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To,
Mr. Kunal Banodkar
Sun Pharmaceutical Industries Ltd.
Sun House CTS No. 201 B/1,
Western Express Highway, Goregaon (E),
Mumbai - 400 063; Tel: + 91 22 4324 1234/4324
Dear Mr. Kunal Banodkar
Subject: In-Practice
Usage and Performance (IPUP) Study of Disperzyme
In response to your
letter, Classic /IPUP/Disperzyme/2023 , Dated 27th
february 2023, I
agree to participate in the study as outlined by you. I understand
that:
- You
will provide me with a copy of the study plan, CRF and full
prescribing
information on Disperzyme.
-
Disperzyme will be prescribed and purchased as in my routine
practice.
- The
patients’ identity will not be disclosed in the CRF.
- I
have to report serious adverse events (SAE), if any, immediately
to your monitor or
to you in the AE reporting form.
- You
will provide the assistance of a monitor to verify the
information in the CRF with
that in the patients’ case papers and reports.
- You
will pay me by cheque a fee of Rs. 10,000 (Rs. Ten thousand only)
per patient, and
accordingly, on receiving the completed CRFs, of these {{$numberOfPatient}}
patient’s, as a compensation
for the extra time spent in record keeping. The cheque for fee
may be drawn in favor
of.
“…………………………………………………………………………………………………….”
My
personal details are given below for accuracy of your records.
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