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Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan

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 c...

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Autores principales: Noor, Muhammad Naveed, Rahman-Shepherd, Afifah, Siddiqui, Amna Rehana, Aftab, Wafa, Shakoor, Sadia, Hasan, Rumina, Khan, Mishal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175940/
https://www.ncbi.nlm.nih.gov/pubmed/36731921
http://dx.doi.org/10.1136/bmjgh-2022-010853
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author Noor, Muhammad Naveed
Rahman-Shepherd, Afifah
Siddiqui, Amna Rehana
Aftab, Wafa
Shakoor, Sadia
Hasan, Rumina
Khan, Mishal
author_facet Noor, Muhammad Naveed
Rahman-Shepherd, Afifah
Siddiqui, Amna Rehana
Aftab, Wafa
Shakoor, Sadia
Hasan, Rumina
Khan, Mishal
author_sort Noor, Muhammad Naveed
collection PubMed
description 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.
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spelling pubmed-101759402023-05-13 Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan Noor, Muhammad Naveed Rahman-Shepherd, Afifah Siddiqui, Amna Rehana Aftab, Wafa Shakoor, Sadia Hasan, Rumina Khan, Mishal BMJ Glob Health Original Research 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. BMJ Publishing Group 2023-02-01 /pmc/articles/PMC10175940/ /pubmed/36731921 http://dx.doi.org/10.1136/bmjgh-2022-010853 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Noor, Muhammad Naveed
Rahman-Shepherd, Afifah
Siddiqui, Amna Rehana
Aftab, Wafa
Shakoor, Sadia
Hasan, Rumina
Khan, Mishal
Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan
title Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan
title_full Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan
title_fullStr Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan
title_full_unstemmed Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan
title_short Socioecological factors linked with pharmaceutical incentive-driven prescribing in Pakistan
title_sort socioecological factors linked with pharmaceutical incentive-driven prescribing in pakistan
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175940/
https://www.ncbi.nlm.nih.gov/pubmed/36731921
http://dx.doi.org/10.1136/bmjgh-2022-010853
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