Table 5 Barriers to ethical promotion of pharmaceuticals in Pakistan; MD’s perceptive
Questions on barriers in ethical promotion | Medical doctors (MDs), n = 51 (%) | p values | ||||
|---|---|---|---|---|---|---|
Strongly disagree | Disagree | Neutral | Agree | Strongly agree | ||
Lack of external accountability can be a reason of unethical practices | 0 (0) | 0 (0) | 0 (0) | 31 (61) | 20 (39) | 0.35 |
Doctors are incentivized to generate business by over investigation and treatment of patients at their mercy, medically and financially | 7 (13.7) | 8 (15.7) | 10 (19.6) | 15 (49) | 11 (21.6) | 0.42 |
Price war among pharmaceuticals | 0 (0) | 0 (0) | 0 (0) | 28 (55) | 23 (45) | 0.24 |
Out of competition companies resort to unethical promotion to maximize the profits | 0 (0) | 0 (0) | 0 (0) | 25 (49) | 26 (51) | 0.66 |
Lack of interests in research and study | 0 (0) | 0 (0) | 0 (0) | 25 (49) | 26 (51) | 0.21 |
Company’s pressure to achieve sale targets | 0 (0) | 0 (0) | 0 (0) | 21 (41) | 30 (59) | 0.59 |
Low quality products need unethical push | 0 (0) | 0 (0) | 0 (0) | 21 (41) | 30 (59) | 0.27 |
Job insecurity if sales targets not met | 0 (0) | 0 (0) | 0 (0) | 17 (33) | 34 (67) | 0.42 |
Non-existence of doctor-patient-pharmacist loop | 0 (0) | 0 (0) | 0 (0) | 20 (39) | 31 (61) | 0.35 |
Prescribing by brand names | 0 (0) | 4 (8) | 1 (2) | 24 (47) | 22 (43) | 0.13 |
Doctors are materialistic lacking ethical and moral values | 1 (2) | 13 (25) | 1 (2) | 16 (31) | 20 (39) | 0.56 |
Sales managers not only condone unethical promotion by MRs but also encourage it | 0 (0) | 0 (0) | 0 (0) | 23 (45) | 28 (55) | 0.02* |
Low salaries, for incentives MRs opt un-ethical promotion | 0 (0) | 0 (0) | 0 (0) | 23 (45) | 28 (55) | 0.24 |
Junior doctors use pharma companies to promote their business (clinic renovation, foreign trips) and clinical practice (speakers at the seminar, free camps) | 2 (4) | 5 (10) | 1 (2) | 16 (31) | 27 (53) | 0.29 |