Dear Colleagues!  This is Asrar Qureshi’s Blog Post #598 for Pharma Veterans. Pharma Veterans welcome 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.

Opening Note

February 2022 marks my completing 47 years of working in Pharma Industry. Allah be praised. I am still working. The first half of my working career was spent in Multinational companies, and the latter half in the Local Pharma, making me well-versed with both innovators and generics markets. I also had the opportunity to work in business as well as operations.

My journey of near half century is also the journey of Pharma Industry in Pakistan. Great changes have occurred in this time and a lot could be written about it. In my blogs, which were started about four and a half years ago, I have covered several topics rel ated to Pakistan Pharma Industry. This multi-part series shall do and review the SWOT – Strengths, Weaknesses, Opportunities, Threats – of the industry as a whole.

Stakeholders 5 – Prescribers (Customers)

Pharmaceutical Selling is indirect selling. Pharma companies do not approach patients/consumers directly to sell their drugs, except in the case of over the counter – OTC drugs like paracetamol, vitamins, and supplements. OTC products are not meant for treating any serious disease; these are meant for general wellbeing or minor ailments. Prescription drugs on the other hand are required for treatment of serious diseases. For one disease, several options are available for treatment and only a qualified person would know what will be better. Patients can neither diagnose nor treat themselves. Doctors are trained to diagnose and treat diseases. Therefore, Pharma companies approach doctors and promote products to them so that they will prescribe these to patients. That makes Pharma business ‘triangular’, where Pharma companies go to doctors who prescribe drugs to patients, who go and buy from pharmacy. Therefore, the actual customers of Pharma companies are Doctors.

Half a century earlier when I started, Pharma business was simple. Fewer medical representatives promoted fewer drugs to fewer doctors in a simple manner. We visited our customers once or twice in a month, talked about our products and left. Many a times, there were good discussions; we presented detailed information about products and the doctors asked questions, expressed their opinions, and shared their experiences. The environment was predominantly academic; we learned from them, and they got specific information from us. No one insisted on business or its quantity, it came automatically if the doctor was convinced on merit.

Things started changing in late 1980s. Several changes started coming in the marketplace. Dr. Rizwan Rahim Ahmad, whose work I quoted in few earlier posts, did a whole thesis on who started the change. His conclusion is that the Pharma companies are to be blamed for starting these trends. Anyway, without putting blames of anyone, we identify and describe trends in a neutral manner.

MNCs promoted research products only at that time (now they are also indulged in generic business). There was competition, but it was presented and addressed on merit. For example, five drugs from ‘sulphonylurea class’ were available for management of Type 2 Diabetes; these had many similarities and some unique points. Sometimes, the USP – Unique Selling Proposal was carved out of thin advantage, but we stayed on merit and tried to convince the doctors to get prescription. We were successful.

Rise of Local Pharma was based on generic drugs business. A generic drug is a replica of the research drug, with same active ingredient, but the formulation may vary. It is understood worldwide that their efficacy would be somewhat less than the innovator drugs, but they do offer substantial price relief. This is the basic reason for the popularity of generic drugs all over the world. Similar generic drugs are manufactured by several companies, and none can claim that one is superior to the other. This is the key factor which should be understood to understand the changes in the Pharma business trends.

The first few Local Pharma companies who marketed first generic versions of popular research drugs were received well. The doctors were unsure about their efficacy but decided to use these in those patients who had the challenge of buying high-cost drugs. The doctors considered that at least some effect would be there. Time and experience established that the efficacy of generic drugs was fairly good, probably better than what was initially considered. Later entrants found the place occupied and tried to determine what could they offer to make their place, either by displacing research drugs further, or displacing earlier generic drugs, or expanding the market. They had two major tools available to them: one to offer lesser price; or offer more attractive services to customers. Local Pharma, emboldened by the initial success, went all out to do all they could. As a result, the whole playbook of Pharma Marketing was rewritten.

Customers were somewhat apprehensive in the beginning, but the onslaught of Pharma companies proved irresistible. Our greed catches up on us sooner or later, and we give in. There were too many things on the offer: foreign trips with families, local excursions, opportunities to attend international and local conferences without spending own money, gifts galore for self, home, clinics, books, clinic upgrades, fine dining, discounts on purchases, or hard cash; choose not one, but as many as you like.

To be Continued……

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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