The Debate on Influencing Doctors’ Decisions: Are Drug Characteristics the Missing Link?

Decision-making by physicians on patients’ treatment has come under increased public scrutiny. In fact, there is a fair amount of debate on the effects of marketing actions of pharmaceutical firms toward physicians and their impact on physician prescription behavior. While some scholars find a strong and positive influence of marketing actions, some find only moderate effects, and others even find negative effects. Debate is also mounting on the role of other influencers (such as patient requests) in physician decision-making, both on prescriptions and sample-dispensing. The authors argue that one factor that may tip the balance in this debate is the role of drug characteristics, such as a drug’s effectiveness and a drug’s side effects. Using a unique data set, they show that marketing efforts – operationalized as detailing and symposium meetings of firms to physicians – and patient requests do affect physician decision-making differentially across brands. Moreover they find that the responsiveness of physicians’ decision-making to marketing efforts and patient requests depends upon the drug’s effectiveness and side effects. The paper presents clear guidelines for public policy and managerial practice and envisions that the study of the role of drug characteristics – such as effectiveness and side effects – may lead to valuable insights in this surging public debate.public policy;side effects;sampling;Physician decision-making;drug effectiveness;drug prescription;marketing efforts;patient requests;pharmaceuticals;sample-dispensing

The Debate on Influencing Doctors’ Decisions: Are Drug Characteristics the Missing Link?

Decision-making by physicians on patients’ treatment has come under increased public scrutiny. In fact, there is a fair amount of debate on the effects of marketing actions of pharmaceutical firms toward physicians and their impact on physician prescription behavior. While some scholars find a strong and positive influence of marketing actions, some find only moderate effects, and others even find negative effects. Debate is also mounting on the role of other influencers (such as patient requests) in physician decision-making, both on prescriptions and sample-dispensing. The authors argue that one factor that may tip the balance in this debate is the role of drug characteristics, such as a drug’s effectiveness and a drug’s side effects. Using a unique data set, they show that marketing efforts – operationalized as detailing and symposium meetings of firms to physicians – and patient requests do affect physician decision-making differentially across brands. Moreover they find that the responsiveness of physicians’ decision-making to marketing efforts and patient requests depends upon the drug’s effectiveness and side effects. The paper presents clear guidelines for public policy and managerial practice and envisions that the study of the role of drug characteristics – such as effectiveness and side effects – may lead to valuable insights in this surging public debate

Moderating effects of contextual factors on relationship between pharmaceutical marketing strategies and physician prescription decision: A review

Decision–making by physicians on patients’ treatment has received increased  research attention. Research on the effect of marketing strategies on prescription behaviour has tended to generate controversial results. While some researchers reported a strong influence, some found only moderate effects, while others find no influence at all. The main objective of this paper is to review the influence of the marketing strategies by pharmaceutical firms and contextual factors on physician attitude to drug prescription. The paper presents comprehensive information on pharmaceutical marketing efforts through exhaustive review of relevant literature, and identifies the moderating effects of contextual factors on physician prescribing  decisions. It also presents a crucial conceptual model for explaining the theoretical linkages between marketing strategies of pharmaceutical firms, contextual factors and the decision of the physician regarding drug prescription.Keywords: Drugs, marketing strategy, Physician prescription, Drug characteristics, Physician persistence, Cost/benefi

Characteristics and Impact of Drug Detailing for Gabapentin

BACKGROUND: Sales visits by pharmaceutical representatives (“drug detailing”) are common, but little is known about the content of these visits or about the impact of visit characteristics on prescribing behavior. In this study, we evaluated the content and impact of detail visits for gabapentin by analyzing market research forms completed by physicians after receiving a detail visit for this drug. METHODS AND FINDINGS: Market research forms that describe detail visits for gabapentin became available through litigation that alleged that gabapentin was promoted for “off-label” uses. Forms were available for 97 physicians reporting on 116 detail visits between 1995 and 1999. Three-quarters of recorded visits (91/116) occurred in 1996. Two-thirds of visits (72/107) were 5 minutes or less in duration, 65% (73/113) were rated of high informational value, and 39% (42/107) were accompanied by the delivery or promise of samples. During the period of this study, gabapentin was approved by the US Food and Drug Administration only for the adjunctive treatment of partial seizures, but in 38% of visits (44/115) the “main message” of the visit involved at least one off-label use. After receiving the detail visit, 46% (50/108) of physicians reported the intention to increase their prescribing or recommending of gabapentin in the future. In multivariable analysis, intent to increase future use or recommendation of gabapentin was associated with receiving the detail in a small group (versus one-on-one) setting and with low or absent baseline use of the drug, but not with other factors such as visit duration, discussion of “on-label” versus “off-label” content, and the perceived informational value of the presentation. CONCLUSIONS: Detail visits for gabapentin were of high perceived informational value and often involved messages about unapproved uses. Despite their short duration, detail visits were frequently followed by physician intentions to increase their future recommending or prescribing of the drug

Sales Growth of New Pharmaceuticals Across the Globe: The Role of Regulatory Regimes

Prior marketing literature has overlooked the role of regulatory regimes in explaining international sales growth of new products. This paper addresses this gap in the context of new pharmaceuticals (15 new molecules in 34 countries) and sheds light on the effect regulatory regimes have on new drug sales across the globe. Based on a time-varying coefficient model, we find that differences in regulation substantially contribute to cross-country variation in sales. One of the regulatory constraints investigated, i.e. manufacturer price controls, has a positive effect on drug sales. The other forms of regulation such as restrictions of physician prescription budgets and the prohibition of direct-to-consumer advertising tend to hurt sales. The effect of manufacturer price controls is similar for newly launched and mature drugs. In contrast, regulations on physician prescription budget and direct-to-consumer advertising have a differential effect for newly launched and mature drugs. While the former hurts mature drugs more, the latter has a larger effect on newly launched drugs. In addition to these regulatory effects, we find that national culture, economic wealth, introduction timing, lagged sales and competition, also affect drug sales. Our findings may be used as input by managers for international launch and sales decisions. They may also be used by public policy administrators to compare drug sales in their country to other countries and to assess the role of regulatory regimes therein.economics;regulation;culture;drug;international new product growth;penalized splines;pharmaceutical;timevarying effects

Competitive reactions to personal selling:the difference between strategic and tactical actions

A recurring question facing managers is how (if at all) to react to competitive actions. In this research the authors distinguish between reactions to competing strategic and competing tactical actions, different from prior homogeneous definitions of competitive actions. Using a unique, single-source dataset of personal selling interactions between firms and customers covering fourteen drug categories, the authors shows that substantial differences in reactions exist. In particular, strategic actions elicit competitive responses with stronger short- and long-term consequences compared to tactical actions. Furthermore, while the decision to react to competing strategic actions is always warranted, this is not the case for a substantial amount of tactical actions, where firms retaliate with an ineffective marketing instrument, or accommodate with an effective marketing instrument. This divide between actions is further exacerbated in the strength of the reactions that we observe: stronger or weaker reactions to strategic actions occur in line with theoretical expectations, whereas reactions to tactical actions often are not. Based on these findings, the authors suggest directions to improve decision maker’s reactions to competing tactical action

Do All Your Detailing Efforts Pay Off? Dynamic Panel Data Methods Revisited

We estimate a sales response model to evaluate the short- and long-term value of pharmaceutical sales representatives’ detailing visits to physicians of different types. By understanding the dynamic effect of sales calls across heterogeneous doctors, we provide guidance on the design of optimal call patterns for route sales. Our analyses reveal that the long-term persistence effect of detailing is more pronounced for specialist physicians; the contemporaneous marginal effect is higher for generalists. Free samples have little effect on any type of physician. We also introduce a key methodological innovation to the marketing and economics literatures. We show that moment conditions—typically used in traditional dynamic panel data methods—are vulnerable to serial correlation in the error structure. However, traditional tests to detect serial correlation have weak power and can be misleading, resulting in misuse of moment conditions and incorrect inference. We present an appropriate set of moment conditions to properly address serially correlated errors in analyzing dynamic panel data

Sales Growth of New Pharmaceuticals Across the Globe: The Role of Regulatory Regimes

Prior marketing literature has overlooked the role of regulatory regimes in explaining international sales growth of new products. This paper addresses this gap in the context of new pharmaceuticals (15 new molecules in 34 countries) and sheds light on the effect regulatory regimes have on new drug sales across the globe. Based on a time-varying coefficient model, we find that differences in regulation substantially contribute to cross-country variation in sales. One of the regulatory constraints investigated, i.e. manufacturer price controls, has a positive effect on drug sales. The other forms of regulation such as restrictions of physician prescription budgets and the prohibition of direct-to-consumer advertising tend to hurt sales. The effect of manufacturer price controls is similar for newly launched and mature drugs. In contrast, regulations on physician prescription budget and direct-to-consumer advertising have a differential effect for newly launched and mature drugs. While the former hurts mature drugs more, the latter has a larger effect on newly launched drugs. In addition to these regulatory effects,