literature13 explains that the recipient of a gift often feels three types of obligation toward the giver: grateful conduct (i.e., acceptance of the gift and expression of gratitude), grateful use (i.e., in accord with the givers intention), and reciprocation. Obligations to accept the gift and thank the giver and to use the gift as the giver intended stem from the purpose of gift exchangebuilding personal, moral relationships. The felt obligation to reciprocate, to give or do something in exchange for the gift is most troubling in the health care context. As Murray notes, Appropriate reciprocation depends on particular cultural norms and the specifics of the relationship.13 In the context of a gift to a health care professional from a pharmaceutical industry representative, practitioners commonly understand that the hoped for reciprocation involves the health care professional writing more prescriptions for the drug(s) the representative is promoting. Bias & Conflicts of Interest. Health care professionals may be influenced by accepting gifts in two ways. As we have noted, they understand that prescribing selected pharmaceutical products is the industrys preferred form of reciprocation, and some may be influenced to do so in response to the gift received. One study, for example, found that physicians who met with or accepted money from representatives of pharmaceutical companies (e.g., for educational presentations) were more likely to request that the companies drugs be added to a hospital pharmacy than were colleagues who did not interact with pharmaceutical companies.18 A review of physicians prescribing patterns found that usage of two drugs increased significantly among physicians who attended all-expense-paid symposia at resorts sponsored by the manufacturer of the drugs compared to their practice before the symposia.19 The majority of physicians responding did not believe that such incentives would alter their prescribing practices. Similarly, a recent study reported that British general practitioners who had weekly contact with drug company representatives were more willing to prescribe new drugs and more likely to express views that will lead to unnecessary prescribing than general practitioners with less frequent contact with pharmaceutical representatives.20 The second concern is that gifts may insidiously introduce undetected or under appreciated bias into professionals assessment of the overall merit or value of promoted pharmaceutical products. There is evidence to indicate that practitioners themselves are often poor judges of whether or when external factors, such as gifts, influence their decision making.3, 15, 2123 For example, 86% of respondents to a nurse practitioner and physician assistant survey regarding pharmaceutical industry.Retention of employees training:

Here training fits in. Many employers believe that training boosts morale, enhances motivation, and improves personnel retention. Marriott hotels found, for example, that effective training of its entry-level workers had a profound effect on keeping these employees.

The Florida Power Corp. reduced its annual turnover rate from 48% to 9% using a unique combination of training and employment screening. After receiving instruction in 12 essential skills, job applicants were expected to successfully demonstrate these skills. A 1992 Southport Institute study of workplace education concluded that the longer an organization had an educational program in place for its personnel, the more likely it was to experience lower turnover, improved morale, and reduced hostility among its people.[2]

* What else affects turnover? While there have been other reports of dramatic decreases in employee turnover due to effective training, most of these studies lack validity since during the periods studied there were concomitant changes that could have influenced turnover rates. For instance, Roma Lee Taunton attempted to measure the impact of management training on turnover among nurses. Although her findings suggested a positive cause-effect, results may have been skewed: At the time of her study, considerable downsizing of hospitals was taking place in her area.[2] It seems to follow that anything that increases unemployment may also increase worker retention.

Employee selection procedures can also distort turnover studies (better selection often results in diminished turnover). Richard Wellins is quoted as saying, "If you have a turnover problem ... 8 of 10 times it may very well be due to selection of personnel rather than (lack of) training."

Leadership styles and major management innovations have a significant impact on turnover, too. Wellins found, for instance, that the turnover rate in work-team--oriented facilities was sometimes half that of similar institutions with traditional worker-management structures.

Almost anything that influences morale can affect turnover (salary and benefits, new policies or practices, changes in leadership, union organizing activities, to name just a few). If you believe employee attitude surveys truly reflect morale, and you accept the theory that morale is an important factor in personnel retention, then there is abundant evidence to support the fact that training positively affects holding onto employees. A study of chain-store employees showed a marked reduction in employee dissatisfaction after an interpersonal skills training program was implemented. Jo Westfall claims that satisfaction surveys led to improved laboratory employee retention.Organization chart:

Research Methodology:

Data Source : Primary Data (Field Survey)

Secondary data-Internet

Area of Research : Bangalore Research approach : Survey method

Research Instrument : Questionnaire

Sample Plan : Personal Interview

.Sampling method : SPSS student version software

Sample size : 100 Respondents

1.In which of he following rewards system would you like to work?

FrequencyPercentValid PercentCumulative Percent

Validpiece rate system3636.036.036.0

fixed salary3232.032.068.0

fixed salary commission2020.020.088.0

any other1212.012.0100.0

Total100100.0100.0

Interpretation:

From above table show that 36% respondent are reward system kike would be piece rate system, 32% fixed salary ,20% fixed and commission,12% any other.

2.Are you getting equal wages for equal work?


Validyes8484.084.084.0

no1616.016.0100.0

Total100100.0100.0

Interpretation: From above table show that out of 100 respondents are response 84%

Are Getting equal wage for equal work. And remaining are 16% are no.3. If, not list the demand that are not so far met by the company?


ValidHRA Increase33.03.03.0

JA Increase44.04.07.0

Basic44.04.011.0

DA55.05.016.0

Not responds8484.084.0100.0

Total100100.0100.0

Interpretation From above table show that 84% are satisefy with equal salary

Only 16% are not happy with salary they demand for 3% HRA increase, 4% JA increase

And basic, 5% DA increase.

4.If the above need fulfilled, for how many extra hours you are ready to work? FrequencyPercentValid PercentCumulative Percent

Valid2 hrs4545.045.045.0

4 hrs4444.044.089.0

8 hrs55.05.094.0

i will not are ready to work66.06.0100.0

Total100100.0100.0

Interpretation:

From above table has show that if the needs are to be fulfilled. The respondent are response 45% are 2hrs,44% are 4hrs, 5% are 8hrs,and remaining 6% areI will not ready work are response

5. Are you having job security in your company?


Validyes7676.076.076.0

no2424.024.0100.0

Total100100.0100.0

Interpretation: According to survey I have know that at 76% are respondents are having job security in company and 24% are not having any security in that company.6.Job security plays very important role to work more? FrequencyPercentValid PercentCumulative Percent

Validstrongly agree1818.018.018.0

agree5858.058.076.0

disagree1414.014.090.0

strongly disagree1010.010.0100.0

Total100100.0100.0

Interpretation: According to survey I have know that out 100 respondents

are job is security plays very important role to work in company 18% are strongly agree

58% are agree, 14% are dis agree, 10 % are strongly dis agree. 7.Do you know the exact goals of your company? FrequencyPercentValid PercentCumulative Percent

Validyes8080.080.080.0

no2020.020.0100.0

Total100100.0100.0

Interpretation: According to survey i know that the responds 80% are know the exact goals of company, and 20% are not exact goals of company. 8.Do you feel are working in consonance with goals of the organization? FrequencyPercentValid PercentCumulative Percent

ValidYes7979.079.079.0

No2121.021.0100.0

Total100100.0100.0

Interpretation: According to survey out 100 respondent are feel working in consonance with go with goals of the organization 79% are respondents yes, and remaining responded are 21% no

9. Recognition of sincere efforts motivates a person work well? FrequencyPercentValid PercentCumulative Percent

Validstrongly gree2929.029.029.0

agree5959.059.088.0

disagree99.09.097.0


Total100100.0100.0

Interpretation: According to survey know that recognition of sincere efforts motivate a person work well out 100 respondents are 29% are strongly agree, 59 % are agree 9% are dis agree and remaining strongly disagree.10.The recognition of good work ,if considered for promotion, it will motivate the workers to work well



agree4141.041.090.0

disagree55.05.095.0


Total100100.0100.0

Interpretation: According to survey the strongly recognition of good work, if considered for promotion, it will motivate workers to work well, 49% are strongly dis agree 41% are agree, 5% are disagree and strongly disagree.11. Authority and responsibility are well balanced in our organization? FrequencyPercentValid PercentCumulative Percent


agree4141.041.092.0

disagree55.05.097.0


Total100100.0100.0

Interpretation:

According to survey out 100 respondents are responds Authority and responsibility are balanced in their organization 51 % are strongly agree, 41% are agree 5% are disagree,3% are strongly disagree. 12. Are you getting canteen, sanitary, quarters, medical fecility very well and those are motivating factors? FrequencyPercentValid PercentCumulative Percent


agree3535.035.082.0

disagree1111.011.093.0


Total100100.0100.0

Interpretation:

According to survey out respondents are responds getting canteen, sanitary, quarters medical facility. 47% are strongly agree, 35% are agree, 11% are disagree and remaining 7% are strongly disagree.

13, Are happy with the position and the status of the job in which you are working? FrequencyPercentValid PercentCumulative Percent

Validyes8181.081.081.0

no1919.019.0100.0

Total100100.0100.0

Interpretation: According to survey I know that the respondents are happy with position and status of the job in which are working at 81% are yes, 19% are no.14. Work and working conditions are pleasant and interesting?


Validyes8080.080.080.0

no2020.020.0100.0

Total100100.0100.0

Interpretation: According to survey the responds are working and working condition are pleasant and interesting 80% are yes, 20% are no.15.If not why? FrequencyPercentValid PercentCumulative Percent

Validplace of work is not congenial1010.010.010.0

strained superior and subordinate relationship88.08.018.0

defective combination system88.08.026.0

any other(specify)1313.013.039.0

not respond6161.061.0100.0

Total100100.0100.0

Interpretation: According to survey 10% are place of work is not congenial 8% are strained superior relationship and defective combination system 13% are any other and 61% are not responds.

16. The worker wishes belong to one or other informal group in organ?


Validyes9090.090.090.0

no1010.010.0100.0

Total100100.0100.0

Interpretation: According to survey I know that the respondents are worker wisher belongs to one and another informal group in the organization 90% are response yes, 10% are no.17.If yes, do you feel the association with the informal group motivates the employee to work well in the organization? FrequencyPercentValid PercentCumulative Percent

Validyes9090.090.090.0

no1010.010.0100.0

Total100100.0100.0

Interpretation: According to survey know that the 90% are responds are yes for they feel the association with the informal group motivate the employee to work well in organization and remaining 10% are no.18. Are you happy other members of the group with which you are working?


Validyes8181.081.081.0

no1919.019.0100.0

Total100100.0100.0

Interpretation: According to survey I have know that 81% are responds are happy with the work with other member in the organization. And 19% are against.

19.If not, why? FrequencyPercentValid PercentCumulative Percent

Validlack of cohesion among the members1616.016.016.0

lack of cooperation among the55.05.021.0

lack of coordination77.07.028.0

any other(specify)1818.018.046.0

not responds5454.054.0100.0

Total100100.0100.0

Interpretation;

According to survey know that 61% are lack of cohesion among the members, 5% are lack of cooperation among members, 7% are lack of coordination ,18% are any specify and 54% are not responds.20. Are you in position to work with head and heart (with devotion and happiness) in your co? FrequencyPercentValid PercentCumulative Percent

Validyes7676.076.076.0

no2424.024.0100.0

Total100100.0100.0

Interpretation: According to survey knot that respondents are position with head and heart (with devotion and happiness) with company at 76% are yes, 24% are no

21. if not, why?


Validlack of efforts by management to improve employee morale2020.020.020.0

improper delegation system1010.010.030.0

imbalance between authority and responsibility44.04.034.0

lack of proper encourage ti sincere workr1010.010.044.0

not responds5656.056.0100.0

Total100100.0100.0

Interpretation: According to survey most respondents are 56% are not responds 20% are lank of efforts by management 10% are improper delegation 4% are imbalance between authority and responsibility, 10% are lack proper encourage increase work. 22. Do you feel you are involved in decision making process? FrequencyPercentValid PercentCumulative Percent

Validyes8080.080.080.0

no2020.020.0100.0

Total100100.0100.0

Interpretation; From above table show that out 100 respondents are responds they feel involved in decision making processes at 80% are yes. And 20% are no.23.if not, why? FrequencyPercentValid PercentCumulative Percent

Validnegligence and unwillingness of management11.01.01.0

procedural problems66.06.07.0

lack of faith77.07.014.0

any other specify66.06.020.0

not respond8080.080.0100.0

Total100100.0100.0

Interpretation: According to survey I know that 80% are not responds for this question but 1%,6%,7%,6%, negligence and unwillingness of management, procedural problems, lack of faith, any other specify.

24.Are you having sufficient job advancement opportunites in your company? FrequencyPercentValid PercentCumulative Percent

Validyes7777.077.077.0

no2323.023.0100.0

Total100100.0100.0

Interpretation: According to survey know that 77% are responds are yes, and 23% are no in having sufficient job advancement opportunities in your company

25.If not, do you feel it need for employees motivation?


Validyes2121.021.021.0

no22.02.023.0

37777.077.0100.0

Total100100.0100.0

Interpretation:

According to survey know that 21% are responds are feel it need for employees motivation, and 2% are no and remaining are not responds. Findings: In company the coordination is very good between the employees and management.

In the company the employee satisfaction with there job.

The mutual coordination between the members in company.

The rewards systems are in the company is very piece rate system

The company has giving equal wages to the employee.

The company recognition of sincere efforts to motivate the employee in organization.

The present working condition is very good in NRI vision care chemical industry.

The employees have facing problem with decision making process to progress there company.

Suggestions:

The company has focus on giving extra security to employee in inside the organization

The company having aware of exact goals of there industry. To motivate employee the company having giving extra benefit to improve Working condition in company.

CONCLUSION:

Assessment of overall performance of the pharmaceutical firms, as perceived by research sample, was relatively high, only learning/ growth/ innovation dimension got an assessment below high level. Performance measures which were assessed a little below high level were:

Resources acquisition and utilization

Employees satisfaction

attracting new customers

introducing new policies, strategies, etc

Only one performance indicator was below the mean of the scale (3); that was development of new production methods.

Research findings indicated rather strong positive relationship between Employee and organization performance at NRI vision care chemical firms.

Bibliography

NRI VISION CARE Chemical Notes

WWW.NRI vision care.com WWW.google.com Business magazines (business times)

News papers (Economic times, Times of India).

Questionnaire

1) Name: _________________________________________________

2) Age :

3) Gender: Male Female

4) Occupation: Professional Others

5) Annual Income: Below 1, 00,000 1, 00,000 3, 00,000

3, 00,000 5, 00, 000 5, 00,000 & Above

6) Address:_______________________________________________________

_______________________________________________________

_______________________________________________________

7) Contact number: _______________________________

INTERVIEW SCHEDULE FOR EMPLOYEES:1. In which of the following reward system would you like to work? i. Piece rate system

ii. Fixed salary

iii. Fixed salary+ Commission iv. Any other

2. Are you getting equal wages for equal work?

i. Yes

ii. No

3. if not, list the demands that are not so far met by the company.

i. HRA increase ii. JA increase iii. Basic iv. DA4. If the above need fulfilled, for how many extra hrs you are ready to work?

i. 2Hrs

ii.4Hrs

iii. 8Hrs

iv. I will not are ready to work?5. Are you having job security in your company?

i. Yes ii. No

6. Job security plays very important role to work more

i. Strongly agree

ii. Agree iii. Disagree

iv. Strongly disagree

7. Do you know the exact goals of your company?

i. yes ii. No

8. Do you feel are working in consonance with the goals of the organization

i. Yes ii. No

9. Recognition of sincere efforts motivates a person work well

i. Strongly agree



10. The recognition of good work, if considered for promotion, it will motivate the workers to work well

i. Strongly agree



11. Authority and responsibility are well balanced in our organ.

i. Strongly agree



12. Are you getting canteen, sanitary, Quarters, Medical facilities very well and those are motivating factors.

i. Strongly agree



13. Are you happy with the position and the status of the job in which you are working

i. Yes ii. No

14. Work and working conditions are pleasant and interesting

i. Yes ii. No

15. If not why?i. place of work is not congenial ii. Strained superior and subordinate relationship

iii. Defective combination system iv. Any other (specify)

16. The worker wishes belong to one or other informal group in Orgn

i. yes ii. No

17. If yes, do you feel the association with the informal group motivates the employee to work well in the organization?

i. Yes ii. No

18. Are you happy other members of the group with which you are working?

i. Yes ii. No

19. If not why?

i. Lack of cohesion among the members ii. Lack of co-operation among the iii. Lack of co ordination

iv. Any other specify

20. Are you in a position to work with head and heart (with devotion and happiness) in your co.,

i. yes ii. No

21. If not, why?

i. Lack of efforts by management to improve employee morale

ii. Improper delegation system

iii. Imbalance between authority and responsibility

iv. Lack of proper encourage to sincere worker

22. Do you feel you are involved in decision making process?

i. Yes ii. No

23. .If not, why?

i. Negligence and unwillingness of management

ii. Procedural problems

iii. Lack of faith

iv. Any other specify

24. Are you having sufficient job advancement opportunities in your company?

i. Yes ii. No

25. If not, do you feel it needed for employees motivation?

i. Yes ii. NoMD

MANEGER ACCOUNT

MANEGER QUALITY ASSURANCE

MANEGER GENERAL WORKS

HEAD BREWER

JUNIR OFFICER ACCOUNT

JUNIR OFFICER

MAINTENANCE ENGINEER

STORES

TRINEE CHEMIST

EXECETIVE

OFFICER

MICROBIOLOGIST

CLERK& OFFICE ASSISTSNT

LAB ASSISTANT

LAB ASSISTANT

OFFICE ASSISTANT

SENIOR

EXCETIVE OFFICER

HR MANEGER

MICROBIOLOGIST

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