Chest

Chest

Volume 102, Issue 1, July 1992, Pages 270-273
Journal home page for Chest

The Effects of Pharmaceutical Firm Enticements on Physician Prescribing Patterns: There's No Such Thing as a Free Lunch

https://doi.org/10.1378/chest.102.1.270Get rights and content

We examined the impact on physician prescribing patterns of pharmaceutical firms offering all-expenses-paid trips to popular sunbelt vacation sites to attend symposia sponsored by a pharmaceutical company. The impact was assessed by tracking the pharmacy inventory usage reports for two drugs before and after the symposia. Both drugs were available only as intravenous preparations and could be used only on hospitalized patients. The usage patterns were tracked for 22 months preceding each symposium and for 17 months after each symposium. Ten physicians invited to each symposium were interviewed about the likelihood that such an enticement would affect their prescribing patterns. A significant increase in the prescribing pattern of both drugs occurred following the symposia. The usage of drug A increased from a mean of 81 ± 44 units before the symposium to a mean of 272 ± 117 after the symposium (p<0.001). The usage of drug B changed from 34 ± 30 units before the symposium to 87 ± 24 units (p<0.001) after the symposium. These changed prescribing patterns were also significantly different from the national usage patterns of the two drugs by hospitals with more than 500 beds and major medical centers over the same period of time. These alterations in prescribing patterns occurred even though the majority of physicians who attended the symposia believed that such enticements would not alter their prescribing patterns. (Chest 1992; 102:270–73)

Section snippets

METHODS

Drug A was a new intravenous antibiotic. Physicians from our institution were invited to an all-expenses-paid trip for themselves and a guest to a luxurious resort on the West Coast.

Drug B was a new intravenous cardiovascular drug. The course was held at an island resort in the Caribbean. All expenses were paid for the physician and a significant other, including airfare, accommodations, meals, and an allowance for incidental expenses. We subsequently discovered that a similar trip had been

RESULTS

The majority of physicians interviewed insisted that elaborate enticements, such as an all-expenses-paid trip to a luxury resort to learn about a new drug, would in no way influence their prescribing decisions (Table 1). They appeared to sincerely believe that any decision to prescribe a drug is based on scientific data, clinical experience, and patient needs, rather than on promotion by pharmaceutical companies. A few physicians were not quite so absolute in their denial, and admitted that

DISCUSSION

Despite a lack of published data on the impact of pharmaceutical firm marketing techniques on the prescribing practices of physicians, it is unlikely that companies would spend large sums of money on marketing efforts if they were not felt to be effective. We have demonstrated that one elaborate promotional technique, the expense-paid seminar at a resort, was associated with a significant increase in the prescribing of the promoted drugs at one institution. This change occurred in spite of the

REFERENCES (15)

There are more references available in the full text version of this article.

Cited by (0)

View full text
Copyright © 1992 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.