DISCUSSION
This study shows that pharmaceutical marketing influences the prescription
behaviour of physicians. The effectiveness of different methods varies widely. The highly
effective communication process was public relations. These public relation strategies are
more expensive than other strategies. Naturally this will lead to increased cost of
prescription medicines and health care expenditure. Sales personnel had also supported
the importance of public relation in influencing the prescribing behaviour of the doctors.
When the physician listens to the detailing by a sales person and later accepts the
gifts or samples given by the sales person an immediate industry-physician relationship is
established. This puts the doctor under some obligation to prescribe the brands that are
promoted. The time spent with sales personnel is associated with some benefits to the
doctor like getting information and free samples but it takes away the physicians’
valuable time. The time, spend with the sales personnel should be valued against the
monetary or leisure benefits gained in that time. The physician could have utilized the
time for leisure activities, gained monetary benefits through consulting patients or even
improve his/her knowledge by keeping up-to-date with the literature.4
Samples left by the
sales personnel may be the only reminder to the product long after the detailing.
Sampling which is part of any visit by a sales person is not a major factor that influences
prescription according to this study. Both sales personnel and physicians felt that
sampling was only “some what effective” in influencing prescription practice. This 9
contradicts the age old notion that sampling of drugs is the major strategy that influences
prescriptions. When the doctor gives free samples to a patient it was taken as an indicator
that the doctor is sensitive to the financial situation of the patient and it may also indicate
the care and involvement of the doctor.
As expensive promotional strategies increase the spending on health care, one has
to decide whether there should be a control on industry-physician relationships. It has
been shown that gifts, however small, influence the behaviour of the recipient6
. A
prescription has an impact on the health of the patient and may also have financial
advantages for the physicians and the pharmaceutical industry. Industry-physician
relationship is an ideal target for interventions aimed at reducing health care costs.