Dear Colleagues!  This is Pharma Veterans Blog Post #485. Pharma Veterans welcomes sharing of knowledge and wisdom by Veterans for the benefit of Community at large. Pharma Veterans Blog is published by Asrar Qureshi onWordPress, the top blog site. Please email to for publishing your contributions here.

The original concept of creating Pharma Veterans Blog and associated activities is to share the information, knowledge, and wisdom about the Pharmaceutical business. The scope is worldwide, but the primary focus is Pakistan market. Being the principal contributor, I am constantly on the lookout for related information which would be of value to the readers.

The original research work on pharmaceutical business practices, promotional tactics, and its influence on prescribers and prescriptions remains in focus in the neighboring India but is less common in Pakistan. So far, I have taken material from Dr. Rizwan Raheem Khan who did a thesis on Pharma promotional practices, its ethics and influence. There was another important research from Dr. Rizwan Rasheed of Government College University, Lahore.

Recently, I came across another interesting and relevant original research article titled ‘A quantitative insight of the interactions of prescribers with pharmaceutical organization’s representatives in clinical settings of Karachi’. The article was published in the Dove Press Journal Integrated Pharmacy Research and Practice 2019:8 75-83. The researchers include Sadia Shakeel, Shagufta Nesar, Wajiha Iffat, Bilqees Fatima, Tahmina Maqbool and Shazia Jamshed. Their institutional affiliations appear at the bottom.

I would like to share the key findings from this interesting, indigenous study.

The objective of the study as stated by the researchers was, “The study was conducted with the aim to evaluate the prescribers’ approach of interaction with medical representatives for drug promotion”.

The method employed was, “An explanatory, cross-sectional design was used to evaluate prescribers’ interactions with the Medical Sales Representatives (MSRs) through an anonymous, self-filled questionnaire from June to December 2017….” The data has been analyzed statistically and presented.

The WHO describes pharmaceutical promotion as ‘all information and persuasive activities by manufacturers and distributors, the effect of which is to induce the prescription, supply, purchase and/or use of medicinal drugs.’ The Pharma companies have been involved in the drug promotion since the beginning of the trade. We can still find 100 years or even older posters advertising various potions and drugs for various diseases. They are interesting in the sense that they make tall claims without any evidence, but the point is that the earliest form of pharmaceutical promotion was like any other advertisement. As science grew further and Pharmaceutical business increased in sophistication and volume, certain restrictions also came into play. No one knows when exactly the personal selling, like we see today, started. But it seems that it might have started in the 1940s, just after the World War II. Pharma companies from Europe and the US spread their businesses quickly around the world and went into aggressive promotion through various means. Presently, Pharma promotion is mainly dependent on the ‘personal selling’ done by the Medical Representative. The promotional call is supported with printed materials, free drug samples, and occasional gifts. Even at the medical conferences, company representatives interact with the doctors in person and promote drugs. For this reason, the study under discussion becomes highly relevant and important.

Pharma business is not B to C (Business to Consumer), it is B to P to C, where P is the Prescriber or Physician. The Pharma companies are dependent upon the Prescribers for the acceptance of their products, their business in the market and their growth over competition and with time.

Pharmaceutical Promotional activities have been under scrutiny in many countries and the International Federation of Pharmaceutical Manufacturers Associations – IFPMA – has issued detailed guidelines about Ethical Pharmaceutical Marketing Practices, the real-life application of which varies from country to country. As may be expected, the situation in Pakistan is unmonitored.

The role of MRs has also changed over time and has added more facets. The primary function is to communicate the drug profile, its attributes and its limitations, drug-drug interactions, its comparison to other drugs in the same class and other classes, correct dosage, and administration. The new clinical research done on the drug is also presented as it comes. In this way, the MSR is an authentic source of drug information for the clinicians. In practice, things have become highly variable. While the information part is still being done by the MRs of MNCs and some generic companies, the other companies are not focusing on the training of MSRs. Most MSRs have unrelated educational background and with little or no training, their information imparting capability is compromised.

To be Continued……


  1. Sadia Shakil – Faculty of Pharmaceutical Sciences, Dow University of Health Sciences, Karachi.
  2. Shagufta Nesar – Faculty of Pharmacy, Hamdard University Karachi.
  3. Wajiha Iffat – Faculty of Pharmaceutical Sciences, Dow University of Health Sciences, Karachi.
  4. Bilqees Fatima – Faculty of Pharmacy, Hamdard University, Karachi.
  5. Tahmina Maqbool – Faculty of Pharmacy, Hamdard University, Karachi.
  6. Shazia Jamshed – Department of Pharmacy Practice, International Islamic University Malaysia, Pahang, Malaysia.

Disclaimer. Dove Press Journal of Integrated Pharmacy Research and Practice is an open-access journal and non-commercial use of published information is allowed without need for further permission. I had, all the same, sent a mail to the correspondence address given on the paper for information and permission of researchers, but it was returned undelivered.

Disclaimer. Most pictures in these blogs are taken from Google Images which does not show anyone’s copyright claim. However, if any such claim is presented, we shall remove the image with suitable regrets.

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