Pharma market was dominated by Multinational Companies at that time. They probably had 80% or more share. Almost all MNCs had manufacturing facilities, mostly in Karachi where their head offices were also located. It was a privilege to work for MNCs. It was said that you join an MNC for life; means you will only leave when you retire, or die. Pakistani Pharma companies were there and some of these were quite well known but they produced simple formulations of old times.
The concept of branded generics was not in yet. MNCs marketed their research products. Local Pharma had their own unique formulations. Pumonol from CCL, Urodonol from Opal and Eplacherry from Epla were few examples of unique products. In short, the local pharma did not manufacture generics of research products deliberately. Tetracycline, Sulphadiazine, Sulphaguanadine, were no one’s property and were marketed by many, including May & Baker (now part of Sanofi). All GPs dispensed medicines from their clinics, hence demand for these products in large packs. GPs wrote prescriptions rarely. Due to these factors, mainstay of promotion was on merit of product vis-à-vis competition; not substitution. Medicines were economical, and no one discussed price.
MNCs ruled supreme. They were power houses for training and development of Pharma professionals in all fields, many of whom later went to local Pharma and were instrumental in bringing the local Pharma to the level where it is now. The contribution of MNCs to development of Pharma business in Pakistan is too big to be denied. Big Pharma also takes a lot of flak for some of their high-handed practices.
I was assigned the territory of Mayo hospital in Lahore, and my first manager was S H Javed. SHJ was elevated and transferred to head office two months later. I had replaced Iqbal Ahmed in this territory as he was nominated to start work on vaccines business which came from Behring Werke, a subsidiary of Hoechst. Somehow it did not materialize, and IA was appointed as Field Manager of Lahore. Hoechst also decided to establish its own distribution network. The first distribution office was opened in Lahore in early 1976 and IA took charge of it as well.
Iqbal Ahmed is a multi-dimensional person, hard to understand, unpredictable and much to learn from. He deserves separate space and I shall do that. Suffice to say here that he is the founder and owner of HiQ Pharma, a multi-billion-rupee company now.
Back to my new job. I found myself getting into the job easily. In the morning, I visited Mayo hospital and in the evening, I visited its consultants in their private chambers. The work was not difficult. Most customers were courteous, and market was not crowded. Except waiting, which is inherent, the work was enjoyable. I had the privilege of meeting some of the best and biggest doctors and I found that they were very big human beings as well.
On my third day of work, I went to visit senior Professor of medicine, Dr. Alamgir Khan in the evening. I was young and looked even younger due to slim physique. He looked at me and asked me if I was new. I said ‘yes, it is my third day’. He asked me if I had gotten the basic training from company. I said yes. He asked me ‘what is the mechanism of action of Segontin?’ It was a cardiac drug for angina and blood pressure and was considered to act through five mechanisms. With product knowledge fresh in my mind, I quickly said it had five mechanisms of action and fluently recited all five. Professor Alamgir looked at me for a while and nodded. He never asked me any question again but was always exceptionally kind to me. He patronized many of our products.
Professor Alamgir did not learn from me; he taught me the benefit and importance of knowledge. I did not fully understand at that time, but I did feel very good and decided to keep product knowledge updated and fresh.
There were two other important lessons that I learned very early in my career……
And, in the second week of working, I had a disaster. I went to visit a senior Professor of Surgery in his private chamber. I said something stupid due to ignorance and he asked me to get out of his clinic. I reported it to SHJ next morning. He was very upset but not hard on me. He went and apologized to the doctor and made it possible for me to visit the doctor again. The incident is still vivid in my mind, so is the learning from it.