Three-country study on pharmaceutical sales visits in primary care

Health care professionals play an extremely important role in the Pharmaceutical field: they need accurate and authentic information about drugs to make informed decisions for quality prescription. 

The provision of safety information before and during treatment is needed to raise awareness of the potential risks relating to that drug. For this purpose, the sales representative from different pharmaceutical companies pay frequent visits to the health care professionals to help keep physicians aware and to market their products. The effectiveness and the influence of those interactions on the prescription can be very helpful to study. This study (Reynolds E, et al. Reconciling a “pleasant exchange” with evidence of information bias: A three-country study on pharmaceutical sales visits in primary care) specifically focused on the interactions of sales representatives with pharmaceutical professionals particularly in regard to their perspective on the provision of safety information and their influence on prescribing that drug. 

For this three-country study, a diverse sample of fifty-seven health care professionals participated among which 38 were men and 19 women. They initially considered themselves to be immune to influence. 12 focus groups were conducted across Canada, France, and the United States for which the thematic data analysis was done to find results. 

Results revealed that the sales orientations of the representative’s visits were acknowledged by physicians as they also valued information on new drugs and drug reminders. Moreover, the authors also found out the gifts and samples were one of the reasons for pleasant sales interaction. 

 The safety information quality was seen by all physicians to be presented neglecting harmful effects unless asked. They also agreed on probing more about the drug’s effects to make informed prescriptions. Further researchers found the scientific quality of the information provided was satisfactory and some reported not to be qualified for the assessment of the scientific quality of the information provided. With one physician stating “I’m not an academic”, “I don’t feel qualified to be able to tell how scientific it really is”.

 The other component observed was the influence of those sales visits on prescription upon which most had a view that they were not influenced by a sales visit of representatives to prescribe that drug. As a physician mentioned that “I like to do what I feel is evidence-based” and also shared their strategies to avoid influence. One strategy was to align the presented information with the external, independent (other specialists) and non-commercial (online concise resources or academic detailing) sources of drug information. 

If prescribing is based on an inaccurate assessment of the balance of potential benefits and harm from medicine, it puts patients at increased risk of harm so this study highlighted that unbiased and informed prescription by physicians is important for the quality of health. Hence these visits should be professionally regulated and have no commercial bias or conflict of interest.

Further, the studies in the future should be conducted to observe the changing attitude of young healthcare professionals in school and their influence on senior professionals.

Source: Reynolds E, et al. Reconciling a “pleasant exchange” with evidence of information bias: A three-country study on pharmaceutical sales visits in primary care. Health Policy (2018), 

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