Global health

When doctors' prescribing decisions are influenced by deals with pharmaceutical companies, patients may receive medicines that are unnecessary, inappropriate, or of poor quality. This is referred to as profit-driven prescribing.

Profit-driven prescribing is difficult to measure and address. To better understand it, Professor Mishal Khan's team carried out a series of studies in Pakistan, the world's fifth most populous country. The research included a survey of 419 private doctors and 94 interviews with patients, doctors, pharmaceutical company staff, and policymakers. They conducted the first randomised trial using a novel method to measure how often doctors engaged in prescribing deals. In this trial, trained data collectors posed as representatives of a fictitious pharmaceutical company.

The team found that nearly nine out of ten primary care doctors in our study reported being involved in deals with pharmaceutical companies. Many doctors also overlooked medicine quality when considering these deals: 40% agreed to prescribe medicines promoted by the fictitious pharmaceutical company without checking their quality.

To help patients play a stronger role in promoting accountability, this project will develop and share carefully designed, culturally appropriate information about how financial relationships between doctors and pharmaceutical companies can influence prescribing. Professor Mishal Khan will also provide practical guidance on what patients can do if they have questions or concerns about the medicines or advice they receive from their doctor.