What does it cost to organize a medical conference in Pakistan? According to pharmaceutical industry estimates, the answer is between Rs7 billion and Rs10 billion every year, a staggering amount spent on sponsoring medical conferences, workshops, seminars and continuing medical education (CME) activities. While medical societies insist such support is essential for scientific education, a growing number of pharmaceutical executives allege the system has evolved into something far more troubling.
Many of them now privately describe it as a culture of pressure, coercion or even extortion, where refusing to sponsor conferences can come at a commercial cost.
Documents, sponsorship packages, invoices and conference tariff schedules reviewed by Vitals reveal that medical societies routinely seek sponsorships ranging from a few hundred thousand rupees to several million for conferences, workshops, scientific sessions, exhibition stalls, hospitality and participant accommodation. Some sponsorship packages reviewed for this investigation ranged from Rs3 million to Rs7.5 million, while one society requested Rs2.665 million for hospitality and registrations alone and another sought Rs2.5 million for a single workshop.
Pakistan has more than 150 medical societies, besides hundreds of hospitals, universities and teaching institutions that organize conferences and CME activities every year. Continuing medical education is indispensable for keeping physicians updated with rapidly evolving medical science. The question, however, is no longer whether these meetings should be held, but who should pay for them, how much, and under what rules.
Several owners and senior executives of pharmaceutical companies told Vitals that sponsorship requests are often accompanied by direct or indirect pressure.
“We are under constant pressure from some societies. If we do not support their conferences, our products may be ignored or sidelined, causing losses running into millions of rupees,” said the owner of a pharmaceutical company, requesting anonymity because of fears of commercial repercussions.
Other executives made similar claims, alleging that companies refusing sponsorships may lose access to scientific meetings or find their products quietly discouraged among prescribing physicians.
None of the executives was willing to speak on the record. Their common concern was that challenging influential professional societies could invite commercial retaliation.
Yet the pharmaceutical industry itself acknowledges that it is not opposed to supporting medical education. Several executives said companies are willing to invest in scientific conferences, research, fellowships and training programmes. Their objection, they say, is the growing commercialization of conferences, where large portions of sponsorship budgets are spent on luxury venues, hospitality and recreation rather than scientific content.
Former Secretary General of the Pakistan Pediatric Association, Dr Khalid Shafi, believes the issue is more nuanced.
He said pharmaceutical sponsorship has historically enabled medical societies to organize scientific meetings and support educational and patient-related initiatives that often receive little government funding. However, he acknowledged that sponsorship demands can sometimes exceed acceptable limits while some pharmaceutical companies also attempt to secure undue influence through non-transparent payments to individuals.
According to him, industry support is an accepted global practice, provided it remains transparent, ethical and focused on education rather than personal benefits.
Regulators also acknowledge that financial relationships between physicians and industry require stronger oversight.
Officials at the Ministry of National Health Services confirmed that the Pakistan Medical and Dental Council (PMDC) has finalized a comprehensive code of ethics governing relationships between healthcare professionals and pharmaceutical companies. Once notified, it is expected to regulate industry interactions, discourage unethical marketing and promote rational prescribing.
Senior PMDC officials point out that Pakistan is hardly alone. Similar concerns emerged decades ago in the United States, eventually leading to the Physician Payments Sunshine Act, which requires pharmaceutical and medical device companies to publicly disclose payments made to physicians and teaching hospitals. Several European countries later adopted similar transparency laws.
According to PMDC officials, when financial incentives influence clinical decisions, patients ultimately bear the cost through unnecessary medicines, avoidable investigations and higher healthcare expenses.
They insist the council has zero tolerance for unethical conduct but say companies must submit documentary evidence against individual physicians if disciplinary action is to be taken.
Ethicists argue that transparency, rather than sponsorship itself, is the real issue.
Prof Amir Jaffery, Chairperson of the Centre of Biomedical Ethics and Culture at SIUT, said that if sponsorships are demanded coercively, such practices would violate professional ethics. Financial relationships between pharmaceutical companies, healthcare institutions and medical societies, he said, should be transparent, auditable and governed by clear ethical standards.
Officials at DRAP agree that greater transparency is needed. They say promotional expenditure is still reported manually, making meaningful oversight difficult, and believe digitizing financial reporting could help regulators identify unusual spending patterns and strengthen accountability.
Prof Dr Shahzad Ali Khan, Vice Chancellor of the Health Services Academy, also defended industry support for scientific education but stressed that transparency and accountability must govern every financial relationship involving pharmaceutical companies and healthcare professionals.
Health policy experts now believe Pakistan may eventually need a disclosure system similar to those adopted internationally, requiring medical societies to publish audited accounts, declare sponsorship revenues and disclose conflicts of interest.
Because in the end, the debate is no longer about whether pharmaceutical companies should support medical education.
It is whether sponsorship remains voluntary scientific collaboration, or whether, in some cases, it has crossed the line into coercion.
That is a question regulators, medical societies, pharmaceutical companies and, above all, patients can no longer afford to ignore.
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