Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan

Datos Bibliográficos

ID21881680
AutoresMuhammad Naveed Noor (0000-0002-7847-6637, Aga Khan University), Afifah Rahman-Shepherd (0000-0002-8845-9275, London School of Hygiene & Tropical Medicine), Amna Rehana Siddiqui (0000-0001-9819-7822, Aga Khan University), Wafa Aftab (0000-0001-5040-5215, Aga Khan University), Sadia Shakoor (0000-0003-1301-5239, Aga Khan University), Rumina Hasan (0000-0003-3738-117X, Aga Khan University), Mishal Khan (0000-0002-8967-1761, London School of Hygiene & Tropical Medicine, autor de correspondencia)
Año2023
Volumen6
NúmeroSuppl 3
Páginase010853
Fecha de publicación2023-02-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaBMJ Global Health (JOURNAL)
Identificadores de la revistaISSN: 2059-7908 • E-ISSN: 2059-7908
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2022-010853
PMID36731921
OpenAlexW4318986834
IdiomaEN
Citas recibidas4
Referencias citadas30

Pharmaceutical marketing through financial incentivisation to general practitioners (GPs) is a poorly studied health system problem in Pakistan. Pharmaceutical incentivisation is seen to be distorting GPs prescribing behaviour that can compromise the health and well-being of patients. We draw on a conceptual framework outlined in the ecological system theory to identify multiple factors linked with pharmaceutical incentivisation to GPs in Pakistan. We conducted qualitative interviews with 28 policy actors to seek their views on the health system dynamics, how they sustain pharmaceutical incentivisation and their effect on the quality of care. Our analysis revealed four interlinked factors operating at different levels and how they collectively contribute to pharmaceutical incentivisation. In addition to influences such as the increasing family needs and peers’ financial success, sometimes GPs may naturally be inclined to maximise incomes by engaging in pharmaceutical incentivisation. On other hand, the pharmaceutical market dynamics that involve that competition underpinned by a profit-maximisation mindset enable pharmaceutical companies to meet GPs’ desires/needs in return for prescribing their products. Inadequate monitoring and health regulations may further permit the pharmaceutical industry and GPs to sustain the incentive-driven relationship. Our findings have important implications for potential health reforms such as introducing regulatory controls, and appropriate monitoring and regulation of the private health sector, required to address pharmaceutical incentivisation to GPs

Business · Economics · Environmental health · Incentive · Public economics · Healthcare Systems and Reforms · Medicine · Pharmaceutical Economics and Policy · Pharmaceutical industry and healthcare