Why doctor-pharma rep interaction matters in healthcare
Recently, authorities in Bangladesh have prohibited medical representatives from entering hospital premises. This decision may stem from the exaggerated activities of a specific group, but there are alternative ways to address concerns while maintaining this vital interaction
Recently, the Ministry of Health and Family Welfare has announced a 10-point directive aimed at improving hospital management, with one provision banning medical representatives (MR) from hospital premises. The directive aims to improve healthcare services in both government and private hospitals.
The relationship between physicians and the pharmaceutical industry has sparked intense debate for decades. Nevertheless, the global practice of MR visits to doctors is widely recognised for its positive contributions. Many medical and governmental institutions in both developed and developing countries have established guidelines and legislative checks to regulate this relationship.
The interaction between doctors and pharmaceutical companies is crucial, as the pharmaceutical business is highly knowledge-driven. Medical Representatives (MRs) serve as a bridge, sharing information between these two parties.
As part of their business strategies, MRs are often trained to analyse physicians' traits, practices, and preferences. This information may even outweigh prescribing preferences in importance. The basic roles of an MR include sharing information about new products, updating doctors on existing products, and demonstrating how these products can benefit their work. They also gather product-related feedback from the market and share it with their companies to facilitate necessary changes.
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This interaction is mutually beneficial: doctors can offer better service to patients with proper drug information, and pharmaceutical companies gain branding opportunities for their products.
Pharmaceutical companies provide valuable contributions to society in many ways. However, as a business, their earnings rely heavily on promotion. The greater the volume of medicines sold, the higher the return on investment.
As mentioned, promotion is a key driver of sales. The World Health Organization (WHO) defines pharmaceutical promotion as "all information and persuasive activities by manufacturers and distributors, the effect of which is to induce the prescription, supply, purchase, and/or use of medicinal drugs." Promotion of pharmaceuticals by MRs to doctors is widely recognised worldwide.
In one study, 479 doctors were asked about their relationship with pharmaceutical companies regarding knowledge-sharing about new molecules, treatments, and healthcare advancements.
A majority (74%) found this relationship valuable. According to a report, pharmaceutical companies in the United States spend over $5 billion annually to send MRs to doctors. These representatives provide product information, answer usage questions, and deliver samples.
The US has more than 300,000 pharmaceutical sales representatives, compared to around 700,000 in India. In Bangladesh, while data is limited, there are an estimated 100,000 MRs.
A study published in The Journal of Pharmacy and BioAllied Sciences reveals that 56.8% of doctors consider MRs a source of appropriate drug information with a valuable guiding role, while 43.2% hold a different view.
Furthermore, 61.7% of doctors acknowledge that MRs impact their prescribing habits.
Many medical and governmental institutions of both developed & developing countries have formulated guidelines and legislative checks to regulate the relationship between physicians and the pharmaceutical industry and its representatives.
However, there are very few or no institutions that completely stopped visiting their doctors through MRs.
The restriction on entry to the hospitals by MRs may be due to some exaggerated activities by a very specific group of people. However, it is important to note that most MRs are well-educated, trained, and highly dedicated to their assignments. MRs have played a significant role in the rapid growth of the Bangladeshi pharmaceutical industry. Their contributions during the Covid-19 pandemic, ensuring the smooth supply of medicines across the country, are particularly noteworthy.
While I respect the decision to restrict MR access to hospitals, my perspective differs slightly. There are alternative ways to address concerns while maintaining this vital interaction.
For instance, many doctors lack private chambers, making it challenging for MRs to connect with them and share medical or product information. In such cases, allowing MRs to visit hospitals before or after office hours or designating fixed visiting times could be a practical solution.
I hope the authorities will consider these suggestions before fully implementing restrictions. Instead of severing the connection between doctors and MRs, it would be more effective to develop ethical guidelines with input from experts to ensure smooth and responsible interactions.
Such measures can strike a balance between addressing concerns and preserving the benefits of this relationship, ensuring continued advancements in healthcare and pharmaceutical practices.
Dr Md Abu Zafor Sadek is a pharmaceutical industry analyst, pharmacist, and doctor of business administration from the Institute of Business Administration (IBA), University of Dhaka. He can be reached at: [email protected].
Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.
