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AppendixA Marketing of Health Products

1. Preamble

Whereas:
1.1
the companies in the healthcare industry have agreed to subscribe to a code of practice for the marketing of health products in South Africa based on the principle of self regulation as set out in this Code;
 
1.2
the enforcement of the Code will be entrusted to a Marketing Code Authority ("MCA”) as herein provided.
 
2. Introduction to, application and interpretation of the code
 
2.1 Introduction

The ethical promotion of health products is vital in helping to ensure that healthcare professionals and the public have access to the information they need, that patients have access to the health products they need and that health products are prescribed and used in a manner that provides the maximum healthcare benefit to patients.

All marketers of health products should maintain high ethical standards when conducting promotional activities and must comply with applicable legal, regulatory and professional requirements. Compliance with the Code will ensure that ethical promotional practices are established for all marketers, prescribers, dispensers, advisers and users of health products. The overarching philosophy is a principle of compliance with the spirit of the Code.

The "Code of Practice for the Marketing of Health products in South Africa” is referred to throughout as "the Code”.The National Department of Health, the pharmaceutical industry and other stakeholders are committed to the provision of affordable and quality healthcare for all South Africans. High quality, effective and accessible health products are a cornerstone of health¬care. Accurate information about health products is integral to providing quality healthcare services.
This Code is adopted by health products trade associations to signify the industry's commitment to ensure that the marketing of health products to healthcare professionals and the public is carried out in a responsible, ethical and professional manner, based on practical and scientifically validated information.

The health products industry is committed to educational and promotional efforts that benefit patients and promotional programs and collaborations that enhance the rational use of health products and fair competition in the marketing thereof. The industry seeks to preserve the independence of the decisions taken by healthcare professionals. The industry has an obligation and responsibility to provide accurate information and education about its products to healthcare professionals in order to establish a clear understanding of the appropriate use of health products. Industry relationships with healthcare professionals must support, and be consistent with the professional responsibilities healthcare professionals have towards their patients.
 
This Code takes cognisance of other professional and industry codes applicable to the health products sector and professions with which the sectorinteracts.2.2 Application of the Code
 
2.2 Application of the Code
 
2.2.1 The Code is applicable to the following organisations and situations:
 
2.2.1.1
All registered health products licence holders, their agents, contractors, third party distributors/
marketers and/or contracted events organisers. Companies that circumvent the Code by engaging or using other companies, agents, contractors or dispensing system software vendors or ordering systems will be infringing the Code.
 
2.2.1.2
All advertising and/or promotion and promotional activities and communication directed at influencing any member of the medical, dental,
pharmaceutical, nursing or allied health professions or any seller of health products who in the course of his or her professional or other activities may prescribe, purchase, supply, administer, loan or lease a health product or recommend the use thereof.
 
2.2.1.3
All advertising and/or promotional material, which is directed to members of the public to inform the general public about the health products available for self medication.
 
2.2.1.4
All advertising and/or promotion and all activities directly or indirectly related to marketing which may reflect on the marketing practices of the industry, including but not limited to sponsorships, patient information sharing, meetings and entertainment.
 
2.2.1.5
Interactions between the industry and healthcare professionals (Part A) and the l industry and the general public (Part B).
 
2.2.2 The Code does not apply to the following situations:
 
2.2.2.1
Factual, accurate, informative announcements and reference material concerning registered health products and relating, for example, to adverse reactions and warnings.
 
2.2.2.2
The following documents are not covered by the Code:
 
2.2.2.2.1
Trade catalogues to suppliers including price lists.
2.2.2.2.2
Product labels, packaging materials and inpack leaflets. These are subject to the labelling and package insert requirements in terms of the Regulations to the Medicines Act and the Guidelines pertaining thereto.
 
2.2.2.3
The marketing or promotion of complementary medicines and Stock Remedies as defined under Act 36 of 1947.
 
2.2.2.4
Issues relating to pricing, bonusing and perverse incentives governed elsewhere in legislation and in codes issued in terms of the Medicines Act, National Health Act No 61 of 2003, etc.
 
2.2.2.5
The Code is not applicable to wholesalers, distributors (excluding distributors of medical devices) and logistics companies except to the extent that they may influence the demand for health products.
 
2.3 Interpretation of the Code

2.3.1
The provisions in this Code should be interpreted in light of both the letter and spirit of the Code. Guidance notes, issued from time to time by the MCA will provide companies with an indication as to how the Code should be applied and adhered to, in practical terms. The rulings of the bodies established as part of the Marketing Code Authority, forms precedent on what constitutes acceptable practices in the marketing of health products.
 
2.3.2
The Code should not be construed to be in conflict with any existing law applicable to the marketing of Medicine, including but not limited to the Medicines Act, the Patents Act No 57 of 1978, the Copyright Act No 98 of 1978, the Trade Marks Act No 194 of 1993 and the National Health Act No 61 of 2003.
 
2.3.3
Any interpretation of the provisions of this Code as well as interaction with healthcare professionals not specifically addressed in this Code should be made in light of the following principle:
"Companies shall adhere to ethical business practices and socially responsible industry conduct and shall not use any unlawful or any unethical inducement or reward, including but not limited to those financial or material in nature, in order to sell, loan, lease recommend or arrange for the sale, loan, lease or prescription of their products.”
 
2.3.4
In any review of advertising and/or promotional material or promotional activities covered by this Code, consideration will be given not only to the impression created by a careful study of an advertisement or activity, but also to the impression likely to be gained from a brief or partial exposure.
 
2.4 Status of the guidelines to the Code
 
2.4.1
Guidelines on the interpretation of the Code appear as supplementary information to the text in separate documents. The examples given are intended to illustrate and clarify the meaning of the Code. They are not exhaustive and do not cover all possible situations to be covered by the provisions of the Code.
 
2.4.2
These guidelines will be updated regularly by the MCA, as part of its mandate to ensure education, application and enforcement of the Code. These guidelines will also be used to regularly update applicable monetary values and examples of conduct that constitutes violations of the Code.
 
2.5 Scope of application
 
2.5.1
PART A - The marketing and promotion of health products to healthcare professionals
 
PART A of the Code applies to the promotion of all health products to members of the healthcare professions, and to appropriate administrative staff by the industry or by other health professions such as those involved in managed healthcare or medical schemes, regardless of the scheduling status of the medicine.
It includes the marketing and promotion of selfmedication products to healthcare professionals when such promotion is aimed at generating prescriptions or recommendations to patients.
Advertising and/or promotion of medicines in Schedules 0 and 1 to the general public is permitted but advertising and/or promotion of medicines in Schedules 2 to 6 to the general public is not allowed under the Medicines Act and Regulations. Therefore the provisions of PART A apply to all medicines (including Schedules 0 and 1) marketed to healthcare professionals, irrespective of the scheduling.
PART A is applicable to medical devices and IVD's unless otherwise specified in PART C.
 
2.5.2
PART B - The marketing and promotion of health products directly to the consumer
 
The advertising and/or promotion of medicines in Schedules 0 and 1, to the general public is permitted by law. The main purpose of the Code is to help ensure that advertising and/or promotion of selfmedication medicines complies with applicable codes and laws. The Code is applied in spirit as well as in principle.
The scope of PART B relates to all self-medication (Schedules 0 and 1) medicines registered or sold in terms of the Medicines Act. PART B of the Code applies to advertising materials and promotional activities for medicines, as defined by the Medicines Act, which are aimed at the general public and persons who may legitimately
purchase medicines on behalf of other consumers (e.g. parents, who purchase health products on behalf of their children). The provisions of PART B of the Code do not apply to advertising and/or promotion aimed at healthcare professionals, i.e. the advertisement of Schedules 0 and 1 medicines to professionals has to comply with the provisions of PART A of the Code.
The provisions in PART B have to be seen in the light of the exemption for Schedule 0 medicines from the provisions of section 18A to the Medicines Act.
PART B is applicable to medical devices and IVD's unless otherwise specified in PART C.
 
2.5.3
PART C – The marketing and promotion of medical devices.
 
2.6 Part D – Provision for enforcement
 
2.6.1
The Code is based on the principle of self regulation of the industry through a procedure for handling complaints which is in line with international standards and practice, but made binding through the legislative recognition of the self-regulatory and subsequent processes which may include the medicines regulatory authority.
 
2.6.2
The process of enforcement and the relevant bodies responsible for such enforcement are set out in Part D of this Code.
 
2.6.3
The MCA has the power to refer issues not within the scope and ambit of this Code to the appropriate authorities, councils or bodies with the authority to deal with such issues.
 
2.6.4
The MCA has the power to outsource any of its enforcement functions in terms of the provisions set out in Part D of this Code and/or to align its administration with that of other Codes in force in the healthcare sector at any point in time.
 
2.7 Glossary
 
In this Code, words and phrases that are defined in the Medicines Act shall bear the same meanings as they do in the Act and all regulations issued in terms of this Act.
 
The following additional definitions are provided to guide the interpretation of this Code:
 
2.7.1
Advertisement includes any statement, pictorial representation or design, however made, that is intended, whether directly or indirectly, to promote the use or supply of the goods.
 
2.7.2
Advertising and/or promotion and promotional materials or activities, include, but are not limited to advertorials; branded materials relating to product sponsorship; aerial promotions such as on hot air balloons and/or blimps; booklets; cinema commercials; consumer leaflets; consumer broadsheets; direct mail materials; website and other Internet materials, including press releases intended for internet publication; onpack statements; outdoor advertising; point of sale materials; posters; print advertisements (for use in newspapers, magazines, etc.); promotional aids including those used for direct selling activities; promotional scripts for use by telephone help lines; promotional text messages; consumer promoters; telephone help lines; television and radio/audio commercials; sports, art and other sponsorships; airport, washroom, shopping centre advertising and/or promotion; touch screen advertising; aisle, ceiling, floor advertising and other signs; counter top advertising; window displays; gondola end advertising; bunting; advertising on electronic ordering systems; bus, taxi and other vehicle advertising; and light box advertising.
 
2.7.3
Company means a company, closed corporation, organisation, firm, vendor or individual who may sell or promote health products.
 
2.7.4
Company Code Compliance Officer means anyone duly authorised by the company, or appointed by the company in writing, to sign documents or give instructions on behalf of the company.
 
2.7.5
Electronic journals mean electronic versions of journals that can be viewed online via any personal computer or other electronic device.
 
2.7.6
Health Care Professional (HCP) includes Healthcare Professional and Healthcare Facilities and includes, but is not limited to persons registered with the Health Professions Council of South Africa (HPCSA), South African Veterinary Council; Allied Health Professions Council, the Nursing Council, the Pharmacy Council, the Engineering Council for Clinical Engineers and includes institutions registered at the Department of Health or other regulatory or organisational body, such as a health facility (which includes hospitals, step-down facilities, etc), managed care companies, etc; which entities purchase, lease, recommend, use, maintain or arrange for the purchase or lease of, members' medical technology products in South Africa.
 
2.7.7
Honorarium means a payment or an award granted in recognition of a special service by a professional person. Honoraria can be paid at fair market value for speeches, articles, appearances or other services rendered in terms of a written agreement, which may be subject to scrutiny by the MCA should such honorarium be the subject of a complaint in terms of the Code.
 
2.7.8
For medical devices:
 
2.7.9
Label means a display of printed information
  • on or attached to the goods; or
  • on or attached to a container or primary pack in which the goods are supplied; or
  • supplied with such a container or pack
2.7.10
Medicines Act (i.e. Medicines and Related Substances Act No 101 of 1965 as amended) means the body of legislation governing the registration and marketing of medicine, as amended from time to time and includes any future legislation that amends or repeals and replaces the Medicines Act.
 
2.7.11
"Medical technology”, "Medical devices”, "Health Technology” refers to medical devices as defined in the Medicines and Related Substances Amendment Act, 2008, and include in-vitro diagnostics.
 
2.7.12
Promotional item means merchandise given away free of charge in an effort to create awareness of a company or product.
 
2.7.13
Minimum Requirements means the legislated requirements for written advertisements as stated in Regulations to the Medicines Act.
 
3. Objectives of the MCA
 
The objectives of the MCA shall be:

3.1
to ensure and maintain the ethical promotion and advertising of health products by all parties and entities, including companies and their employees and agents as described in clause 2.2 and who are or may be subject to the Act (hereinafter referred to as the "Companies” and the company);
 
3.2
to ensure that those bound by the Code maintain high ethical standards when conducting promotional activities and comply with applicable legal, regulatory and professional requirements.
 
3.3
to adjudicate on complaints and disputes in terms of the Code.
 
Part A – Marketing and promotion of health products to healthcare professionals
 
4. Registration status of medicines
 
A medicine must not be advertised or promoted:
 
4.1
prior to the product being registered by the medicines regulatory authority or
 
4.2
unless an application has been submitted in terms of Section 14(3) of the Medicines Act ("old medicine”), which permits its sale, supply and use in South Africa.
 
The promotion of a medicine must be in accordance with the terms of its registration, and must not be inconsistent with the particulars listed in its package insert.
 
5. Advertising and promotion material of medicines
 
5.1
All advertising and/or promotional material must be based on the current approved South African package insert.
 
5.2
The minimum requirements must:
 
5.2.1 Conform with the applicable regulations in terms of the Medicines Act.
5.2.2 Form part of the promotional material and not be separate.
5.2.3 Be included in all promotional material (except for promotional items - see Clause 18.3).
5.2.4 Be provided in a clear and legible manner.
5.2.5
Be consistent with the most recently approved package insert for the medicine.
 
5.3
In all forms of advertising and/or promotion i.e. written, audio, audio-visual, internet, the statement "For full prescribing information refer to the package insert approved by the medicines regulatory authority” should appear or be stated. This does not apply to promotional items as referred to in Clause 18.3.
 
5.4
In the case of an advertisement included as part of independently produced information on the internet, the statement should be in the form of a direct link between the first page of the advertisement and the minimum information.
 
5.5
In the case of printed promotional material consisting of more than two pages, the minimum information can appear either on the first or last page.
 
5.6
Promotional material other than advertisements appearing in professional publications must include the date or a code number identifying the version on which the promotional material was drawn up or last revised.
 
5.7
Audio-visual or audio material such as films, video recordings, sound bites, interactive data systems and such like:
 
5.7.1 The minimum information must be provided either by way of a document that is made available to all persons to whom the material is shown or sent, or by inclusion on the audio-visual recording or in the interactive data system itself in line with the general provisions in Clause 5.2.
5.7.2 When the minimum information is included in an interactive data system, instructions for accessing it must be clearly displayed.
5.7.3
If the material consists of sound only, the minimum information may be provided by the way of a document that is made available to all persons to whom the material is played or sent.
 
6. Journal advertising
 
6.1
An advertisement which contains two or more pages must not be false or misleading when each page is read in isolation.
 
6.2
An advertisement taking the form of a loose insert in a journal may not be of a size larger than the page size of the journal itself.
 
6.3
Advertisements in journals must not resemble editorial matter unless clearly identified as advertorial or as a sponsored feature.
 
6.4
In the case of a journal advertisement where the prescribing information appears overleaf, a reference to where it can be found must appear in a type size which is legible at either the beginning or the end of the advertisement.
 
7. Information, claims and comparisons
 
7.1 Accuracy, balance, fairness of claims.
 
Information, claims and comparisons whether in advertisements, promotional items, product detailing and all information relating to health products, whether verbal or in writing, must be accurate, balanced, fair, objective and unambiguous and must be based on an up-to-date evaluation of all the evidence, and must reflect that evidence clearly. Such information or the manner in which it is portrayed, must not mislead either directly or by implication by distortion or undue emphasis. Material must be sufficiently complete to enable the recipients to form their own opinion of the therapeutic value of the health product.Any information, claim or comparison must be capable of substantiation. No substantiation is required for claims in the package insert which has been approved by the medicines regulatory authority.
 
7.2 Exaggerated or misleading claims

Promotion material must encourage the rational use of health product by presenting it objectively and without exaggerating its properties. Exaggerated or all-embracing claims must not be made and superlatives must not be used except for those limited circumstances where they relate to a clear fact about a health product. Claims should not imply that a medicine, active ingredient or health product has some special merit, quality or property unless this can be substantiated.
 
7.3 Comparisons
 
A comparison in the marketing and promotion of health products is only permitted in promotional material if:

7.3.1
It is not misleading or disparaging.
 
7.3.2
Health products or services for the same needs or intended for the same purpose are compared.
 
7.3.3
One or more material, relevant and representative features which is capable of substantiation is compared.
 
7.3.4
No confusion is created between the health product advertised and that of a competitor or between the advertisers' trademarks, proprietary names, other distinguishing marks and those of a competitor.
 
7.3.5
The trademarks, proprietary names, other distinguishing marks, health products, services, activities or circumstances of a competitor are not discredited or denigrated.
 
7.3.6
Trademarks/trade names or company names of another company may only be mentioned with written permission from the other company.
 
7.3.7
No unfair advantage is taken of the reputation of a brand, trademark, proprietary name or other distinguishing marks of another company.
 
7.3.8
Health products or services are not presented as imitations or replicas of goods or services bearing another company trademark or trade name.
 
7.3.9
Hanging (open ended) comparisons are not allowed.
 
7.4 Substantiation
 
Substantiation for any information, claim or comparison must be provided without delay at the request of members of the health
professions or appropriate administrative staff. It need not be provided in relation to the validity of a health products regulatory authority approved indication(s) in the package insert.
 
7.5 References
 
When promotional material refers to published studies, clear and complete references must be given.
 
7.6 Unpublished supporting data
 
When promotional material refers to (unpublished) data on file, the relevant part of this data must be provided without delay at the request of members of the health professions or appropriate administrative staff.
If confidential information, such as information relating to trade secrets, sensitive commercial information or information of a com¬petitive nature is involved, the material may be given to an independent arbitrator acceptable to both parties or a person appointed by the MCA from its Adjudication Panel for assessment, in the case of a dispute. The arbitrator or person appointed by the MCA will make an assessment as to whether the unpublished data in fact support the statement(s) made in the promotional material.
 
7.7 Artwork
 
All artwork, including illustrations, graphs, tables, logos and trade dress must conform to the letter and spirit of the Code. Graphs and tables must be presented in such a way as to give a clear, fair, balanced view of the matters with which they deal, and must not be included unless they are relevant to the claims or comparisons being made.
 
7.8 Use of the word ‘safe'
 
The word ‘safe' or words containing references to safety must not be stated in such a way as to imply that a product has no side effects, toxic hazards or risk of addiction. The word ‘safe' must not be used without scientific qualification and substantiation.
 
7.9 Use of the word ‘new'
 
The word ‘new' must not be used to describe any product or presentation, which has been generally available or any therapeutic indication, which has been available for more than twelve months in South Africa.
 
7.10 Other claims
 
It must not be stated that a product has no side-effects, toxic hazards or risk of addiction or dependency.
 
8. Disparaging references

8.1
The health products, products and activities of other companies, including manufacturers of generic health products, must not be disparaged in any way, including:
 
8.1.1 safety, quality and efficacy;
8.1.2 the effectiveness of the official registration process by which the product obtained market authorisation;
8.1.3 disparaging references relating in general terms to generic or originator health products.
 
8.2 The health professions and the clinical and scientific opinions of their members must not be disparaged.
 
9. High standards, format, suitability and endorsement by HCP's
 
9.1
All materials and activities must recognise the special nature of health products, and the professional standing of the audience to which they are directed and must not be likely to cause offence. High standards must be maintained at all times.
 
9.2
The name or photograph or film of a member of a health profession must not be used in any way that is contrary to the applicable professional codes for that profession and all endorsements, where permitted by professional codes, have to be done within the scope of such codes.
 
9.3
Promotional material must not imitate the devices, copy, slogans or general layout adopted by other companies in a way that is likely to mislead or confuse.
 
9.4
Promotional material must not include any reference to the medicines regulatory authority unless this is specifically required by the medicines regulatory authority, through the applicable legislative and other provisions. This provision does not preclude references to important medicines regulatory authority Guidelines and Policies, such as those on the reporting of adverse events, which serves as important regulatory frameworks for the utilisation of medicines.
 
9.5
Reproductions of official documents must not be used for promotional purposes unless permission has been given in writing by the appropriate body.
 
9.6
The telephone, SMS, e-mail, telex or facsimile machines must not be used for promotional purposes, except where, when first contact is made, the option to opt out is given and the decision is subsequently respected. The option to opt out should also be provided on all subsequent communications, even if the addressee has not opted out after the first contact.
 
9.7
All material relating to health products and their uses, which is sponsored by a company, must clearly indicate the details of the company that sponsored it. The only exception to this clause is market research material that need not reveal the name of the company involved but must state that a company sponsors it.
 
9.8
Postcards, other exposed mailings, envelopes or wrappers must not carry matter which may be regarded as advertising and/or promotion to the general public contrary to relevant legislation.
 

10. Disguised promotion

10.1
Promotional material and activities must not be disguised.
 
10.2
Market research activities, post-marketing surveillance studies, post authorisation studies, clinical trials and the like must not be disguised promotion, nor contain or lead to disparaging comments about competitors or their products. Such trials/studies must be conducted with a primarily scientific or educational purpose. Material relating to health products and their uses, whether promotional in nature or not, which is sponsored by a company should clearly indicate by whom it has been sponsored.
 
10.3
Clinical trials should not be undertaken for the purpose of promotion of health products intended for administration to human beings.
 
10.4
Observational/Non-interventional studies of registered medicines are studies where the medicinal product(s) is(are) prescribed in the usual manner in accordance with the approved medicines regulatory authority package insert. The assignment of the patient to a particular therapeutic strategy is not decided in advance by a trial protocol but falls within current practice and the prescription of the medicine is clearly separated from the decision to include the patient in the study. No additional diagnostic or monitoring procedures shall be applied to the patients and epidemiological methods shall be used for the analysis of collected data. This clause is not applicable to veterinary medicines.
 
10.5
Observational/Non-interventional studies involving health products that are intended for administration to humans, that are prospective in nature and that involve the collection of patient's data from or on behalf of an individual, or groups of healthcare professionals specifically for the study must comply with all of the following criteria:
 
10.5.1
The study is conducted with a scientific purpose and there must be:
 
10.5.1.1 a written study plan (protocol) and
10.5.1.2
written contracts between healthcare professionals and/or the institutions at which the study will take place, on the one hand, and the company sponsoring the study on the other hand, which specify the nature of the services to be provided and, subject to what is stated below, the basis for payment of those services.
 
10.5.2
Remuneration provided must be reasonable and of fair market value to the work performed.
 
10.5.3
The study protocol must be submitted to the appropriate ethics committee for review.
 
10.5.4
Personal data privacy including the collection and use of personal data must be respected.
 
10.5.5
The study must not constitute an inducement to participate, recommend, prescribe, purchase, supply, sell or administer a particular medicinal product.
 
10.5.6
The study protocol must be approved by the company's scientific/medical department, who must also supervise the conduct of the study.
 
10.5.7
The study results must be analysed by or on behalf of the contracting company and summaries thereof must be made available within a reasonable period of time to the company's scientific service, which service shall maintain records of such reports for a reasonable period of time. The company should send the summary report to all healthcare professionals that participated in the study and should make the summary report available to the MCA upon request. If the study shows results that are important for the assessment of benefit-risk, the summary report should be immediately forwarded to the medicine regulatory authority. In addition, companies are encouraged to publicly disclose the summary details and results of non-interventional studies in a manner that is consistent with the parallel obligations with respect to clinical trials.
 
10.5.8
Medical Sales Representatives may only be involved in an administrative capacity and such involvement must be under the supervision of the company's scientific service that will also ensure that the Medical Sales Representatives are adequately trained. Such involvement must not be linked to the promotion of any medicinal product or used as a pretext to obtain access to the healthcare professional for any purpose.
 
10.6
Material issued by companies that relates to health products but which is not intended as promotional material for those health products per se, for example corporate advertising, press releases, market research material, financial information to inform shareholders, the stock exchange, should be examined to ensure that it does not contravene the Code or the relevant statutory requirements.
 
11. Provision of reprints and the use of quotations
 
11.1
Reprints of articles in journals must not be provided unsolicited to any healthcare professional unless the articles have been published in a peer reviewed publication in line with good principles of scientific review and publication. When providing a reprint of an article about a health product, it should be accompanied by prescribing information. If a non-peer-reviewed article is requested by a healthcare professional, a copy may be provided on written request.
 
11.2
Quotations from medical and scientific literature must accurately reflect the intention and meaning of the author(s). If unpublished, "personal communications” shall not be used unless the company, organisation or individual is able to supply written substantiation based on scientific data upon request.
 
11.3
Quotations taken from public broadcasts, for example radio, television or the Internet, and from private occasions, such as medical conferences or symposia relating to health products, must not be used without the formal permission of the speaker unless there is a published record of the proceedings and this is accurately given as a reference.
 
11.4
Utmost care must be taken to avoid ascribing claims or views to authors when these no longer represent the current views of the authors concerned.
 
11.5
The provision of articles and the use of quotations are also subject to the provisions of Clause 8.
 
12. Distribution of promotional material
 
12.1
Promotional material should only be sent or distributed to those categories of persons whose need for, or interest in, the particular information can reasonably be assumed.
 
12.2
A company that is requested by an addressee to cease or limit the volume of promotional material should respect the wishes of the addressee.
 
12.3
Mailing lists must be kept up-to-date. Requests from healthcare professionals to be removed from promotional mailing lists must be complied with promptly and no name may be restored except at their request or with their permission.
 
Note: For medical devices refer to Part C: Sales and Marketing Programs
 
13. Scientific information service
 
Every company must compile and collate information about the health products they market, and must be able to provide such information to authorities, members of healthcare professions or the general public, where appropriate. This may include information about adverse events
 
14. Certification of promotional materials, meetings and other activities
 
14.1 Appointment of person(s) responsible as Company Code Compliance Officer for approval of promotional material, meetings or activities.
 
14.1.1
Promotional material and activities must not be approved nor issued unless its final form, to which no subsequent amendments will be made, has been certified by an individual on behalf of the company i.e. the Company Code Compliance Officer. Company Marketing Personnel and Medical Sales Representatives must ensure they obtain the necessary approval from the Company Code Compliance Officer prior to placing adverts in any publications and/or forums.
 
14.1.2
The appointed Company Code Compliance Officer should either be the responsible pharmacist and/or a natural person responsible for the enforcement and compliance with the Act.
 
14.1.3
Each company or individual should have a Standard Operating Procedure (SOP) for the approval process. The SOP and documentation must be available for auditing by the Marketing Code Authority or the medicines regulatory authority according to the medicines regulatory authority's auditing requirements.
 
14.1.4
Activities which would be subject to certification include, but are not limited to, Continued Professional Development (CPD) or similar professionally required educational events, the presentation of scientific or promotional material, journal club meetings organised and/or sponsored by the company, the use of observational/non-interventional studies for promotional purposes, etc.
 
14.1.5
Meetings that fall within the ordinary scope of the day-to-day activities of company Healthcare Sales Representatives, and/or where the events, parts of the event, a speaker or an attendee is not sponsored by the company, are not subject to certification.
 
14.2 The Certificate

The Certificate must state that the Company Code Compliance Officer has examined the final form of the material or arrangements for an event and that it is in accordance with the requirements of the relevant advertising and/or promotional regulations and this Code, is not inconsistent with the product registration and the package insert and is a fair and truthful presentation of the facts about the medicine.
 
14.3 Recertification of promotional material
 
Promotional material that is still in use must be re-certified at intervals of no longer than two years to ensure that it continues to conform to the relevant regulations and the Code.
 
14.4 Retention of documentation
 
14.4.1
Companies, organisations or individuals shall preserve all certificates and the relevant accompanying information for not less than five years after the final use of the promotional material or the date of the meeting and produce them on request from the MCA or the medicines regulatory authority.
 
14.4.2
In relation to certificates for promotional material, the material must be preserved in the form certified with information indicating the persons to whom it was addressed, the method of dissemination and the date of first dissemination. It is, however, in the interest of storage space, acceptable to store accurate photographic or other electronic representations of material, information or items.
 
14.4.3
All documents/material relating to marketing and promotion, including the agenda for the event, irrespective of the nature of the campaign or event, have to be retained for the minimum period.
 
15. Healthcare sales representatives
 
15.1 Training of healthcare sales representatives
 
Each company shall ensure that its Healthcare Sales Representatives, including personnel retained by way of contract with third parties, and any other company representatives who call on healthcare professionals, pharmacies, hospitals or other healthcare facilities in connection with the promotion of healthcare products (each, a "Healthcare Sales Representative”) are familiar with the relevant requirements and all applicable laws and regulations related to the promotion and advertising, and are adequately trained and have sufficient scientific knowledge to be able to provide precise and complete information about the healthcare products they promote or services offered.
 
15.2 Compliance with codes and laws by Healthcare Sales Representatives
 
Healthcare Sales Representatives must comply with all relevant requirements of the applicable professional and good practices codes and all applicable laws and regulations, and companies are responsible for ensuring their compliance.
 
15.3 Gaining interviews
 
Healthcare Sales Representatives must not employ any inducement or subterfuge to gain an interview. No fee should be paid or offered for the granting of an interview. Donations to charities in return for Healthcare Sales Representatives gaining interviews are prohibited. Offering or making donations in lieu of hospitality are unacceptable. In an interview, or when seeking an appointment for one, Healthcare Sales Representatives must at the outset take reasonable steps to ensure that they do not mislead as to their identity or the company that they represent.
 
15.4 Organising meetings
 
Healthcare Sales Representatives organising meetings are permitted to provide appropriate hospitality and/or to meet any reasonable, actual costs, which may have been incurred. All meetings have to conform with the provisions of Clause 17 (Interaction with Health Care Professionals).
 
15.5 Consideration for healthcare professionals and others
 
Healthcare Sales Representatives must ensure that the frequency, timing and duration of calls on healthcare professionals, pharmacies, hospitals, other healthcare facilities, medical schemes or funders and the like, together with the manner in which they are made, do not cause inconvenience. The wishes of individuals on whom Health¬care Sales Representatives wish to call, and the arrangements in force at any particular establishment, must be observed.
 
15.6 Information to scientific service of company
 
Healthcare Sales Representatives must transmit to the scientific service of their companies (Clause 13) any information that they receive in relation to the use of the health products that they promote, particularly reports of adverse events.
 
15.7 Information to be provided to healthcare professionals
 
When Healthcare Sales Representatives introduce a medicine to a healthcare professional for the first time, they should provide a copy of the latest medicines regulatory authority approved package insert. On subsequent occasions, such information should be available on request.
 
15.8 Follow up on requests for information
 
If discussion on a medicine is initiated by the person or persons on whom a Healthcare Sales Representative calls, the medical representative should make available the information on that medicine referred to in Clause 15.7, as soon as possible after the request.
 
15.9 Detailed briefing materials
 
Companies may prepare detailed briefing material for Healthcare Sales Representatives on the technical aspects of each healthcare product that they will promote. Briefing material must comply with the relevant requirements of the Code and must be approved by the Company Code Compliance Officer in the company, where applicable.
 
15.10 Company responsibility for healthcare sales representatives
 
Companies are responsible for ensuring that the activities of their Healthcare Representatives comply with the Code and all applicable laws and regulations.
 
15.11 Healthcare Sales representatives in an Operating Room or Clinical Environment.
 
Healthcare Sales representative must be appropriately trained on operating room/clinical environment protocol(s).
 
16. Training
 
All personnel, including members of staff concerned in any way with the preparation or approval of promotional material or of information to be provided to members of South African health professions and to appropriate administrative staff or of information to be provided to the public, must be fully conversant with the requirements of the Code.
 
17. Interactions with healthcare professionals
 
17.1 Hospitality/Venues of meetings and events

Companies, organisations or individuals are permitted to organise or sponsor meetings and events including Continuing Professional Development (CPD). The following should be adhered to:
 
17.1.1
The merit and focus of the meeting should be clearly scientific and/or educational.
 
17.1.2
The venue and hospitality should be secondary to the meeting both in time allocation and focus.
 
17.1.3
The venue should be appropriate and conducive to the scientific or educational objectives and the purpose of the event or meeting.
 
17.1.4
Hospitality, meals and entertainment should be modest. As a general rule, hospitality must not exceed what the healthcare professionals would normally be prepared to pay for themselves.
 
17.1.5
Invitations should not be extended to spouses or other guests except if they are healthcare professionals or administrative staff i.e. any costs incurred by spouses or other guests cannot be reimbursed or paid for by the company.
 
17.1.6
Inappropriate financial benefit or material benefits including excessive hospitality cannot be offered and/or extended to healthcare professionals.
 
17.1.7
For speakers, payment of reasonable honoraria and reimbursement of out of pocket expenses, including travel are permissible provided it is in terms of a written contract.
 
17.1.8
CPD meetings:
 
17.1.8.1
No product promotion is allowed in the CPD meeting room. Company-branded items/promotion are permissible.
 
17.1.8.2
Speakers should use the INN names of products during CPD events. Companies must make it known to speakers that the use of trade names is not permitted.
 
17.1.8.3
Product promotional material displayed outside of the CPD meeting room should not be accessible to the general public, if it is not permissible to market such product directly to the public.
 
17.1.9 For local CPD events and product launches which are held in major cities, reasonable travel arrangements or travel reimbursement can be made to ensure that the healthcare professionals that do not reside/practice in major cities are able to access the applicable information.
17.1.10 The criteria for selection of attendees/invitees must be transparent and available to the MCA on request for scrutiny.

17.2
For medical or scientific congresses, conferences or seminars held in South Africa, internationally or international meetings held overseas and held in South Africa:
 
17.2.1
Meetings organised by companies, other organisations or individuals at venues outside South Africa, that are educational and scientific in nature and involve South African healthcare professionals are acceptable.
 
17.2.2
The rationale for any meeting, or sponsorship to attend a meeting, is to be transparent, valid and cogent.
 
17.2.3
Consideration must be given to the educational programme, overall cost, facilities offered by the venue, nature of the audience, hospitality provided and the like.
 
17.2.4
As with any meeting, it should be the programme that attracts delegates and not the associated hospitality or venue and all entertainment and events have to be subordinate in time and nature to the sponsored meeting, congress, conference or seminar
 
17.2.5
Payment of registration fees, travel and accommodation must be made to the professional associations/organisers and not directly to the healthcare professional or appropriate administrative staff, unless proof is received that the amounts spent are in the name of the sponsored person and which corresponds to each and every line item as per the agreed sponsorship. No payment may be made to the professional/staff for time spent at the event.
 
17.2.6
Sponsored speakers may receive reasonable honoraria.
 
17.2.7
Advertisement and promotion are subject to domestic legislation, i.e. if a product is not registered in South Africa, it cannot be promoted, even if the congress is international in nature, unless exemption has been granted in terms of applicable legislation.
 
17.2.8
Sponsorship of congress organised events, other than recreational and sporting events, is permitted. However sponsor¬ship of any stand alone social or entertainment event is not permitted.
 
17.3 Transparency
 
When meetings are sponsored by companies, other organisations or by individuals, the fact must be disclosed in the papers relating to the meetings and in any published proceedings. The declaration of sponsorship must be sufficiently prominent to en-sure that readers are aware of it at the outset.
 
17.4 Stand-alone entertainment, leisure, social or cultural events with healthcare professionals
 
17.4.1
Meetings organised for patients, general public, individual or groups of doctors, other healthcare professionals and/or for administrative staff that are wholly or mainly of an entertainment, leisure, social or sporting nature is not permitted.
 
17.4.2
No stand-alone entertainment or other leisure, social or sporting activities may be planned, arranged or funded by companies as these are unrelated to the promotion of scientific or educational objectives.
 
17.5 Other interactions with healthcare professionals
 
17.5.1 Consultancy services
 
17.5.1.1
The engagement of a healthcare professional to provide genuine consultancy or other genuine services to a company is permitted. Healthcare professionals that provide consulting services to a company and are still practicing their profession must declare their employment arrangement with the company whenever they write or speak in public about a matter that is the subject of the employment or any other issue relating to that company. Such arrangement must be formalised in a written agreement, which may be subject to scrutiny by the MCA if such interaction forms part of a complaint lodged in terms of this Code.
 
17.5.2 No direct payments to healthcare professionals for any other services
 
17.5.2.1
Payments may not be made to doctors or groups of healthcare professionals, either directly or indirectly, for rental for rooms or other services.
 
17.5.2.2
Healthcare professionals involved in bona-fide and if relevant, peer reviewed research, are not subject to 17.5.2.1.
 
17.5.3 Certification of meetings

For the purposes of certification envisaged in Clause 14, the following details have to be retained:
 
17.5.3.1
Details of the programme, both scientific/education and entertainment/hospitality, if any.
 
17.5.3.2
Invitations, the choice of venue(s).
 
17.5.3.3
Documentation as to the rationale for the meeting or sponsorship.
 
17.5.3.4
Participant selection processes and criteria.
 
17.5.3.5
The anticipated costs associated with the event, as well as that associated with all entertainment and hospitality. Records of actual costs will be retained by the company's finance department and be available for auditing purposes.
 
18.1 Inducements, gifts and promotional items, competitions

18.1 Inducements
 
There should be no personal enrichment of healthcare professionals or other healthcare providers. No gift, benefit in kind, rebate, discount, kickback or any other pecuniary advantage shall be offered or given to members of the health professions, administrative staff, government officials, or the general public as an inducement to prescribe, lease, loan, supply, stock, dispense, administer or buy any healthcare product, subject to the provisions of Clause 18.2. No donation should unjustifiably enrich healthcare professionals performing a health related service.
 
18.2 Gifts and promotional items

Occasional gifts and promotional items to healthcare professionals, appropriate administrative staff, sales and other staff are acceptable provided that they are:
 
18.2.1
Inexpensive and of minimal intrinsic value i.e. within the cost limit set from time to time per annum by the MCA.
 
18.2.2
Not for personal use e.g. no entertainment CD's/DVD's, electronic items for entertainment, tickets to attend sporting events or other forms of entertainment.
 
18.2.3
Educational and/or of scientific value, benefit the patient and/or be relevant to the practice.
 
18.2.4
No cash or cash equivalents are allowed.
 
18.3 Promotional items
 
It is permissible to brand promotional items. The minimum information for a medicine as required under Clause 5 does not have to be included on a promotional aid provided that no promotional claims are made. The following information may be included on such items:
 
18.3.1
The name of the medicine.
 
18.3.2
An indication that the name of the medicine is a trademark.
 
18.3.3
Relevant company name, company logo and/or product logo.
 
18.4 Cultural courtesy gifts

An inexpensive gift not related to the practice of medicine, the value of which will determined by the MCA, may be given as a maximum of one gift per year to healthcare professionals, in recognition of significant national, cultural or religious days. The maximum value of the gift must be in line with the value of general gifts.
Note: The Medical Device and IVD industry may not give gifts pertaining to cultural, religious or national events.
 
18.5 Competitions
 
18.5.1
Competitions should fulfil the following criteria:
 
18.5.2
the competition is based on medical/product knowledge or the acquisition of scientific knowledge;
 
18.5.3
the prize is relevant to the practice of medicine, dentistry or pharmacy; and
 
18.5.4
individual prizes or educational items offered and within the cost limit set from time to time by the MCA;
 
18.5.5
entry into a competition must not be dependent upon prescribing, ordering or recommending of a product and no such condition shall be made or implied.
 
18.6 Donations and grants to charities
 
18.6.1
Financial donations or other appropriate donations to registered charities or other institutions may be made if properly recorded and approved by the responsible per-son(s) in each company or organisation. Donations, grants and benefits in kind to institutions, organisations or associations are only allowed provided:
 
18.6.1.1
they are made for the purpose of supporting healthcare or research;
 
18.6.1.2
they are documented and kept on record by the donor/grantor; and
 
18.6.1.3
they do not constitute an inducement to recommend, prescribe, purchase, supply, sell or administer specific medicinal products.
 
18.6.2
Donations must not be paid directly to healthcare professionals.
 
18.6.3
Companies are encouraged to make available publicly, information about donations, grants or benefits in kind made by them as covered in this section.
 
18.7 Corporate social investment
 
18.7.1 Donations to meet identified corporate social responsibility projects may also be made if judged on its merits, approved by the responsible person(s) in each company or organisation and documented.
18.7.2
Corporate social investment is excluded from the operation of the Code in so far as such donations do not induce the overall over or under utilisation of a health product.
 
19. Relations with the general public and the media
 
19.1
Medicines must not be advertised to the general public if they are Schedule 2 – 6 products.
 
19.2
Patient support and/or group meetings, events and patient support materials may be sponsored provided that proper records are kept and that no product promotion takes place. The fact that sponsorship or support has been provided should be displayed on the materials and/or at the meeting or event.
 
19.3
Information that is made available to the general public either directly or indirectly about health products must be factual and presented in a balanced way. It must not raise unfounded hopes of successful treatment or be misleading or disparaging with respect to the safety of the product and may not refer to a medicine's safety, quality or efficacy. Statements, representations or tie-off lines must not be made for the purpose of encouraging members of the public to ask their doctors to pre-scribe a specific health product. Clause 19.1 does not prohibit education or information relating to substitution of a health product or inform¬ation on safe use, storage of health products in general.
 
19.4
Requests from individual members of the public for information or advice on personal medical matters must be refused and the enquirer should be recommended to consult with his or her own healthcare professional.
 
19.5
Companies are responsible for information that is issued by their public relations agencies about their products.
 
19.6
Patient education ("help-seeking advertisements”) directed at general public is acceptable, provided that it:
 
19.6.1 Does not contain the name of the specific health product.
19.6.2 Does not make or allude to a medicinal or therapeutic claim
19.6.3 Does not provide any risk information.
19.6.4 Lets the public know that treatment exists for a medical condition.
19.6.5
"For more information, refer to your doctor or pharmacist (or healthcare professional)” is mentioned.
 
20. Samples
 
The supply of samples is not permitted to extend beyond the conditions as prescribed under the Medicines Act.
Note: Medical devices and IVD Sampling may only take place within the ambit of the Medicines Act and applicable regulations, and includes the provision of devices for product evaluations/appraisals as outlined in this Code, and for purposes of exhibition.
Demonstration products which are not intended to be used in patient care should be accompanied by designations such as "Sample - Not for Human Use,” or other suitable designation on the product, the product packaging, and/or documentation that accompanies the product.
 
21. The internet
 
21.1
Access to promotional material directed at the South African public provided on the Internet in relation to Schedule 02 to Schedule 06 should be limited through a password protection scheme to healthcare professional.
 
21.2
Information or promotional material covered by Clause 21.1 about medicines which is placed on the Internet outside South Africa will be regarded as within the scope of the Code if it was placed there by a South African company, or an affiliate of a South African company, or at the instigation or with the authority of such a company and it makes specific reference to the availability or use of the medicine in South Africa.
 
21.3
medicines covered by Clause 21.1 may be advertised in a relevant, independently produced electronic journal intended for healthcare professionals or appropriate administrative staff which cannot be accessed by non-healthcare professionals.
 
21.4
Package inserts for medicines covered by Clause 21.1 above may be included on the Internet and be accessible by members of the public provided that they are not presented in such a way as to be promotional in nature.
 
21.5
It should be made clear to an internet user when he/she is leaving any of the company sites, or sites sponsored by the company, or is being directed to a site, which is not that of the company.
 
22. Compliance with undertakings and rulings
 
When an undertaking has been given in relation to a ruling under the Code or when a ruling is made under the Code, the company concerned must ensure that it complies with that undertaking and/or the specific ruling.
Part B: – Marketing and promotion of health products directly to the consumer
 
23. Registration status of medicines

A medicine must not be promoted:
 
23.1
prior to the product being registered by the medicines regulatory authority or;
 
23.2
unless an application has been submitted in terms of Section 14(3) of the Medicines Act ("old medicine”) which permits its sale, supply and use in South Africa.
 
The promotion of a registered self-medication product must be in accordance with the terms of its registration and must not be inconsistent with the particulars listed in the package insert or approved text.
 
24. Advertising and/or promotion
 
24.1
Advertisements must be consistent with the requirements of the Medicines Act and other applicable legislation.
 
24.2
Advertisements shall not mislead or disparage either directly or by implication. Information, claims and comparisons must be accurate, balanced, fair, objective, unambiguous and supportable and must be based on an up-to-date evaluation of all the evidence and reflect that evidence clearly. The use of medical terminology is acceptable provided that this does not confuse or mislead the consumer.
 
24.3
Advertising and/or promotion shall not be misleading as to the nature of the product, its ingredients or indication(s).
 
24.4
Advertisements must not contain any other express or implied exaggerated claims as to the benefits that can be obtained from use of the health product.
 
24.5
Efficacy claims should clearly state if health products are intended to be used over extended periods of time or where the health product is indicated for disease risk reduction or prevention.
 
24.6
Advertising and/or promotion can refer to the prevention of symptoms and use of a product in chronic conditions, if in line with the registered indication. The advertisement shall make it clear under what circumstances use of the product is appropriate. This is particularly important in therapeutic areas where individuals may be asymptomatic.
 
24.7
Advertising and/or promotion shall not cause consumers unwarranted anxiety with regard to any condition. Nor should it suggest that suffering might arise if a consumer fails to respond to the advertisement's claim. Advertising and/or promotion must not suggest that the condition will deteriorate or that it will become more severe if the individual does not use the medicine featured. Language which causes fear or distress should not be used.
 
24.8
Advertisements should not suggest that using a health product could enhance normal good health or be a substitute for a healthy diet and lifestyle.
 
24.9
Advertising and/or promotion shall not be aimed principally or exclusively at children (under the age of twelve years).
 
24.10
Advertising and/or promotion shall not show children using, or within reach of, health products without adult supervision.
 
24.11
Advertising and/or promotion shall encourage responsible self-medication and should not encourage individuals to exclusively self-diagnose. Nor should it encourage self-diagnosis where medical intervention is required. Particular care should be taken where symptoms are generalised and a diagnosis is made by exclusions of more serious complaints or where use of the health product could mask the symptoms of a more serious condition. Advertisements should encourage individuals to share information with the pharmacist or healthcare practitioner so that they can ensure the health product will be suitable for the intended user.
 
24.12
Advertising and/or promotion shall not suggest that a medical consultation or surgical operation is unnecessary nor shall it discourage consumers from seeking medical or pharmaceutical advice. Consideration should be given to the inclusion of information concerning the availability of professional advice.
 
24.13
Advertising and/or promotion shall not offer to diagnose, advise, prescribe or treat personally by correspondence.
 
24.14
 
Advertising and/or promotion shall not claim guarantees on a product's effects, safety or quality.
 
24.15
Advertising and/or promotion shall not encourage, either directly or indirectly, the indiscriminate, unnecessary or excessive use of any health product.
 
24.16
Advertisements should not be flippant or use inappropriate imagery or imagery out of context. Advertisers are encouraged to convey the message that health products should be treated with respect and may not be suitable for some people.
 
24.17
Sponsored advertorials shall be appropriately identified as such in the particular publication at the place where it appears, in order to be distinguished from editorials.
 
24.18 Advertising and/or promotion should not encourage consumers to discontinue the use of prescribed health products.
24.19
Advertising and/or promotion shall not contain recommendations of a product by scientists or health professionals unless substantiated.
 
24.20
Advertising and/or promotion shall not include recommendations by a person who, because of their celebrity status, may encourage consumers to use a particular health product.
 
25. Information, claims and comparisons in advertising and/or promotion

 
25.1
All advertising and/or promotion must be consistent with the provisions of the Medicines Act i.e. all advertising and/or pro-motion must give the information necessary for the correct use of a product as approved by the medicines regulatory authority and may not deviate from, be in conflict with or go beyond the evidence submitted in the application for registration with regard to its safety, quality and efficacy in respect of what has been approved by the medicines regulatory authority and incorporated in the approved package insert.
 
25.2
In the case of an advertisement for a health product which contains more than one active ingredient, no specific reference shall be made to the specific properties of any individual active ingredient unless a reference of this nature has been approved by the medicines regulatory authority for inclusion in the package insert of the medicine.
 
25.3
A written advertisement for a medicine shall comply with Regulation 45 of the Medicines Act.
 
25.4
Advertising and/or promotion shall not unfairly denigrate or discredit, either directly or by implication, a competitor product, ingredient or treatment type.
 
25.5
Advertising and/or promotion should not suggest that a product's effects are better than or equal to another identifiable product or treatment.
 
25.6
Advertising and/or promotion should not suggest that a product's effects are better than or equal to another identifiable product or treatment.
 
25.7
Trade names or products of other companies shall not be used without permissions of the owner.
 
25.8
Hanging (open ended) comparisons are not allowed.
 
25.9
Comparisons are only permitted in advertising and/or promotion or promotional material if:
 
25.9.1
they are not misleading or disparaging;
 
25.9.2
health products or services for the same needs or intended for the same purpose are compared;
 
25.9.3
one or more materials, relevant and representative features, capable of substantiation, are compared;
 
25.9.4
no confusion is created between the health product advertised and that of a competitor or between the advertiser's trademarks, proprietary names, other distinguishing marks and those of a competitor;
 
25.9.5
the trademarks, proprietary names, other distinguishing marks, health product, services, activities or circumstances of a competitor are not discredited or denigrated. Trademarks/proprietary names of a competitor may only be mentioned with written permission from the competitor;
 
25.9.6
no unfair advantage is taken of the reputation of a trade-mark, proprietary name or other distinguishing marks of a competitor;
 
25.9.7
health products or services are not presented as imitations or replicas of goods or services bearing a competitor's trademark or trade name.
 
25.10
Substantiation for any information, claim or comparison must be provided at the request of the marketing code authority. It need not be provided, however, in relation to the validity of indications approved in the product registration.
 
25.11
When a written advertisement refers to the medicines regulatory authority approved package insert as well as scientific, published studies, clear and complete references must be listed on the advertisement.
 
25.12
When a written advertisement refers to unpublished data on file, the relevant part of this data must be provided at the request of the MCA.
 
25.13
All artwork including illustrations, graphs, tables, logos and trade dress must conform to the letter and spirit of the Code.
 
25.14
Graphs and tables must be presented in such a way as to give a clear, fair, balanced view of the matters with which they deal, and must not be included unless they are relevant to the claims or comparisons being made.
 
25.15
Information and claims about side effects must reflect available evidence or be capable of substantiation by clinical experience. It must not be stated that a product has no side effects, toxic hazards or risks of addiction. It is acceptable to highlight the absence of a specific side effect, e.g. ‘no drowsiness'. The word ‘safe' or phrases containing reference to safety must not be used without adequate scientific substantiation.
 
25.16
Exaggerated, all-embracing claims or superiority claims must not be made and superlatives must not be used except for those limited circumstances where they relate to a clear fact about a health product. Claims should not imply that a health product or an active ingredient has some special merit, quality or property unless this can be substantiated.
 
25.17
The word ‘new' must not be used to describe any product or presentation, which has been generally available or any therapeutic indication, which has been available on the market for more than twelve months in South Africa.
 
25.18
Advertising and/or promotion of a self-medication medicine shall not suggest that a product is a foodstuff, cosmetic or other non-medicinal product.
 
25.19
Although it is acceptable to indicate that a self-medication medicine is palatable, advertising and/or promotion shall make clear that it is a medicine.
 
25.20
Advertising and/or promotion shall not suggest, directly or indirectly, that a product contains an unknown active ingredient.
 
25.21
A product, or any of its attributes, shall not claim to be unique unless substantiated.
 
25.22
Advertising and/or promotion shall not mislead about the novelty of a preparation.
 
25.23
Advertising and/or promotion claims relating to speed of absorption, dissolution, distribution or other pharmacokinetic particulars are acceptable if supported evidence and if in line with the product's registration dossier. However, such evidence may not be extrapolated to claims that a product offers improved efficacy or speed of efficacy, without supporting evidence to substantiate such claims.
 
25.24
Advertising and/or promotion shall not suggest that the safety, quality or efficacy of a product is due to the fact that it is natural. Advertising and/or promotion shall not claim that a product is ‘natural'.
 
25.25
Advertising and/or promotion shall not suggest that a product is herbal, unless all the active ingredients are plants or extracts of plants. ‘Herbal' can only be used to describe those elements that are of plant origin e.g. ‘herbal ingredient'.
 
25.26
Claims for weight management, meaning weight loss, measurement reduction, clothing size reduction and weight control/
maintenance, can only be made in conjunction with reference to sensible lifestyle factors including a diet and exercise.
 
26. Disparaging references

26.1
The medicine, health products and activities of other companies must not be disparaged.
 
26.2
The health professions and the clinical and scientific opinions of their members must not be disparaged.
 
27. Suitability and taste

27.1
All material and activities must recognize the special considerations relating to the promotion of the health product and must not be likely to cause offence.
 
27.2
The name or photograph or film of a member of a health profession must not be used in any way that is contrary to the conventions of that profession.
 
27.3
Promotional material must not imitate the devices, copy, slogans or general layout adopted by other companies, organisations or individuals, in a way that is likely to mislead or confuse.
 
27.4
Promotional material must not include any reference to the medicines regulatory authority unless this is specially required by the medicines regulatory authority.
 
27.5
Reproductions of official documents must not be used for promotional purposes unless permission has been given in writing by the appropriate body.
 
27.6
All material relating to health products and their uses, which is sponsored by a company, must clearly indicate that the company, organisation or individual had sponsored it. Market research material need not reveal the name of the company, organisation or individual involved but must state that a company, organisation or individual sponsors it.
 
28. Prohibitions or restricted representations

An advertisement for a self-medication medicine must not refer, expressly or by implication, to products during or assisting in the treatment of serious forms of disease, conditions, ailments or defects unless prior approval is given under the Medicines Act.

 
29. Quotations

Quotations relating to a medicine taken from public broadcasts, for example radio, television or Internet, and from private occasions, such as medical conferences or symposia, must not be used without the written permission of the speaker.

 
30. Testimonials
 
30.1
Testimonials shall comply with the approved package insert and with the other principles of this Code.
 
30.2
Testimonials should be less than three years old and be the genuine views of the user.
 
30.3
The use of healthcare professionals for marketing, promotion, endorse¬ments or testimonial has to take place within the scope set by the professional codes applicable to such professionals.
 
31. Healthcare professionals
 
31.1
Advertising and/or promotion shall not claim that a product is, or has been available on prescription. However, it is acceptable to state that a product's active ingredient, formulation or preparation has been prescribed by a health professional, provided there is evidence that this is the case.
 
31.2
Advertising and/or promotion shall not refer to a ‘college', ‘hospital', ‘institute', ‘laboratory' or similar establishment, unless the establishment genuinely exists.
 
32. Views of authors

The utmost care must be taken to avoid ascribing claims or views to authors when these no longer represent the current views of the authors concerned.
 
33. Scientific information services

All companies, organisations or individuals must compile and collate all information about the health products that they market, and must be able to provide such information to authorities, members of healthcare professions or the general public, where appropriate. This may include information about adverse drug reactions.
 
34. Certification of promotional material

The same process and principals stipulated in Clause 14 of Part A of the Code applies in the context of Part B.
 
35. Relations with the general public and the media

35.1
Requests from individual members of the public for information or advice on personal medical matters must be refused and the enquirer advised to consult his or her own health professional.
 
35.2
Companies are responsible for information about their products that is issued by their public relations agencies.
 
36. Promotions, gifts, prizes and inducements
 
36.1
No company shall be involved in promotional schemes which are hazardous to the public or which bring the industry into disrepute.
 
36.2
Entry into consumer competitions shall not be dependent on the conditional purchase of a health product nor shall a medicine be offered as a prize. The value of the prize shall not exceed the limits set by the Marketing Code Authority from time to time.
 
37. Hospitality and meetings

Companies may provide hospitality to persons or appropriate administrative staff in association with professional, scientific and promotional meetings/events, provided that it is reasonable and subordinate to the main purpose of the meeting or event.
 
38. Training and education

Companies may provide training or education for the general public and may also sponsor training provided by other organisations. Such materials should offer accurate, balanced information on the subject area and include a clear indication of which company has produced or sponsored the material.
 
39. Healthcare sales representatives/consumer promoters

39.1
Companies should ensure that Healthcare Sales Representatives/consumer promoters have adequate training to ensure sufficient scientific knowledge of the health products which they promote to enable the provision of precise and complete information about such health products.
 
39.2
All materials including slides and handouts shall comply with the requirements of the Code.
 
39.3
Product training must be consistent with the package insert of a medicine.
 
39.4
Healthcare Medical Sales Representatives/consumer promoters must notify their company regarding any information received in relation to the use of health products which they promote, particularly any information relating to adverse event reporting.
 
39.5
Healthcare Sales Representatives/consumer promoters are to conduct the promotion of product in a professional manner, and are not permitted to disparage any opposition products.
 
40. Compliance with undertakings and rulings

When an undertaking has been given in relation to a ruling under the Code or when a ruling is made under the Code, the company concerned must ensure compliance with that undertaking and/or specific ruling.
Part C: Medical devices
 
41. Advertisements and promotions

General Principles
All technology has to be advertised and promoted according to any applicable laws and regulations which exist or may be set for the promotion and advertisements of medical devices and IVDs.
 
Advertisements and promotions have to portray the technology in line with the approved uses and attributes of the technology. Where products are not registered in South Africa or any other jurisdiction, advertisements and promotions have to be in line with the known uses and attributes of the technology, and the appropriateness of promoted or advertised uses or attributes may be investigated on receipt of a complaint in this regard.
 
The use of all artwork (logos, tables, graphics, illustrations, etc) should reflect the principles of fairness, balance and accuracy and should not distort, mislead, etc.
 
The use of words such as safe, new and other claims should be within the relevant legal frameworks, and should not be used in contravention of the above principles, i.e. should be subject to substantiation, be accurate and balanced.
 
All promotions and advertisements should be of a high standard and respect HCP's and patients.
 
41.1 Promotions or advertisements to the public have to take place within the applicable regulatory frameworks, and where such advertisement or promotion relates to help-seeking behaviour amongst the public, conform to the following:
 
41.1.1
Should not make or allude to inappropriate healthcare claims associated with a particular product;
 
41.1.2
Should not use risk or safety information in a distorted way to scare members of the public or to induce a sale based on fear, exaggerated, distorted or misleading information or in a manner that leads consumers to make deductions on the comparative safety or risk of competitor products;
 
41.1.3
May let the public know of a particular disease or condition and that treatment exists for such disease or condition.
 
41.2 An advertisement must:
 
41.2.1 contain correct and balanced statements only and claims which the supplier has already verified;
41.2.2
include the phrase: "For more information, refer to your HCP”.
 
41.3 An advertisement must not:
 
41.3.1
be likely to arouse unwarranted and unrealistic expectations of product effectiveness;
 
41.3.2
be likely to lead to consumers self-diagnosing or inappro¬priately treating of potentially serious diseases;
 
41.3.3
mislead, or be likely to mislead, directly or by implication or through emphasis, comparisons, contrasts or omissions;
 
41.3.4
abuse the trust or exploit the lack of knowledge of consumers or contain language which could bring about fear or distress;
 
41.3.5
contain any matter which is likely to lead persons to be-ieve: that they are suffering from a serious ailment; or
 
41.3.6
that harmful consequences may result from the technology not being used.
 
41.3.7
encourage, or be likely to encourage, inappropriate or excessive use;
 
41.3.8
contain any claim, statement or implication that it is infallible, unfailing, magical, miraculous, or that it is a certain, guaranteed or sure cure;
 
41.3.9
contain any claim, statement or implication that it is effective in all cases of a condition;
 
41.3.10
contain any claim, statement or implication that the goods are safe or that their use cannot cause harm or that they have no side-effects.
 
42. Incentives to pharmacy assistants and other non-healthcare professional sales
 
An advertisement must not offer any personal incentive to a pharmacy assistant, or other non-healthcare professional sales person at retail level, to recommend or supply medical devices.
 
43. Scientific information

Any scientific information in an advertisement should be presented in a manner that is accurate, balanced and not misleading.
Scientific terminology must be appropriate, clearly communicated and able to be readily understood by the audience to whom it is directed.
Publication of research results must identify the researcher and financial sponsor of the research.
Any statement made may be subject to scrutiny for its scientific validity, and independent experts may be called upon in the case of a complaint, to verify such statement(s).
 
44. Comparative advertising

Comparative advertisements must be in alignment with South African law, be balanced and must not be misleading or likely to be misleading, either about the technology or classes of technology, with which it is compared.
Points of comparison should be factual and reflect the body of scientific evidence. Comparisons should not imply that the technology, or classes of technology, with which comparison is made, are harmful or ineffectual.
 
45. Professional recommendation

Advertisements may include reference to sponsorship of any government agency, hospital or other facility providing healthcare services, provided that sponsorship is explicitly acknowledged and is not pre-sented as an endorsement of a medical device.
Advertisements must not contain or imply endorsement by:
  • any government agency;
  • hospitals and other facilities providing healthcare services;
  • individual or groups of healthcare professionals, other than where the emphasis is on the availability, which may include the price of the technology through his/her retail business; or
  • by individuals, who are healthcare professionals by way of their representation in advertisements or academic qualifications, and/or who are likely to be known as healthcare professionals by the reasonable person.
  • Advertisements must not contain or imply endorsement of the goods by bodies or peak healthcare professional associations that:
    – represent the interests of health consumers;
    – conduct or fund research into a disease, condition disorder or syndrome; or represent healthcare professionals;
    unless:
  • the advertisement names the body or association;
  • the endorsement is authenticated;
  • the nature of the endorsement is clearly disclosed; and
  • the endorsement is based upon an objective assessment of available scientific data supporting the use of that product.
Where this is not the case and where the body or association has received valuable consideration for the endorsement, the advertisement must acknowledge that consideration.
 
46. Testimonials
 
Testimonials must not breach the Code. They must be documented, genuine, not misleading and illustrate typical cases only.
 
47. Conformity
 
The conformity of an advertisement with this section will be assessed in terms of its probable impact upon the reasonable person to whom the advertisement is directed.
Trade associations and companies involved in development of the South African marketing code:
 
Innovative Medicines SA (IMSA)
 
Contact details

Postal Address: P.O. Box 2008, Houghton, 2041
Physical Address: 52 Glenhove Road, Melrose, 2196.
Tel: 011 880-4644
Fax: 011 880-4644
E-mail: imsacom@imsa.org.za
Website: www.imsa.org.za
 
List of IMSA members

Boehringer Ingelheim (Pty) Ltd
Fresenius Kabi
GE Healthcare (Pty) Ltd
Genzyme Biopharmaceuticals (Pty) Ltd
Eli Lilly SA (Pty) Ltd
Norgine (Pty) Ltd
Novartis South Africa (Pty) Ltd
Nycomed (Pty) Ltd
Pfizer Laboratories (Pty) Ltd
Roche Products (Pty) Ltd
Sanofi-aventis (Pty) Ltd
 
National Association of Pharmaceutical Manufacturers (NAPM)
 
Contact details
 
Postal Address: P.O. Box 32361, Kyalami, 1684
Physical Address: 1342 Howick Mews, Waterfall Park, Bekker Road, Midrand, 1685
Tel: 011 312-6966
Fax: 086 529 4245
E-mail: napm@mweb.co.za
Website: www.napm.co.za
 
List of NAPM members
 
Abex Pharmaceutica (Pty) Ltd
Activo Health
Arrow Pharma (Pty) Ltd
Aurobindo Pharma (Pty) Ltd
Austell Laboratories (Pty) Ltd
Be – Tabs Pharmaceuticals (Pty) Ltd
Bodene (Pty) Ltd
Caps Pharmaceuticals SA (Pty) Ltd
Columbia Pharmaceuticals
DI Medicine Registration Consultants
Dr Reddy's Laboratories (Pty) Ltd
Cipla-Medpro (Pty) Ltd
Ferring Pharmaceuticals (Pty) Ltd
Litha Healthcare (Pty) Ltd
MC Pharma (Pty) Ltd
Medreich S.A
Mylan (Pty) Ltd
Pharma Dynamics (Pty) Ltd
Ranbaxy (SA) (Pty) Ltd
Sandoz SA (Pty) Ltd
Sekpharma (Pty) Ltd
Teva Pharmaceuticals(Pty) Ltd
Thebe Medicare (Pty) Ltd
Zydus Group
 
Pharmaceuticals made in SA (PHARMISA)
 
Contact details
 
Postal Address: P O BOX 1587, Gallo Manor, 2052
Physical Address: Building 7 Health Care Park, Woodlands Drive, Woodmead
Secretariat: Phoebe Phaka
Tel: 011 239-6549
Fax: 011 239-6530
Email:pphaka@aspenpharma.com
 
List of PHARMISA members:
 
Sekpharma (Pty) Ltd
Specpharm Holdings (Pty) Ltd
The Biovac Institute
Bodene (Pty) Ltd
National Bioproducts Institute
Phambili Hospital Products (Pty) Ltd
Pharmacare Limited trading as Aspen Pharmacare
Bioclones (Pty) Ltd
 
Pharmaceutical Industry Association of SA (PIASA)
 
Contact details
 
Postal Address: P O Box 12123, Vorna Valley, 1686
Physical Address: Building 5, Thornhill Office Park, 94 Bekker Street, Vorna Valley, 1686
Tel: 011 805 5100
Fax: 011 805 5105/9
Email: info@piasa.co.za
Website: www.piasa.co.za
 
List of PIASA Members:
 
Abbott Laboratories SA (Pty) Ltd
Adcock Ingram Healthcare (Pty) Ltd
Alcon Laboratories (Pty) Ltd
AHN Pharma (Pty) Ltd
AstraZeneca Pharmaceuticals (Pty) Ltd
Bayer–Schering Pharma (Pty) Ltd
Bioclones (Pty) Ltd
Bristol-Myers Squibb (Pty) Ltd
Covidien (Pty) Ltd
Galderma Laboratories (Pty) Ltd
iNova Pharmaceuticals (Pty) Ltd
Janssen Pharmaceutica (Pty) Ltd
Key Oncologics (Pty) Ltd
Merck (Pty) Ltd
MSD
Novo-Nordisk (Pty) Ltd
Servier Laboratories (Pty) Ltd
Solvay Pharma (Pty) Ltd
 
Self-medication manufacturers association of SA (SMASA)
 
Contact details
 
Postal Address: P O Box 71351, The Willows, Pretoria, 0041
Physical Address: 381 Rossouw Street, Murrayfield, Pretoria, 0184
Tel: 012 803 5955
Fax: 012 803 3575
Email: smasa@telkomsa.net
Website: www.smasacc.net
 
List of SMASA members
 
Adcock Ingram
Aspen Pharmacare
Bausch & Lomb
Bayer Healthcare
Boehringer-Ingelheim
GlaxoSmithKline
Johnson & Johnson
Merck (Pty) Ltd
Norgine
Novartis Consumer Health
Nycomed
Pharmafrica
Proctor & Gamble
Reckitt Benckiser
Smith & Nephew
Vital Health
Winthrop Pharmaceuticals (Sanofi-Aventis)
Wyeth Consumer Healthcare
Pharmaceutical Wholesalers and Distributors
UTI Pharma
PHD
UPD
 
National Association of Pharmaceutical Wholesalers (NAPW) and members:
 
Amalgated Pharmaceuticals
Aptekor
CJ Pharmaceuticals
Citymed
Helderberg
PHD
Randpharm
Ringpharmaceuticals
Topmed
Zenith
 
The South African Animal Health Association (SAAHA)
 
Contact details
 
Postal Address: P O Box 1995, Halfway House, 1685
Physical Address: Lanzerac Building, Constantia Square, 138 16th Street, Midrand, 1685
Tel: 011 805 2000
Fax: 011 805 2222
Webiste: www.saaha.co.za
 
List of SAAHA members
 
Bayer (Pty) Ltd Animal Health division
Boehringer-Ingelheim Vet Medica
Cipla Vet (Pty) Ltd
Intervet SA (Pty) Ltd
Merial SA (Pty) Ltd
Norbrook Laboratories (SA) (Pty) Ltd
Novartis SA (Pty) Ltd Animal Health
Pfizer Animal Health
Virbac RSA (Pty) Ltd
 
South African Medical Device Industry Association (SAMED)
 
Contact details
 
P O Box 651761, Benmore, 2010, South Africa
Physical address: 52 Thembi Place, Calderwood Road, Lonehill
Tel: 011-467 9855
Fax: 011-467 1697
 
List of SAMED members
 
3M South Africa (Pty) Ltd
Abbott Laboratories S.A. (Pty) Ltd
AEC-Amersham (Pty) Ltd
Affordable Medical (Pty) Ltd
Afrisugical
Amayeza Abantu
Arjo Huntleigh Africa (Pty) Ltd
Auckland Orthopaedics (Pty) Ltd
B Braun Medical (Pty) Ltd
B S N Medical (Pty) Ltd
BARD Medical
Baroque Medical (PTY) Ltd
Becton, Dickinson and Company (Pty) Ltd
Biomet
Bloomberg, Holomisa Orthopaedic Solutions (Pty) Ltd
Bone SA
Boston Scientific (SA) (Pty) Ltd
BRANDTECH
Brittan Healthcare Group (Pty) Ltd
Browning Medical Supplies CC
CareFusion SA 319 (Pty) Ltd.
Coloplast SA
Covidien (Pty) Ltd
Dinaledi Medical (Pty) Ltd
Dräger Medical South Africa (Pty) Ltd
Edwards Life Sciences
Elite Surgical Supplies (Pty) Ltd
EQOS (Pty) Ltd
Fresenius-Kabi South Africa
G E Healthcare
Gabler Medical (Pty) Ltd
Germo Pulse Therapy
Haemotec (Pty) Ltd
HemoCue SA (Pty) Ltd
Hollister SA (Pty) Ltd
Intamarket Medical Technologies (Pty) Ltd
Johnson & Johnson Medical
Karl Storz Endoscopy (South Africa)(Pty) Ltd
KCI Medical South Africa (Pty) Ltd
Kimberly-Clark of SA (Pty) Ltd
Marcus Medical (Pty) Ltd
Mbekani Group (Pty) Ltd
Medhold Medical (Pty) Ltd
Medical Distributors (Pty) Ltd
Medical Excellence
Medifix (Pty) Ltd
Meditek-Hemco (Pty) Ltd
Medtronic Africa (Pty) Ltd
Myriad Medical (Pty) Ltd
OmniMed (Pty) Ltd
Orthomedics (Pty) Ltd
Paragmed (Pty) Ltd
Perryhill International (Pty) Ltd
Philips Medical Systems South Africa (Pty) Ltd
Respiratory Care Africa
Roche Products Pty Ltd - Diagnostics Division
Roth Medical (Pty) Ltd
SA Biomedical (Pty) Ltd
Safmed (Pty) Ltd
SALDA (Pathteq-Qpl)
Siemens Healthcare Diagnostics (Pty) Ltd
Siemens Limited Healthcare Sector
SM Specialist Solutions (Pty) Ltd
Smith & Nephew (Pty) Ltd
Smiths Medical South Africa (Pty) Ltd
Southern Implants (Pty) Ltd
Specmed Medical Services PTY (Ltd)
Stat-Tiakeni Medical (Pty) Ltd
Stryker South Africa (Pty) Ltd
Surgical & Ophthalmic Supplies (Pty) LTD
Surgitech (Pty) Ltd
SxS Surgical Solutions (Pty) Ltd
SYNCRO Medical (Pty) LTD
Syntacoll (Pty) Ltd
Synthes (Pty) Ltd
Teleflex Medical (Pty) Ltd
The Scientific Group
Thebe Medical
Umsinsi Health Care
Vertec Scientific SA (PTY) LTD
Viking Medical & Surgical (Pty Ltd
Vision Biotech (Pty) Ltd
Welch Allyn South Africa (Pty) Ltd
Werkomed (Pty) Ltd
Zimmer South Africa (Pty) Ltd
 
Southern African Laboratory Diagnostics Association (SALDA)
 
Contact details
 
 
List of members
 
Abbott Laboratories:
AEC Amersham:
Selecta-MEDIA
BioMerieux South Africa
Siemens Healthcare Diagnostics
Beckman Coulter:
Bioweb
Clinical Sciences Diagnostics
Davies Diagnostics:
Diagnostic Products:
Alere Healthcare
Iepsa:
Ilex:
Laboratory Specialities:
Omnimed:
Replamed:
Roche Diagnostics:
Separation Scientific:
The Scientific Group:
Thistle QA
Southern Cross Biotechnology
Orb Diagnostics
Hemocue
Haemotec
Diagnostech
Pro Gen
Safarmex
Nyala Technologies
Whitehead Scientific
DTS Diagnostic & Technical Services
Erez Trade South Africa
Biocom Biotech
LabCare
Human South Africa
Quantumbiotech
BD
Labotec
Sysmex South Africa
SMR Diagnostics
GLOBALeMED
Hain Life sciences
Humor Diagnostics
L&T diagnostics
F&M Import & Export
 
 

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