The attitude and acceptability towards medical promotional tools and their influence on physicians' prescribing practices in Jordan and Iraq: a cross-sectional study

Background

Pharmaceutical companies spend more than one-third of their sales revenue on marketing and promotion directed toward healthcare professionals. There has been a focus on the relationship between healthcare professionals and the pharmaceutical industry in recent years. This study aims to explore the attitude toward and acceptability of medical promotional tools and their influence on physicians’ prescribing practices in Jordan and Iraq.

Methods

A cross-sectional survey study was conducted to explore the influence of visits by medical representatives (MRs) and medical promotions on physicians’ prescribing practices between June and October 2020 in Jordan and Iraq. Previously validated questionnaires were used.

Results

A total of 801 physicians completed the questionnaires. Face-to-face visits, followed by the dispensing of medical samples, were the two most common promotional methods used by MRs. 48% of participating physicians reported that they would accept the promotional marketing tools offered to them. MRs focused on the key selling points of their product during medical promotions, and 39.6% of the physicians reported that MRs had a negative attitude toward their competitors’ products. 69.9% of the physicians reported that they would change their practice after participating in conferences or meetings.

Conclusion

Medical promotional tools have a clear influence on physicians’ prescribing practices in Jordan and Iraq. Therefore, medical promotion should be controlled and guided by clear and country-specific ethical guidelines. This will ensure safe medical promotion to physicians and optimise the healthcare practices provided to patients.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07525-1.

Perceptions of and barriers to ethical promotion of pharmaceuticals in Pakistan: perspectives of medical representatives and doctors

Background

In Pakistan, drug promotion practices, ethical or unethical, have rarely been in the spotlight. We aimed to assess the perception and barriers of medical representatives (MRs) and doctors (MDs) regarding ethical promotion of pharmaceuticals in Pakistan.

Methods

A cross sectional survey was conducted in seven major cities of Pakistan for 6-months period. Self-administered questionnaire was used for data collection. Logistic regression and five-point Likert scale scoring was used to estimate the perceptions and barriers.

Results

Compared to national companies (NCs), the medical representatives (MRs) of multinational companies (MNCs) strongly believed that their companies follow World Health Organization (WHO) (OR; 5.31, p = 0.0005), International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) (OR; 6.45, p = 0.0005) and national codes of ethics (OR; 5.84, p = 0.0005). MNCs trained their MRs (OR; 6.68, p = 0.0005), provide accurate and valid scientific data (OR; 4.01, p = 0.007) with adequate system of accountability and controls on product samples (OR; 1.96, p = 0.047), while, NCs sponsor social or entertainment activities, seminars and conferences, and all sort of facilitation in form of gifts of their choice and clinic renovation for medical doctors (MDs). MDs perceptions were similar to MRs mentioned above, yet strongly agreed that companies offer cash payments or equivalents to MDs. The MRs of NCs/MNCs and MDs agreed/strongly agreed that no external accountability, profiteering, pressure on sale targets, job insecurity, condoning unethical promotion by high-ups’ and business promotion by junior MDs were the predominant barriers.

Conclusion

In conclusion, MRs of MNCs and MDs believed that MNCs follow certain codes of ethics in the promotion of pharmaceuticals, while NCs tend to be more profit oriented and even condone unethical promotion. All stakeholders, MRs, MDs and companies, might pose certain barriers, intentionally or unintentionally, in ethical promotion.

Evaluating Scientific Research Knowledge and Attitude Among Medical Representatives in Jordan: A Cross-sectional Survey

BACKGROUND

Pharmaceutical companies provide a broad range of different mandatory trainings to their medical representatives to keep the business running; however research related training has often been neglected by these companies. Thus, this study was developed to assess the amount of scientific research knowledge and interest among pharmacy medical representatives in Jordan.

METHOD

A cross sectional study was conducted in Jordan in 2016. During the study period, a questionnaire was administered to 250 medical representatives working in pharmaceutical companies to evaluate their scientific research knowledge and attitudes.

RESULTS

The majority of medical representatives had positive attitudes towards clinical trials and research communication and believe that it will increase the value of their work, but a considerable number of medical representatives did not detail clinical trials on every visit and found difficulty in answering clinical trials and research related questions asked by health care professionals. Most of the medical representatives did not have a complete understanding of some basic research terminologies. Medical representatives working in multinational companies seemed to have a significantly better understanding of research and terminologies compared to local companies (P-value= 0.000). Also Medical representatives with higher educational degrees seemed to have significantly better understanding of basic research terminologies (P-value= 0.023).

CONCLUSION

The majority of medical representatives had positive attitudes towards clinical trials and research communication and found that it will increase the value of their work, but still there is a gap in their frequency of detailing. Thus, local pharmaceutical companies need to invest more in research and clinical trials knowledge kind of training. Also, universities need to include research related courses and subject in their bachelors' program curriculum in order to make pharmacists equipped in terms of research knowledge, regardless of the career path they choose.

What do they do? Interactions between village doctors and medical representatives in Chakaria, Bangladesh

BACKGROUND

Informally trained village doctors supply the majority of healthcare services to the rural poor in many developing countries. This study describes the demographic and socio-economic differences between medical representatives (MRs) and village doctors in rural Bangladesh, and explores the nature of their interactions.

METHODS

This study was conducted in Chakaria, a rural sub-district of Bangladesh. Focus group discussions and in-depth interviews were conducted, along with a quantitative survey to understand practice perceptions. Data analysis was performed using grounded theory and bivariate statistical tests.

RESULTS

We surveyed 43 MRs and 83 village doctors through 22 focus group discussions and 33 in-depth interviews. MRs have a higher average per capita monthly expenditure compared to village doctors. MRs are better educated with 98% having bachelor's degrees whereas 84% of village doctors have twelfth grade education or less (p<0.001). MRs are the principal information source about new medications for the village doctors. Furthermore, incentives offered by MRs and credit availability influence the prescription practices of village doctors.

CONCLUSIONS

MRs being the key player in providing information about drugs to village doctors might influence their prescription practices. Improvements in the quality of healthcare delivered to the rural poor in informal provider-based health markets require stricter regulations and educational initiatives for providers and MRs.