In the latest English-language version of this still evolving story (earlier April 2010 backgrounders here and here), we learn that doctors prescribing New Merck/Legacy Schering-Plough's PegIntron® for Hep C were requiring patients to pay vastly marked up prices, either by essentially "forcing" purchases directly from the doctors, or from a pharmacy with which the doctors had reciprocal profit sharing arrangements.
We also learn that, according to the multiple published reports, in-country Schering/Merck representatives both encouraged, and fostered this practice -- profiting from it, as well -- do go read it all at VietNamNet:
. . . .Triple Alliance
. . .[S]ales of Peg-Intron in 2008 were around $4 million and rose to $5 million in 2009. In 2008 and 2009, Phytopharma conducted promotional programmes, discounting 23 percent on price (registration), totaling 18.8 billion dong. Actually, some pharmacies enjoyed a discount rate of up to 30 percent from Zuellig Pharma under the instruction of the Schering-Plough representative office in HCM City.
Hoang Lan and Cam Ha pharmacys are the two major buyers of Peg-Intron and Pegasys.
Apart from the collusion between doctors and pharmacies, Tuoi Tre concludes, there was an alliance among the representative offices of the drugs’ producers, the importers and the distributors. . . .
A woman in Binh Thanh district, ‘M’ said she has had to sell her house and other assets to raise over 100 million dong to treat hepatitis C. She started using Peg-Intron 80mcg in early April 2010, on the prescription of Dr. ‘BHH,’ who works at the HCM City Medical University Hospital. The doctor charged ‘M’ 3.4 million dong for a phial of Peg-Intron plus some pills. . . .
The doctor told M that his medicine is guaranteed because he bought it directly from the producer and has preserved it well. However, since Tuoi Tre newspaper denounced high markups on hepatitis C medicines, Dr. BHH has refused to provide Peg-Intron to patients, saying that the situation had changed and he didn’t have the medicine, so patients must buy it themselves. . . .
Hmmmm. . . smells a lot like an [alleged] Foreign Corrupt Practices Act violation to me. We'll keep you informed.