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Medicine promoting marketing factors: Survey among medical representatives in Bangladesh

Authors:

Abstract

Introduction: This study was aimed at gaining marketing insight by analysis of factors that influence medical representatives’ drug promotion and thus the prescription preparation of physicians. Methods: A descriptive cross-sectional study was conducted from February to October, 2013 among medical representatives by purposive convenient sampling. A structured questionnaire with measurements on 5-point Likert Scale was provisioned. Data input, format, transformation and analysis were performed using SPSS version 22 and Microsoft Excel 2010. Results: A total of 245 medical representatives were enrolled who were affiliated with a pharmaceutical company. Representatives’ improvisation, easy brand availability, regular promotion and company image are the factors having most influence. Easy brand name, low price and international certification of the company were on lower side. Conclusion: This study contains a brief summary of experience of medical representatives and insights of this paper will be helpful for marketers to ensure greater effectiveness and economic efficiency from drug prescribing.
Research Article
MEDICINE PROMOTING MARKETING FACTORS: SURVEY AMONG MEDICAL
REPRESENTATIVES IN BANGLADESH
1S.M. Yasir Arafat, 2,*Zuhayer Ahmed, 2Md. Jahid Hasan and 3S.M. Hafiz Al Asad
1Bangabandhu Sheikh Mujib Medical University & State University of Bangladesh
2Dhaka Medical College Hospital, Bangladesh
3University of Dhaka, Bangladesh
ARTICLE INFO ABSTRACT
Introduction: This study was aimed at gaining marketing insight by analysis of factors that influence
medical representatives’ drug promotion and thus the prescription preparation of physicians.
Methods: A descriptive cross-sectional study was conducted from February to October, 2013 among
medical representatives by purposive convenient sampling. A structured questionnaire with
measurements on 5-point Likert Scale was provisioned. Data input, format, transformation and
analysis were performed using SPSS version 22 and Microsoft Excel 2010.
Results: A total of 245 medical representatives were enrolled who were affiliated with a
pharmaceutical company. Representatives’ improvisation, easy brand availability, regular promotion
and company image are the factors having most influence. Easy brand name, low price and
international certification of the company were on lower side.
Conclusion: This study contains a brief summary of experience of medical representatives and
insights of this paper will be helpful for marketers to ensure greater effectiveness and economic
efficiency from drug prescribing.
Copyright © 2016, S.M. Yasir Arafat et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original work is properly cited.
INTRODUCTION
Investment on pharmaceutical companies has been accelerated
greatly in recent years and is now the fastest growing
component of the health care budget (Heffler et al., 2001). In
the countries of the Organization for Economic Cooperation and
Development (OECD), average pharmaceutical expenditure
accounts about 1.5% of the Gross Domestic Product (GDP).
However, it is notable that in real terms, it grows by 4.6%
annually, which is higher than the growth rate of total
healthcare expenditure (Theodorou et al., 2009). In Bangladesh,
it contributes about 1% to the GDP and is the third largest
industry in terms of contribution to government revenue
(Sultana and Khosru, 2011). Pharmaceutical expenditure has
risen rapidly over the past few decades in most western
countries, for which the policymakers reacted with healthcare
reforms and measures to guarantee the sustainability of health
care systems of respective countries (Barber, 2005). There is
widespread concern, however, that increased expenditures too
often result from more advertising of drugs that do not provide
more effective or efficient care (Wilkes et al., 2000).
*Corresponding author: Zuhayer Ahmed,
Dhaka Medical College Hospital, Bangladesh.
Direct-to-consumer advertising of prescription drugs has
become controversial for a number of reasons (Rosenthal et al.,
2002). So, drug promotion by sales representative visits to
physicians has gained priority for a long time in most of the
pharmaceutical companies. Although a wide range of views
prevail amongst health professionals about pharmaceutical
promotion, qualitative studies suggest that many of them
perceive it to be a useful and convenient source of information
(Prosser and Walley, 2003; Chimonas et al., 2007; Fischer et
al., 2009). Some doctors prefer to claim that they are not
influenced by pharmaceutical company promotion though it
influences others (Steinman et al., 2001). However, the sales
division, comprising of medical representatives, is playing the
imperative role for marketing division (Arafat et al., 2016).
Medical representatives regularly make sales call to doctors by
sharing scientific information and competitive advantages of
their products over the competitors (Habib and Alam, 2011).
Spurling et al. mentioned that decrease in visiting time of
medical representatives to physicians decreased in the rate of
prescription rate of that particular drug (Spurling et al., 2010).
So, a conventional way of promoting prescription rates, sales
representative visits, still plays an important promotional role.
It is notable that no other study has attempted so far to analyze
the marketing factors and its influence on medical
representatives to motivate Bangladeshi physicians.
International Journal of Information Research and Review
Vol. 03, Issue, 05, pp. 2315-2318, May, 2016
Article History:
Received 16th February 2016
Received in revised form
21st March 2016
Accepted 19th April 2016
Published online 30th May 2016
International Journal of Information Research and Review, May, 2016
Keywords:
Medicine, Prescriptions,
Medical Representatives,
Pharma Marketing.
The main focus of this study was to gain marketing insight by
analysis of factors those influence the prescription preparation
of physicians. Knowing the factors that drive the medical
representatives to promote a drug may be helpful for the
pharmaceuticals to frame a strategy to keep sales department
motivated to a level that will serve the purpose of the
companies.
METHODS
It was a descriptive type of cross-sectional study conducted for
a period of 8 months from February to October, 2013 among
medical representatives from 16 pharmaceutical companies. In
this study, medical representatives from the districts of Dhaka,
Rangpur, Comilla, Narayanganj, Mymensingh and Khulna were
approached by convenient sampling. A structured questionnaire
was prepared and finalized after pre-testing. Pre-testing was
done on 40 medical representatives and minimal change was
done after pretesting. Measurements were made on the basis of
5 point Likert Scale. ‘Non response’ was very minimal and that
was filled up by neutral value. All data input, format,
transformation and analysis were performed using SPSS 22
version and Microsoft Excel 2010.
RESULTS AND DISCUSSION
A total of 245 medical representatives were enrolled. All were
affiliated with a pharmaceutical company and spent most of
their time in direct contact with physicians. Characteristics of
participants are displayed in Table 1.
Table 1. Distribution of respondents by
demographic characteristics
Characteristics Percentage
Age
< 25 years
25-35 years
36-45 years
>45
3.7
84.9
9.8
1.6
Sex
Male
Female
97.1
2.9
Designation
MSO
FM/AM/ASM
RSM
86.5
12.7
0.8
Region
Dhaka
Narayanganj
Rangpur
45.3
30.2
24.5
MSO: Medical Sales Officer, FM:
Field Manager, AM: Area Manager,
ASM: Area Sales Manager, RSM:
Regional Sales Manager.
Among the participants, 238 were male and 7 were female,
with 84.9% from 25-35 years age group. 212 were medical
sales officer and 33 were area and regional manager. 45.3%
were from Dhaka. In Figure 1, marketing factors and response
for each factor in 5-point Likert scale were presented after
analysis. Representatives’ improvisation (40.8%), easy brand
availability (51%), regular promotion (45.3%) and company
image (37.1%) had more impact comparing with other factors.
37.1% strongly agreed that scientific information had an impact
on prescription.
Easy brand name (23.7%), low price (13.9%) and international
certification of the company (25.3%) were on lower side in the
survey response. However, nobody strongly agreed that
personal experience and promotional tools had an influence on
physicians’ prescription. (Figure 2).
Figure 1. Medicine promoting marketing factors.
Responses presented in percentages in 5-point Likert scale
The progressive importance of promotion to health care
professionals reinforces the conventional wisdom that
physicians are most likely reluctant to prescribe a drug unless
they are familiar with it and are comfortable prescribing it
(Rosenthal, 2002). In a systematic review, it was stated that
among the 29 pharmaceutical sales representative visits, 17 was
associated with increased prescribing of the promoted drug
(Spurling et al., 2010). So, regular sales visit to physicians had a
positive impact on prescription behavior of the physicians. It is
similar to our study as 45.3% participants strongly agreed that
regular promotional activities increase the prescription of
intended drug by the physicians.
On direct-to-consumer advertising, almost surely adds to
physicians’ workloads by requiring them to help patients
interpret the information presented by advertisers.
Pharmaceutical companies have disrupted long-standing
conventions governing the doctor–patient relationship in
bypassing physicians (Rosenthal, 2002). So, conventional
promotions through sales officers always warrant the prime
choice for pharmaceutical companies. An association with more
frequent prescribing was more likely when pharmaceutical sales
representatives visited groups of physicians, when physicians
had lower baseline prescribing of the promoted drug (Rosenthal,
2002; Steinman et al., 2007).
2316 S.M. Yasir Arafat et al. Medicine promoting marketing factors: survey among medical representatives in Bangladesh
Sales representative visits to physicians and residents for longer
period were also more likely to be associated with increased
prescribing (Clinical approach to the patient with diabetes
mellitus and very high insulin requirements, 2010). So,
deploying same representative to a physician is also associated
with better outcome. If this cohort is satisfied with their job,
they will enjoy their job and visit at their own will. However,
leave facility and job security are main factors identified for
their satisfaction and adhering to the job, which in turn will be
beneficial for the pharmaceutical companies (Arafat et al.,
2015).Medical representatives strongly agreed upon several
strategies used by pharmaceutical companies to influence the
prescribing behaviors including easy availability of the brands
in drug stores, regular promotive activities and representatives’
improvisation. In a study on NSAID prescribing behavior, it
was revealed that practice guidelines, peer-reviewed evidence
and local physician experts were viewed as important
counterweights to the influence of pharmaceutical companies on
prescribing behaviors. All study participants there described
routine experiences with pharmaceutical marketing and their
use of counterweights to this influence (Naik et al., 2009).
However, effect of journal advertisement was not measured in
this study because most of pharmaceutical companies in
Bangladesh do not rely on that. Though it was revealed in a
study that use of a medication class increased after
pharmaceutical advertising commenced in a country where the
medication class was previously available but was not promoted
(Hemminki et al., 2004). Finally, a qualitative study that was
carried out in 2007 in Denmark had almost similar results of our
own. It showed that drug price was considered an important
factor influencing prescribing decision as 33.9% of medical
representatives agreed and another 13.9% strongly agreed upon
that low price was more persuasive for the physicians
(Buusman et al., 2007).
Conclusion
According to medical representatives, the physicians’ choice of
drugs and companies’ influence on their choice were dependent
on a constellation of factors, most prominently brand
availability, regular promotion and representatives’
improvisation. Personal experience with drugs and promotional
tools had no impact at all. This study contains a brief scenario
of the efforts of medical representatives to incline prescriptions
in their favorable way. Whole country coverage would be
helpful for better generalization of the findings. Addition of
negative questions in the questionnaire would more solidify the
perception. This study contains a brief summary of experience
of medical representatives and insights of this paper will be
helpful for marketers to ensure greater effectiveness and
economic efficiency from drug prescribing.
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2318 S.M. Yasir Arafat et al. Medicine promoting marketing factors: survey among medical representatives in Bangladesh
... Pharmaceutical industry is one of the progressive sectors in Bangladesh economy [1,2]. It contributes 1% to the country's GDP and is the third largest industry in terms of contribution to government revenue [1,2,3]. The current market size is about 12,100 million with having almost persistently double-digit growth [2]. ...
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The aim of the study is to present the current scenario of the pharmaceutical industry in Bangladesh. Since inception, there was little consensus on the development of pharmaceutical policies best suited in a developing country such as Bangladesh. Here, the pharmaceutical industry developed rapidly from the 1980s after the introduction of Drug (Control) Ordinance-1982. Adequate infrastructure and use of trained manpower were two essential requisites for implementation of national pharmaceutical policies in Bangladesh. The country was importing significant amount of medicine and also raw materials for the industry from abroad. But the industry has started to export its products in foreign market, especially in the Middle East and Europe with great success. This study tries to identify the major problems of marketing, exporting, production and operations, quality control in the pharmaceutical sector and proposes strategies to overcome these problems, it also identifies the prospects of pharmaceutical industry in Bangladesh.Keywords: Drug; Problem; Education; Health; Policy; Pharmaceutical; Deficit; Facilities; Executives.DOI: http://dx.doi.org/10.3329/jbt.v6i1.9995 Journal of Technology (Dhaka) Vol. 6(1), January-June, 2011 61-77
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To describe the taxonomy of methods used by pharmaceutical companies to influence physicians' nonsteroidal anti-inflammatory drug (NSAID) prescribing behaviors and to elicit physicians' perceptions of and counterbalances to these influences. In-depth interviews analyzed using the constant comparative method of qualitative data analysis. Qualitative interviews were conducted with physicians representing various clinical specialties. Interviews were transcribed and coded inductively using grounded theory. Recruitment was stopped at 25 participants after the attainment of thematic saturation, when no new concepts emerged from ongoing analysis of consecutive interviews. Physicians described a variety of influences that shaped their NSAID prescribing behaviors, including detailing and direct contact with pharmaceutical representatives, requests from patients inspired by direct-to-consumer advertisements, and marketing during medical school and residency training. Physicians described practice guidelines, peer-reviewed evidence, and opinions of local physician experts as important counterweights to pharmaceutical company influence. Local physician experts interpreted and provided context for new clinical evidence, practice guidelines, and NSAID-related marketing. The social and communicative strategies used by pharmaceutical companies can be adapted to improve physicians' adoption of guidelines for safer NSAID prescribing. Communicative interactions between local experts and other physicians who prescribe NSAIDs may be the critical target for future interventions to promote safer NSAID prescribing.