Prof Nadeem Irfan Bukhari
A medical representative (MR) is the first link between pharmaceutical companies and doctors. Mostly pharmacy graduates opt for this career, acting as product specialists who explain how medicines work, their correct use, benefits, side effects and comparisons to other medicines in the same therapeutic class. They also collect feedback from physicians, support new product launches and contribute to market research, making them an important stakeholder in the medical market and a significant component of the pharmaceutical ecosystem.
Recently, the Punjab Government has banned interactions between medical representatives and physicians, probably in an effort to curb bribery and unethical pharmaceutical marketing. The intention is clear and positive: to avoid unethical marketing practices and reduce undue influence on prescribing practices. Yet questions remain: is this ban the right solution, is it effective or does it risk creating new issues?
Unethical marketing in pharmaceuticals is a real global issue. It includes gifts, sponsored trips, biased promotion and incentives linked to prescriptions. However, banning all interaction between MRs and doctors may be an overadjustment. This ban will cut off a legitimate channel of scientific information, particularly about new drugs and will create unemployment for young pharmacy graduates pursuing MR roles. More importantly, the measure will push interactions underground, making them harder to regulate.
Unethical practices exist and flourish not because of the communication itself, but due to weak regulations, poor enforcement and lack of transparency in the system. Most developing and third-world countries have regulations that avoid outright prohibitions. India allows professional interaction but restricts gifts and incentives under the Uniform Code of Pharmaceutical Marketing Practices. Bangladesh permits MR-doctor interaction, following regulator-monitored ethical guidelines.
Sri Lanka emphasizes essential drug lists and hospital formularies to restrict influence of unethical promotion. Even African countries like Kenya and Nigeria rely on professional accountability, codes of conduct and procurement reforms rather than bans. Developed countries, such as the UK and Australia, allow interactions but strictly regulate them.
Instead of a ban, the government needs structural and policy-level reforms. These reforms should include transparent e-procurement systems, independent tender committees with third-party audits and medicine selection based on quality, bioequivalence and cost—free from company influence. Legally enforceable ethical marketing codes, clear penalties for violations by companies and medical professionals, MR training in ethical promotion and public disclosure of sponsorships, funding for continuous medical education or other financial relationships are all feasible measures.
Indeed, there is a need to limit incentives and travel perks—but not information, scientific detailing or approved literature. There is also a need to empower pharmacists and drug & therapeutics committees to decide hospital formularies. Allowing a greater and genuine role for clinical pharmacists in evaluating medicines offers a more balanced and sustainable solution than simply closing doors for young professionals.
—The writer is PhD, RPh, Dean, Pharmaceutical Sciences, Qarshi University, Lahore.
