EEffect of Pharmaceutical Marketing Practice on Physicians’ Prescribing Behavior in the Gaza Strip
Rafat Subhi Abd Elftah Aburedwan
رأفت صبحي عبد الفتاح أبو رضوان
Pharmaceutical Companies (PCs) are using different marketing activities to influence physicians’ prescribing behavior. However, the interaction between physicians and PCs is a real leading factor for conflicts of interest that negatively impact physician prescribing behaviors worldwide. The aim of this study is to identify the effect of pharmaceutical marketing practice on physicians’ prescribing behavior in the Gaza Strip (GS). To fulfill the aim of the study, the researcher followed a mixed approach that utilizes quantitative and qualitative data. For quantitative data, a cross-sectional, descriptive-analytical survey was utilized among specialist physicians working in the governmental hospitals as well as the private hospitals and clinics in the GS in 2020. A self-administered well-structured questionnaire was used. For the qualitative part, focus groups and in-depth interviews were used for data collection from physicians, pharmacists, and pharmaceutical medical representatives (PMRs). Data were analyzed using SPSS. The questionnaire response rate is 91.3% (347 returned questionnaires) was achieved. This study revealed that many physicians prefer the internet (82.4%) the medical, textbooks (80.2%), and academic journals (74%) as sources of drug information rather than commercial sources of medical information However, nearly (64.2%) of physicians depend on detailing as a source of drug information. Also, 70.8%, 68.6% of physicians agreed on the importance and credibility of information provided through PMRs about the new and old drugs respectively. Results highlighted the complex correlated factors that impact physicians’ prescription behavior. These factors were categorized into drug characteristics (80.1%), organizational factors (79.1%), physician factors (75.8%), patient contexts (69.3%), and the least influential factor was pharmaceutical company factors (59.9%). However, results showed that there is an active interaction between physicians and the PCs. Findings revealed that 96% of the study sample had been visited by PMRs at least once a month. Almost all of the physicians (98.3%) received at least one of the marketing tools offered by (PCs). PMRs detailing has become prevalent in health facilities in the GS with 96.2% of physicians received skillful detailing. The provision of promotional printed material (95.7%), free medical samples (93.9%), and inexpensive gifts (74.6%) were the major prescribing inducement tools used by PMRs. The study results revealed that the current marketing tools have a considerable effect on drug choice decisions (64.2%), motivating physicians to prescribe promoted drugs (65.2%) and new drugs (66.8%). However, the influence of these tools was not similar in their effect. The most effective tools used were detailing and discussions with PMRs (73.4%). The following characteristics were significantly associated with the effect of pharmaceutical marketing on physicians’ prescription behavior: age, years of practice, average monthly income, income satisfaction, graduation country of bachelor. Also, results confirm that physicians (61.73%) are prepared to implement regulations and ethical codes that govern physicians – PMRs interactions. In conclusion, there is an active interaction between physicians and the pharmaceutical industry in the GS in both private and public sectors. These interactions had a considerable role in affecting physicians’ prescription behavior. An agreed drug prescribing policy, as well as a comprehensive guideline for physicians’ interactions with pharmaceutical companies along with follow-up mechanisms for its enforcement, should be created. Also, should promote the concept of essential drug list of medicines and developing clear protocols and guidelines and applying them. Also establish comprehensive formal training courses for physicians on their prescribing behavior. Promoting the concept of rational use of medicines and developing protocols and guidelines and enforcing them.