Effects of the distribution of product samples to patients and physicians by pharmaceutical companies

Background@#Distribution of product samples is a typical and traditional marketing and promotion strategy used by pharmaceutical companies. However, issues have been raised about their influence on physicians' prescribing behavior and patients' health outcomes. @*Objectives@#This study aimed to determine the effects of the distribution of product samples on physicians' prescribing behavior and adherence to patients' treatment regimens. It also sought to provide policy recommendations on product sample distribution and the administrative order on pharmaceutical promotion. @*Methodology@#The study involved a descriptive design. The study sites were Manila City, Cebu City, and Davao City. Data were collected using focus group discussions, key informant interviews, and surveys among patients and physicians. Content analysis was performed to analyze qualitative data, while descriptive statistics and measures of association were conducted to analyze quantitative data. @*Results@#A total of four FGDs were conducted with one FGD for each stakeholder group, and 846 patients and 286 physicians answered the study questionnaire. About half (48.0%) of the patients received product samples; 75.8% had low medication adherence. Product sample distribution was not significantly associated with patients' adherence (p=0.150). The majority of the physicians (69.2%) received product samples. There was no significant association between product sample distribution and physicians' prescribing behavior (p=0.111). It was found, however, that the distribution of product samples was significantly associated with the other physicians' prescribing behavior (p=0.009). The issues identified included the influence of medical representatives on physicians' prescribing behavior, incapacity of the poor and marginalized population to complete their treatment regimen due to lack of supply of product samples, and mentality of patients that product samples have better quality.@*Conclusion@#This study emphasized that the regulation of product sample distribution was justifiable since this might negatively influence professional behavior affecting rational prescribing and the use of medicines. Furthermore, the distribution of product samples did not directly translate to increased patients' medication adherence. Should the distribution of samples be continuously practiced, the provision of product samples should be strictly followed, and the distribution should be regulated and monitored to prevent the occurrence of violative practices.

Pharmaceutical promotional literature: opinions of physicians in a tertiary care hospital in Mumbai.

Backgrounds: The aim of this study was to assess physician’s opinion regarding pharmaceutical promotional material and make an objective assessment about their opinion on current drug promotional methods. Methods: 250 questionnaires were sent to physicians. Questionnaires was based on question assessing physicians opinion about 1) Influence of information provided on their prescription writing pattern. 2) Most common information which they seek for and find missing, was assessed on a Likert scale of 1 to 5 for each type of information 3) Type of promotional material preferred for drug information. 4) Significance of the various types of references cited which was assessed on likert scale of 1 to 5. Results: 207 questionnaires were returned. 59.5 % of the physicians were of the opinion that the information provide in promotional literature mostly influences their prescription. Physicians feel that there is minimal information on adverse drug reaction, comparison with other drugs, price, drug interactions and clinical trial results and contraindications. Likert score of 4.8, 4.7, 4.6, 4.6, 4.5 and 3.9 respectively. 41.07% physicians prefer pamphlets, and leave behind leaflet. Whereas they consider randomized controlled trials, meta-analysis and case controlled or cohort studies as significant references, with likert score 4.9, 4.7, and 4.6 respectively. Conclusion: There is need for strong regulatory infrastructure and monitoring of the content of pharmaceutical promotional activities. Therefore, in the absence of effective regulations and standards physicians should be aware of the risks of using non independent information sources.

Ethical evaluation of pharmaceutical marketing in Pakistan / Evaluación ética del mercado farmacéutico en Pakistán / Avaliação ética do mercado farmacêutico no Paquistão

Our aim in this study is to give a broad overview of the main ethical and legal challenges of pharmaceutical marketing. The purpose of this study was also to investigate unethical pharmaceutical marketing, the effect on physicians of receiving gifts, the influences of perceptions regarding the importance of ethics and social responsibility on ethical intentions of marketing professionals. It also investigates the effect of unethical marketing on ultimate consumer (patient). Questionnaire based survey study was conducted from two main categories: (i) physicians/consultants and (ii) pharmaceutical companies. In Pakistan, there is no mechanism to monitor the drug promotional campaign by pharmaceutical industry despite the fact that there is enough evidence that irrational pharmacotherapy is increasingly encountered even in the developed countries due to unethical practices of pharmaceutical promotion. Medical practitioners and the pharmaceutical industry serve interests that sometimes overlap and sometimes conflict. There is strong evidence that associations between industry and physicians influence the behaviour of the latter in relation to both clinical decision making and ethical promotion of drugs. The basic principles underlying the conduct of physicians with respect to pharmaceutical companies should be openness and transparency.

Nuestro objetivo es dar una amplia visión de los principales desafíos éticos y legales del mercado farmacéutico. El propósito de este estudio fue investigar faltas éticas en el mercado farmacéutico, el efecto de la recepción de regalos por parte de los medicos y la influencia de las percepciones respecto de la importancia de la ética y la responsabilidad social en las intenciones éticas de los profesionales del mercado. También se investigó el efecto de las faltas éticas sobre el consumidor último (el paciente). Se realizó un estudio, mediante una encuesta cuestionario, con dos categorías principales: (i) médicos/consultores y (ii) empresas farmacéuticas. En Pakistán no existe un mecanismo para monitorear la campaña promocional de medicamentos realizada por la industria farmacéutica, a pesar de existir bastante evidencia de que ha aumentado la farmacoterapia irracional, incluso en países en desarrollo, debido a prácticas contrarias a la ética de la promoción farmacéutica. Los médicos practicantes y la industria farmacéutica sirven a intereses que algunas veces se superponen y otras entran en conflicto. Existe fuerte evidencia de que las asociaciones entre la industria y los médicos influyen el comportamiento de los últimos, tanto en relación con la toma de decisiones clínicas como en la promoción contraria a la ética de medicamentos. La apertura y transparencia debieran ser los principios básicos que fundamenten la conducta de los médicos respecto de las empresas farmacéuticas.

Nosso objetivo é dar uma ampla visão dos principais desafios éticos e legais do mercado farmacêutico. O propósito deste estudo foi investigar faltas éticas no mercado farmacêutico, o efeito da recepção de brindes por parte dos médicos e a influência das percepções a respeito da importância da ética e da responsabilidade social nas intenções éticas dos profissionais do mercado. Também se investigou o efeito das faltas éticas sobre o consumidor último (o paciente). Foi realizado um estudo, mediante um questionário, com duas categorias principais: (i) médicos/consultores e (ii) empresas farmacêuticas. No Paquistão não existe um mecanismo para monitorar a campanha promocional de medicamentos realizada pela indústria farmacêutica, apesar de existir bastante evidência de que tem aumentado a farmacoterapia irracional, inclusive em países em desenvolvimento, devido a práticas contrárias à ética da promoção farmacêutica. Os médicos praticantes e a indústria farmacêutica servem a interesses que algumas vezes se superpõem e em outras entram em conflito. Existe forte evidência de que as associações entre a indústria e os médicos influenciam o comportamento destes últimos, tanto em relação à tomada de decisões clínicas quanto na promoção contrária à ética dos medicamentos. A abertura e transparência deveriam ser os princípios básicos que fundamentam a conduta dos médicos a respeito das empresas farmacêuticas.