Impact of Pharmaceutical Industry Promotion Mix on Doctor's Prescribing Behaviour‪.‬

Introduction Pharmaceutical marketing is unique as the decision making of buying the medicine lies in the hand of intermediate customer (doctor) rather than final consumer (patient). Thus pharmaceutical companies try to influence the customer (doctor) rather than final consumer (Patient). Thus doctors are the most important players in pharmaceutical marketing system. Doctors write the prescriptions that determine which drugs (brands) will be used by the consumer (patient). Thus influencing the doctor is a key to the pharmaceutical sales. Pharmaceutical companies try to influence prescription pattern of doctors in favor of their brands by offering various kinds of promotional inputs like samples, gifts and sponsorships etc. (Arora and Taneja, 2006). Usual marketing practices followed by most of the large and mid-sized companies include valuable gifts, arranging foreign trips with family and complimentary tickets and memberships for social activities to doctors (Jayakumar, 2008). Interaction of the medical professional with the pharmaceutical industry starts as early as in medical school. The doctor and sales representative meet about 4 times a month (Ziegler et al, 1995). In Canada, on an average 6 gifts are received per year by doctors with average value of $60. Eighty per cent of residents take pharmaceutical industry paid meals about 14 times in a year in Canada (Hodges, 1995). The expenses for travel, stay and even local sight seeing are paid directly to the tour operator by the pharmaceutical company or travel ticket and hotel accommodation are booked by the company in the name of the doctor. The expenses of not only the doctor but also of their spouse and family are borne by the pharmaceutical companies (Mehta, 2000). The policies adopted by the pharmaceutical firms may include extravagant marketing practices like offering vacation/travel expenses; gifts of substantial value; lavish meals and entertainment; offering cash/ commission for prescribing a particular brand/drug; offering money for drug trial; samples and promotional material; and CME (continuous medical education) funding and honoraria (Wazana, 2000). One study involving about one hundred doctors, conducted to determine the roles of various information sources in influencing the prescribing behaviour of doctors, revealed that promotional information by pharmaceutical companies (commercial sources) plays a greater role in the decision process of the doctors to prescribe the drugs than even scienfic sources of the information (Chaganti, 2005). Social scientists describe and the pharmaceutical industry follows the, "norm of reciprocity" i.e., the obligation to help those who have helped you, as one of the fundamental guiding principle of human interactions. It is not surprising, therefore, that pharmaceutical companies rely on this principle of human nature by giving gifts to doctors in hope that they will prescribe their firm's product in return (Verma, 2004).