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Table 4 Barriers to ethical promotion of pharmaceuticals in Pakistan; MR’s perspective

From: Perceptions of and barriers to ethical promotion of pharmaceuticals in Pakistan: perspectives of medical representatives and doctors

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
  1. MNCs multinational companies, NCs national companies, MR medical representative (s)
  2. p values: p 0.05–0.002 = *, p ≤ 0.001 = **