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Continued from Previous……

This is Part 2 of 3 blog series based on the study published in Integrated Pharmacy Research and Practice Journal from Dovepress. The study is titled ‘A quantitative insight of the interactions of prescribers with pharmaceutical organization’s representatives in clinical settings of Karachi’. It was published in 2019. [Quote]

Study Duration

The study was conducted from June to December 2017.

Study Population

The physicians working in private and government health care facilities of Karachi were included in the study to observe their opinion about MSRs, drug promotion and prescribing practice. The selection of the participants was based on convenient sampling. The questionnaire-based interviews were conducted in person; out of the total 250 physicians contacted, 207 agreed to participate in the research.

Study Instrument

The study instrument consisted of a survey questionnaire which was obtained from previous studies, and slightly modified to assess the opinion of the physicians toward the interaction with MSRs and the effect of MSRs on their prescribing practice. The first part of the questionnaire contained questions about the socio-demographic characteristics of the physicians (age, gender, year of experiences, department, organization and qualification). The second part contained 32-items to observe the physician’s opinion about MSRs, drug promotion and prescribing practice by using a 5-point Likert scale ranging from 1=“strongly disagree” to 5=“strongly agree.”

As is required, Ethical Approval and Informed Consent were taken.

Results – Basic Data

A response rate of 82.8% was achieved. More than 50% (53.1%) of the respondents were males and 46.9% of them were female with a mean age of 40 years. Majority (65.2%) practiced in private health care facilities. Frequencies of interactions of respondents with MSRs reported to be either once a week, (32.7%), or twice a month (28.5%).

Results – Respondents Opinion regarding their interactions with MSRs

Following are the highlights.

  1. Nearly half of the population (45.41%) agreed and (41.55% strongly agreed) that MSRs are a key link between pharmaceutical companies and healthcare professionals.
  2. More than 85% concurred that MSRs should be allowed to interact with doctors.
  3. More than 65% considered that the interactions of Physicians and MSRs are important/beneficial and knew that MSRs perform an important teaching function.
  4. More than 70% agreed that knowledge obtained from MSRs is reliable and useful.
  5. However, 61.84% of the respondents believed that the only goal of MSR is the promotion of their own products.
  6. Around 30% claimed that MSRs provide misleading information for promoting their products.
  7. More than half (58%) opined that communication with MSRs should only be permitted in an educational setting. [Unquote]


The commonest belief which has taken root in the last fifteen years is that the Pharma-Physician relationship has come down to only one point – the money in any form. And this is the lowest point. The money may be spent as sponsorship, as cash, as gift, as services, as travel or whatever. The prevailing concept is that the only merit for drug prescription is the benefit attached to it. This ubiquitous thinking has clouded some real issues.

One issue is the quality of MSRs going in the field. Owing to the large number of manufacturers and even larger number of franchise marketers, an average of 40-50 medical representatives may visit a busy doctor daily. This is an unmanageable number for any physician. We are still a courteous society, and the doctors rarely refuse point blank. They try to control by fixing days and timings. The contact time has reduced, and the overall relationship has been adversely affected.

Second issue is the quality of MSRs, which has seriously deteriorated over the years. The hiring is compromised due to multiple reasons: irrelevant qualification, unsuitable profile for sales, poor compensation packages, no or almost no training, pressure to do business by any means are some of the reasons. The average quality of an MSR is such that the physician is not pleased to see him (Pharma sales is entirely male dominated now). The MSR is not able to present information about their own products, what to talk of competitors.

Third issue is the overall management structure which has also deteriorated in quality. The poor-quality hiring of yesteryears has sustained and is now the management layer. Many of the finer things are lost in understanding and never reach the implementation phase. the market situation twenty years ago was much less competitive, and one could get business even by showing up regularly.

Fourth issue is that due to lack of quality selling skills, the MSRs keep harping that money is the only motivation for prescription. The chorus is so unanimous and loud that the seniors are under constant pressure to comply. It should be clear that if all resources are diverted towards customer services, nothing would be left for improving quality of people.

This study should set the record better in some ways. It shows that there is a demand for knowledge from customers and it is understandable.

The first and primary concern of a physician is his/her patient; everything else comes later. No doctor would knowingly prescribe a product which will not benefit his patients or harm them.

The business of doctor is patients, not Pharma companies. His profession is treating patients, not patronizing pharma companies. Yes, he does prescribe lots of drugs and there is a convergence of benefits between prescribing ‘required’ drugs and getting ‘sponsored’ for that.

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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