Half of all medicines are prescribed or sold inappropriately and half of all patients fail to take their medicines correctly worldwide. The present study was conducted to evaluate the pattern and practice of drugs within the modern medical system by investigating the prescription pattern, drug use in private and public health care facilities, assessment of the magnitude of the problem, identifying factors responsible for the problem, suggesting measures in Pakistan. There were marked differences between the qualities of consultation indicators between general practitioners (GPs) and public health care providers. The average number of drugs per prescription was 2.92 for all types of health care providers, mean number of drugs dispensed was 2.41 and 50% of the dispensed drugs were adequately labeled. Five categories of drugs comprised around 70% of all drugs prescribed. Injections prescribed per prescription were 0.32, infusions 0.07, capsules/tablets 1.85, syrups/suspensions 0.8. Number of drugs prescribed by GP's was 4.3 and was 2.9 (P = 0.001) for public health care providers and antibiotics prescribed per prescription were 0.9 and 0.8 (P = 0.176) for the GP's and public health care providers. The availability of drugs at public health care facilities influenced prescription in 88% of cases as compared to 57% (P = 0.001) at GPs clinics. Prescribing and dispensing practices are irrational both in public and private sector in Pakistan like many developing countries. Workable and appropriate interventions need to be developed and implemented in countries to improve trends of prescribing. The essential drug list and standard treatment guidelines should be disbursed to all medical, dental and pharmacy students.

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