Marketing practices of pharmaceutical business in Pakistan

The dissemination of health care facilities is not only the contractual obligation of government but the role of medical team is of utmost meaning, what we generally overlook during the consideration of healthcare system is the commitments of pharmaceutical companies and unlike the primitive idea of healthcare triad, which is no longer valid, the de facto role of fourth partner i.e. pharmaceutical industry has certain implications as they are the vendor of physical form of health. As commonly advocated, an enthusiastic relation between the physician and patient is mandatory for the preeminent compliance but what are the responsibilities of pharmaceutical companies? Is it plainly driven by the demand and supply rules or they are just silent cohorts?
A randomized pilot study to understand the marketing practices of pharmaceutical business in Pakistan is conducted under the auspices of The Network for Consumer Protection under the supervision of Mian Imran Masood and Naeem Gul from 2nd may, 2006 to 7th July, 2006. The results of the study reports are disheartening as the pharmaceutical industry’s preached motives are inconsistent and dubious; there exist covert marketing practices rather than the overt meaning of doctor-pharmaceutical relations as they should be. The pilot study is conducted in two parts and views of both doctors and medical representatives are given equal weighting and marked similarities of opinion exist between the both interviewees. It is difficult to snuggly adjust the observation as the market behavior is very subtle yet the results of study are laid as follow;
It is widely acknowledged facts that the ongoing research should be incorporated in the healthcare system and the preferred medium in our healthcare system is by pharmaceutical companies engaged medical representatives and to further hoodwink the fact they organize different seminars to harp the same old fugues.
Different techniques are employed for the marketing and the basic motives of marketing practice is shrouded in the sham mist of educational promotional visits and most of the time a symbiotic relation exists between the doctors and interlopers. There is no definitive form of these business relations but companies offer prescription based incentives in form of extra percentage per pack, cash, bonus and home appliances. The logic for free samples as advocated by the pharmaceutical companies is the efficacy guarantee and pseudo pretense of charity but number of times scams of physician sample sales is registered but even if the logic of efficacy guarantee and charity is valid then the role of books and moral obligation of health professionals to update their knowledge is questionable.
The young graduates and even the seasoned health workers consider the medical representative visits indispensable as they help to update their knowledge about the newly introduced drug thus keeping them at a bay
Although the thirty one clinics are selected for the pilot study and adequate assurance of secrecy is stipulated and even then most of the doctors and medical representatives withheld their opinion.
The results are quite alarming as the intrusion of pharmaceutical business has tarnished the doctor-patient relation and the corrosive effects are felt only by the patients while the doctors and pharmaceuticals are the harvesters of benefits, ranging from the petty gifts like tongue depressors, stethoscope, and thermometers to refrigerators, microwaves, home maintenance and foreign tours.

To appease doctors even more pharmaceutical industry train their staff to remember the special days in the life of doctors and shower the gifts on these auspicious events while there is a silent majority of medical representatives whom sole discretion is to look for the events to bless their client doctors.
On the other hand doctors expect the medical representatives to give them due protocol and from the corner of their eyes they particulate the presentation, appearance, confidence, personal relation, time of visits and knowledge of the medical representatives. Obviously doctors expect the fulfillment of the pledges and it is so easy for doctors to be irritated and chagrin if a medical representative is overactive and appears without showing any samples. The ability to answer cross questioning of doctors pertaining to the promoted drug is variable and a huge percentage of doctor thinks that the knowledge of medical representatives is not consistent with their job and it is also learnt from the pilot study that a vast majority of representatives are meagerly educated and are not fit to sustain the cross questioning regarding their field as they are solely trained to market the product yet the full concept of drug is left for the doctors imagination.
Apart from verbal coaxing and generously gifting the doctors another gimmick which is employed is quite inexpensive yet very efficient, the deliberate use of sponsored prescription pads and wall hangings is a reminder to increase the prescription and also encourages the self medication on the behalf of patients.
To lure more health professionals, non routine promotional activities in practice are camps in the hospitals, conferences, lectures for the public awareness and lecture for the doctors which are particularly engineered to oblige them for pharmaceutical business.

Conclusion:

The knowledge imparted by the pharmaceutical representatives is brand specific and new research is seldom delivered by the representatives and if at all the quality of knowledge is unsatisfactory and it’s the moral obligation of doctors to update the umpteen knowledge rather than relying on the unconventional channels. The views of both respondents are self explanatory and it is the duty of regulatory authorities and consumers by themselves to check the malpractice by pharmaceutical industry and sponsored doctors by insisting upon generic formulation.