Marketing of medicines in primary care: An analysis of direct marketing mailings and advertisements.

INTRODUCTION: Marketing materials from pharmaceutical companies attempt to create a positive image of marketed, often new, medicines. To gain more insight in strategies pharmaceutical companies use to influence primary care practitioners' attitudes towards marketed medicines, we investigated the use of persuasion strategies in direct marketing mailings and advertisements from pharmaceutical companies sent to general practitioners. METHODS: General practitioners in the Netherlands were recruited to collect all direct marketing mailings, meaning all leaflets, letters and other information sent by pharmaceutical industries to the practice during one month (June 2022). Direct marketing mailings and advertisements in collected medical journals concerning medicines or diseases (together called marketing materials) were analysed according to presence of one of the seven common persuasion strategies, i.e. reciprocity, consistency/commitment, social proof, liking, authority, scarcity and unity; as well as marketed medicine and year of introduction. RESULTS: Twenty general practices collected 68 unique marketing materials concerning 37 different medicines. Direct factor Xa inhibitors (n = 12), glucagon-like peptide-1 analogues (n = 5) and sodium-glucose co-transporter 2 inhibitors (n = 4) were the most frequently marketed medicines. The median year of introduction of all marketed medicines was 2012. All seven persuasion strategies were identified, with liking (64.7% of all materials) and authority (29.4%) as most prominent strategies, followed by social proof (17.6%), unity (14.7%), scarcity (13.2%), reciprocity (11.8%) and consistency/commitment (2.9%). In addition to those strategies, we identified emotional pressure (30.9%) as one commonly used new strategy. CONCLUSION: Marketing materials sent to general practices use a wide range of persuasion strategies in an attempt to influence prescription behaviour. Primary care practitioners should be aware of these mechanisms through which pharmaceutical companies try to influence their attitudes towards new medicines.

[What can you do to not be influenced?] / Wat kunt u doen om niet beïnvloed te worden?

OBJECTIVES: To identify persuasion strategies in paper-based marketing materials about medicines, sent to general practices. DESIGN: Observational study. METHOD: Twenty Dutch general practices collected all mail from pharmaceutical companies during one month. These materials were assessed by researchers with backgrounds in pharmacy and marketing for the presence of seven persuasion strategies, described by Cialdini. The researchers also identified the marketed medicines. RESULTS: The general practitioners collected 68 unique marketing materials involving 37 different medicines with a median introduction year of 2012 (range 1966-2022). Factor Xa inhibitors, glucagon-like peptide-1 analogues, and sodium-glucose co-transporter-2 inhibitors were the most marketed drugs. All persuasion strategies described by Cialdini were observed: liking (65% of all materials), authority (29%), social proof (18%), unity (15%), scarcity (13%), reciprocity (12%), and consistency/commitment (3%). Emotional pressure was identified as a new strategy (31%). This strategy leverages the prescriber's professional responsibility by appealing to the physician's duty to do what is best for the patient. CONCLUSION: General practitioners regularly receive paper-based marketing materials about new medicines that attempt to influence the recipient. In the context of rational use of medicines, it is recommended to be vigilant about such persuasion strategies and to make physicians (both practicing and in training) aware of these strategies, including possible mechanisms to resist them whenever possible.