Table 4 Barriers to ethical promotion of pharmaceuticals in Pakistan; MR’s perspective
Questions on barriers in ethical promotion | Medical representatives (MRs) (5-point Likert score) | p values | |
|---|---|---|---|
NCs, n = 205 (Mean ± SD) | MNCs, n = 125 (Mean ± SD) | ||
Lack of external accountability can be a reason of unethical practices | 3.66 ± 1.33 | 4.17 ± 1.1 | 0.0003* |
Doctors are incentivized to generate business by undue investigation and overtreatment of patients who are at their mercy, medically and financially | 3.56 ± 1.23 | 3.82 ± 1.26 | 0.077 |
Price war in Pharmaceuticals | 3.73 ± 1.26 | 4.18 ± 0.97 | 0.0007** |
To maximize the profit | 3.83 ± 1.19 | 4.22 ± 0.99 | 0.003* |
Lack of Research and Study | 3.62 ± 1.33 | 4.28 ± 0.96 | 0.0001** |
Company pressure to achieve sale targets | 3.88 ± 1.24 | 4.02 ± 1.21 | 0.318 |
Low quality products need unethical push | 3.67 ± 1.35 | 4.38 ± 0.96 | 0.0001** |
Job insecurity if sales below target | 3.61 ± 1.34 | 4 ± 1.19 | 0.008* |
Non-existence of Doctor-Patient-Pharmacist Loop | 3.55 ± 1.27 | 3.98 ± 1.11 | 0.003* |
Prescribing by Brand names | 3.8 ± 1.23 | 4. ± 1.11 | 0.097 |
Doctors are materialistic lacking ethical and moral values | 3.57 ± 1.2 | 3.88 ± 1.26 | 0.033* |
Sales managers not only condone unethical promotions of MRs but also encourage it | 3.31 ± 1.34 | 3.75 ± 1.28 | 0.003** |
Low salaries, thus for incentives, MRs opt un-ethical promotion | 3.57 ± 1.23 | 3.96 ± 1.22 | 0.006* |
Junior doctors use Pharma companies to promote their business (clinic renovation, foreign trips) and clinical practice (speakers at the seminar, free camps) | 3.94 ± 1.14 | 3.98 ± 1.17 | 0.747 |