A new study has revealed excessive medicine prescriptions at hospitals and clinics across Pakistan. Patients are receiving far more medicines than international guidelines recommend. Researchers at the Health Services Academy in Islamabad conducted the study.
The team published their findings in Discover Public Health. They reviewed 15 research papers on prescribing practices nationwide. The papers covered Punjab, Khyber Pakhtunkhwa, Sindh, Balochistan and Islamabad. Additionally, the review spanned the years 2013 to 2024.
Patients received an average of 4.2 medicines per prescription. This figure sits well above the WHO-recommended range of 1.6 to 1.8. One tertiary hospital in Peshawar recorded an average of 10.56 medicines per prescription.
That figure is nearly six times the recommended level. Still, even the lowest figure, from an emergency department in Bahawalpur, exceeded the WHO limit.
Generic prescribing also fell far short of targets. Doctors prescribed only around 25% of medicines by generic name. The WHO target for generic prescribing stands at 100%.
In some hospitals, generic prescribing was close to zero. Meanwhile, just two of the 15 studies recorded rates above 50%. Antibiotics appeared in 45% of prescriptions on average. Furthermore, this figure far exceeds the WHO-recommended range of 20% to 26.8%.
Injections told a similarly troubling story. Doctors used injections in more than 27% of prescriptions. This rate exceeds the recommended range set by the WHO.
However, usage varied sharply between hospitals, from zero to as high as 98%. Additionally, only 72% of prescribed medicines came from Pakistan’s essential medicines list. The recommended target for that list stands at 100%.
Prof. Shahzad Ali Khan leads the Health Services Academy as Vice Chancellor. He said researchers found this prescribing pattern across every level of healthcare. The problem, he explained, is not confined to one hospital or city.
Instead, it occurs nationwide, at every tier of the healthcare system. Doctors often prescribe antibiotics and injections without proper testing, he added. Patients frequently request these treatments, believing they work faster. Therefore, doctors under time pressure often give in to these requests.
Prof. Khan also linked low generic use to pharmaceutical marketing. Some doctors and patients still believe generic medicines are less effective than branded ones. However, no proven quality difference actually exists between them.
He noted that Pakistan already has prescribing guidelines in place. Still, enforcement of these guidelines remains weak on the ground. The study recommends regular monitoring and feedback for prescribers.
It also calls for action against those who repeatedly violate the rules. Finally, it urges coordinated efforts among the government, pharmaceutical companies, hospitals and doctors’ associations. These combined steps could help correct excessive medicine prescriptions before patient safety suffers further.
