The healthcare field as a marketplace: general practitioners, pharmaceutical companies, and profit-led prescribing in Pakistan

Muhammad Naveed Noor, Marco Liverani, Joanne Bryant, Afifah Rahman-Shepherd, Sabeen Sharif, Wafa Aftab, Sadia Shakoor, Mishal Khan, Rumina Hasan

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)198-212
Number of pages15
JournalHealth Sociology Review
Volume32
Issue number2
DOIs
Publication statusPublished - 2023

Keywords

  • Healthcare
  • capital
  • general practice
  • incentivisation
  • pharmaceutical industry

Fingerprint

Dive into the research topics of 'The healthcare field as a marketplace: general practitioners, pharmaceutical companies, and profit-led prescribing in Pakistan'. Together they form a unique fingerprint.

Cite this