Special Correspondent ; Dhaka — While television viewers in nations like the United States are accustomed to pharmaceutical commercials pairing product benefits with rapid-fire recitations of side effects, such imagery remains entirely non-existent in Bangladesh.
Under stringent domestic regulations, the direct-to-consumer advertisement of prescription-only medication is strictly prohibited across national mass media.
However, an investigation has revealed that instead of protecting public health, this advertising ban has inadvertently given rise to an aggressive alternative marketing matrix, channeling an estimated BDT 6,000 crore annually into doctors’ pockets to influence prescriptions.
Denied the avenue of public broadcasting, pharmaceutical operations have diverted their massive financial portfolios toward “field-level marketing,” targeting medical practitioners with transactional inducements ranging from paid seminars and international luxury travel to home appliances and direct cash payments.
The BDT 6,000 Crore “Black Hole”
Data compiled by the Bangladesh Institute of Development Studies (BIDS) indicates that local pharmaceutical entities channel an estimated 29% of their total turnover exclusively into marketing campaigns.
Back in 2018, when the market valuation stood at BDT 20,500 crore, firms expended approximately BDT 6,500 crore on aggressive promotion.
This hyper-competitive environment has bred deep systemic corruption. A 2022 survey conducted by Transparency International Bangladesh (TIB) revealed that 77% of surveyed physicians openly admitted to accepting diverse gifts from pharmaceutical companies.
A subsequent 2025 study detailed even more aggressive tactics, noting that corporations are now swaying prescriptions by securing corporate employment for physicians’ immediate family members.
“Because direct-to-consumer advertising is tightly restricted in Bangladesh, companies rely entirely on Medical Representatives (MRs),” explained Dr. Syed Abdul Hamid, Professor at the Institute of Health Economics, University of Dhaka. “When firms engage in blind competition solely to secure market share and maximize sales volumes, the entire process devolves into institutionalized corruption.”
Information Deficit Exploited at the Patient’s Expense
This structural arrangement shifts focus completely away from patient awareness. Everyday consumers are left completely unaware of what they are consuming, why it was prescribed, or what side effects may follow.
To fill the information vacuum, a vast army of Medical Representatives routinely crowd hospital entryways and clinic lounges to influence physicians.
Although the Directorate General of Health Services (DGHS) recently issued orders limiting MR access within state-run medical facilities, enforcement remains a challenge.
Syed Ershad Ahmed, President of the American Chamber of Commerce in Bangladesh (AmCham), stressed that rigid blocks on controlled drug advertising severely undermine consumer awareness and basic data access.
“A significant percentage of our population remains cut off from institutional literacy and stable internet access,” Ahmed noted. “If systematic, highly regulated pharmaceutical messaging were permitted, marginalized populations could easily comprehend the benefits and risks of their medications. To attract large-scale domestic and foreign investment, Bangladesh must dismantle these unethical syndicates and cartels.”
Outdated Legal Foundations
The restriction on pharmaceutical advertisements is governed by the Directorate General of Drug Administration (DGDA) under the strict provisions of the 1982 Drugs (Control) Ordinance and the more recent Drugs and Cosmetics Act of 2023.
Health Ministry officials maintain that pharmaceuticals are not common consumer commodities. Marketing them like toothpaste or soap could trigger dangerous waves of self-medication, posing critical clinical risks with antibiotics, hormonal treatments, psychiatric drugs, and cardiovascular medications.
However, modern biomedical researchers argue that these decades-old policies require immediate modernization. Dr. Humaira Ferdous, Associate Professor and Head of Physics at the American International University-Bangladesh (AIUB), suggested that updating the legal framework would foster fair market competition and significantly drive down costs.
“The DGDA should host transparent registries detailing generic names, brand titles, and retail prices directly on their web portal,” Dr. Ferdous proposed. “This would empower patients to easily substitute an expensive prescribed brand with an affordable generic equivalent.
Furthermore, shifting from expensive medical reps to controlled public advertisements would save massive corporate overhead, allowing companies to reallocate funds into clinical research and development.”
Oligopolies and Consumer Backlash
The urgency for reform is intensified by market concentration: the top 10 pharmaceutical firms control 65% to 70% of the domestic market, while the top 30 corporations command nearly 90%.
To recover their massive field-marketing budgets, these dominant players routinely inflate retail drug prices, a burden borne entirely by the public.
Consumer rights advocates argue that allowing tightly regulated advertisements could break this corporate chokehold. Dr. Ahsan Habib, President of the Conscious Consumers Society (CCS), pointed out that a primary crisis stems from the fact that doctors write specific brand names on prescriptions rather than generic chemical formulas.
“To shatter this syndicate, we must promote generic prescribing and ease the blanket ban on structured drug advertisements to build grassroots health awareness,” he stated.
Responding to calls for legal revision, DGDA Director Md. Aktar Hossain clarified that the regulatory body does not object to companies broadcasting public-interest data regarding side effects or usage guidelines.
“However, using information channels to induce or lure the public into consuming specific prescription products violates existing law,” Hossain emphasized. “We strongly urge pharmaceutical companies to halt wasting billions on medical bribes or lavish gifts, and instead channel those funds into enhancing drug quality and lowering prices for citizens. Any future modifications to the existing advertising framework will depend entirely on evolving national requirements.”