Sir,

This is an undeniable fact that physicians bank upon on the medical advisors, liaison officers and representatives for latest medical field update due to their hectic schedule as mentioned in article by Anant Patil "Evolving role of pharmaceutical physicians in the industry".\[[@ref1]\] However this matter is a cause of concern than rejoice as many a time pharmaceutical representatives market their product in a way that physicians have no choice but to believe them.  Many such examples are discovered after long years of prescription due to misconceptions generated by the pharmaceutical companies.\[[@ref2]\]

Letrozole, as an ovulatory drug, was promoted by the companies and rampantly prescribed by the physicians.  It has been banned by the central government in 2011 for causing bone malformations, cardiac stenosis and cancers in newborns.\[[@ref3]\] Other fixed dose combination products, which seems to be fundamentally contradictory to the pharmacokinetic principles, are being prescribed due to vehement marketing, such as combination of formoterol and tiotropium once a dose preparation despite having 12 hours and 24 hours duration of action respectively.  Thus, adding unnecessary cost to the consumers.  Not only this but many pharmaceutical company representatives use survival analysis, including survival function, survival time, hazard function and hazard ratio as the outcome of the clinical trials.  The Researchers and physicians are not confident in the theory of its application as well as its interpretation.\[[@ref4]\]

There is neither inbuilt mechanism in the hospitals nor is the matter taken up by any faculty in teaching hospitals to circumvent the abovementioned situations for better patient care.  It is the onus of pharmacologists to start the units such as

(a)Academic Clinical Trials (ACT) to understand the rationality of marketing claims of pharmaceutical firms as well as to check the status of the new combination of drugs/ regime for better patient care.  Creating this unit will help in training the physicians in different specialties as better clinical research professionals.(b)Predictive/Prognostic Biomarker lab (PBL) can be started as central facility run by pharmacologists to correlate the patients of same morbidity under different physicians that will include follow up of investigations such as ECG and Echocardiography for cardiac safety and time-wise drug-wise claims of companies etc.(c)Therapeutic Drug Monitoring lab (TDM) as a mandatory part of the hospital will not only help the physicians in deciding the therapy but will also provide safer medication to the patients.(d)Antibiotic Resistance Prevention and Policy (ARPP) as a unit under pharmacology will prevent the use of irrational marketing of newer antibiotics and thus resulting resistance.  It can also frame hospital specific antibiotic policy. 

The growth of pharmacologists in teaching hospitals and the growth of Medical advisors are counterbalancing to each other.  The growth and involvement of pharmacologists in hospital will decrease the bankability of physicians on information from pharmaceutical firms and equip them for good decision making.  It, thus, can provide better patient care and training for clinical research professionals and obviate the advocacy of the company\'s profit making policies to the physicians. 

Mr. Mohammed Rizwan, IRS, Department of Revenue, Government of India, Delhi.