The healthcare field as a marketplace

General practitioners, pharmaceutical companies, and profit-led prescribing in Pakistan

Dados Bibliográficos

ID3635258
AutoresMuhammad Naveed Noor (0000-0002-7847-6637, Aga Khan University, autor correspondente), Marco Liverani (0000-0003-0829-291X, London School of Hygiene & Tropical Medicine), J Bryant (0000-0002-5271-2881, UNSW Sydney), Afifah Rahman-Shepherd (0000-0002-8845-9275, London School of Hygiene & Tropical Medicine), Sabeen Sharif (0000-0002-3848-6443, Aga Khan University), Wafa Aftab (0000-0001-5040-5215, Aga Khan University), Sadia Shakoor (0000-0003-1301-5239, Aga Khan University), Mishal Khan (0000-0002-8967-1761, London School of Hygiene & Tropical Medicine), Rumina Hasan (0000-0003-3738-117X, Aga Khan University)
Ano2023
Volume32
Fascículo2
Páginas198-212
Data de publicação2023-05-04
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoHealth Sociology Review (JOURNAL)
Identificadores do periódicoISSN: 1446-1242 • E-ISSN: 1839-3551
EditoraInforma UK Limited (PUBLISHER • GB)
DOI10.1080/14461242.2022.2139628
PMID36322797
OpenAlexW4308055352
IdiomaEN
Citações recebidas6
Referências citadas40

Incentivisation of general practitioners (GPs) by pharmaceutical companies is thought to affect prescribing practices, often not in patients' interest. Using a Bourdieusian lens, we examine the socially structured conditions that underpin exchanges between pharmaceutical companies and GPs in Pakistan. The analysis of qualitative interviews with 28 GPs and 13 pharmaceutical sales representatives (PSRs) shows that GPs, through prescribing medicines, met pharmaceutical sales targets in exchange for various incentives. We argue that these practices can be given meaning through the concept of 'field' - a social space in which GPs, PSRs, and pharmacists were hierarchically positioned, with their unique capacities, to enable healthcare provision. However, structural forces like the intense competition between pharmaceutical companies, the presence of unqualified healthcare providers in the healthcare market, and a lack of regulation by the state institutions produced a context that enabled pharmaceutical companies and GPs to use the healthcare field, also, as space to maximise profits. GPs believed the effort to maximise incomes and meet socially desired standards were two key factors that encouraged profit-led prescribing. We conclude that understanding the healthcare field is an important step toward developing governance practices that can address profit-led prescribing

Business · Economics · Health care · Management · Political science · Project commissioning · Public relations · Publishing · Sociology · Healthcare cost, quality, practices · Law · Pharmaceutical Economics and Policy · Pharmaceutical industry and healthcare