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PHARMACEUTICAL INDUSTRY IN
PAKISTAN:
UNETHICAL PHARMACEUTICAL
MARKETING PRACTICES
Rizwan Raheem Ahmed Tariq Jalees
30 SZABIST
Karachi, Pakistan
College of Management Science
PAF-KIET
tariqj@pafkiet.edu.pk
1.0.0 INTRODUCTION Lack of research on the subject does not mean that unethical
The unethical drug practices are common phenomenon drug promotion practices do not exist. The pre-survey and
worldwide but it is more severe in developing countries. focus groups discussions indicate that unethical
Unethical drug practices have two dimensions. One is pharmaceutical marketing practices have become an
drug related, and other is drug promotion related. acceptable norm of the pharmaceutical industry, and almost
Extensive researches on drug related unethical practices all the pharmaceutical companies patronize these unethical
have been carried out internationally. However, there practices in collaboration with doctors, government and
is a dearth of literature on unethical drug promotion private hospitals, health related agencies, and pharmacies
practices. Parmar and Jalees (2004) observed that at the cost of patients well being.
pharmaceutical industry spends a substantial portion
of its budget on market research but do not carry out All the entities as discussed above appear to be directly
the research on how to curb the unethical drug or indirectly involved and it would not be fair to blame
promotion practices. any one of them, including pharmaceutical industry.
The focus of the subject study was to identify the
Unethical marketing practices have become an intensity and trends of unethical drug promotion
integral part of Pakistans pharmaceutical industry. practices in Pakistan examine. Ascertain the involvement
These practices is so deep rooted that it has become of doctors, health related institutions and the
extremely difficult for pharmaceutical companies pharmaceutical industry in promoting such practices.
to compete without indulging in such practices
(Parmar & Jalees 2004). The findings of the study 1.2.0 LITERATURE SURVEY
by Parmar & Jaleees (2004), were mainly focused The previous researches indicate that unethical
to such practices in one city, Hyedrabad, therefore, pharmaceutical marketing practices have become an
it lacked generalizeability. In view of this limitation acceptable norm of the pharmaceutical industry, and
there was a need to find whether such unethical almost all the pharmaceutical companies patronized
practices exist in other parts of country as well. these unethical practices in collaboration with doctors,
This paper has been undertaken with the objective government and private hospitals, health related agencies
broadening the scope of the study to the whole of and pharmacies at the cost of patients well being.
Pakistan. (Parmar and Jalees 2004)
The acceptable norms of promoting drugs through (iv) Gifts & Give away
doctors are visiting them, giving them presentations
on the merits and demerits of the drugs. Explicitly, a. Medical Equipments:
pointing out the side effects of drugs, giving Pharmaceutical firms give medical equipments like
nominal quantity of drugs sample. These gifts and stethoscope, thermometers, surgical kits and other
give away must not be highly expensive and expensive medical equipments.
restricted to items such as dairies, calendar, year
planner, etc. (Parmar and Jalees 2004) b. Personal Use Items:
In this category the pharmaceutical companies give
Comparatively, unethical drug promotion practices personal use items such as mobile, laptop, air-
are prescribing drugs to the patients based on the conditioners, and even cars.
monetary considerations, and ignoring the well
being of the patients. The commonly used monetary (v) Chamber Decoration
rewards for unethical promotion of the drugs are In this category, the pharmaceutical companies,
discussed below: [Parmar and Jalees 2004] not only, refurnish the doctors chambers, but also
ar range fur niture/fixture, sign boards, air-
(i) Monetary Reward conditioners, computers, curtains, etc.
The crudest form of unethical drug promotion is
monetary reward. In this category, the cash reward (vi) Home Decoration
is linked with the quantum of the drug prescriptions. The arrangement of the home decoration is similar
The payments, in this case, are made on monthly to the chambers decorations as discussed above.
or quarterly basis.
1.3.0 PHARMACEUTICAL INDUSTRY
(ii) Visits Within Country After partition, Pakistan did not inherit any industrial
In this category, the pharmaceutical companies base. Like other consumer items, Pakistan met the
arrange conferences and seminars for the doctors drugs demand through imports. The situation
in those cities where doctors are not domiciled. remained the same up to 1960. In early sixties the
The objectives of such conferences/seminars may multinational pharmaceutical companies made heavy
be to update the doctors on the latest development, investment in Pakistan for setting up pharmaceutical
but the real motive is to provide fully paid vacation. manufacturing units. National pharmaceutical
The pharmaceutical companies arrange the air companies also got encouraged, and started making
TABLE 5
GRAPH 1
T o o ls u s e d fo r u ne th c ia l d ru g p rm o tio n p ra c tic e s
5.00
Majority of respondents of all the segments such as
36
4.47
4.00
4.04 4.23
3.58 doctors, Pharmaceutical companies, hospitals,
3.00
pharmacies, were strongly against drug promotion to
2.07 the non-qualified doctors. However, despite their
2.00
1.48 opinions it is a fact that the drugs are being promoted
1.00
through non-qualified doctors.
-
1
3.2.3 Legislation For Unethical Drug Promotion
Monetory Rewards Local visits Foreign Visits Respondents opinions were obtained on the prospects
Peronalized gifts Chamber decoration Home decoration
of strong legislation against unethical drug promotion
practices. The respondents opinions are presented
below:
The above table and graph shows that foreign visits
with a mean of 4.47 are more in demand and local TABLE 7
visits being the second. The reasons for high
preferences for local visits and foreign visits are that Pharmaceutical Doctors Hospital Pharmacy
pharmaceutical industry could justify these expenses company
by charging these expenses in the heads of 4.76 4.51 4.42 4.35
conferences and seminars.
GRAPH 3
3.2.2 Drug Promotion To Non-Qualified Doctors
Opinions on drug promotion to non-qualified doctors
were obtained. Ethically, the firms should not promote
their drugs through them. The respondents opinions
are presented below:
TABLE 6
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Pharmaceutical Representatives and Doctors in Training. medical profession. Indian Journal of Medical Ethics, Oct-
Journal of International Medicine. August; 20(8): 777786. Dec, 6 (4).