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08-01-2013 | Article

Even subtle brand-name drug marketing sways prescribing decisions


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medwireNews: Around four out of 10 physicians say they sometimes or often prescribe a brand-name drug to appeal to patients' wishes despite the availability of a generic option, according to a research letter in JAMA Internal Medicine.

The likelihood of a doctor honoring this request for brand-name drugs was positively and significantly associated with contact physicians had with the respective industry.

"It's often hard to identify a medical practice that almost everyone agrees is completely unnecessary and a good example of wasteful medical practice," primary author Eric Campbell (Harvard Medical School, Cambridge, Massachusetts) explained to medwireNews. "Well, prescribing a brand-name drug to a patient when there is a generic available just because the patient wants it is an excellent example."

Campbell and colleagues analyzed 1891 physician surveys. In all, 43% of physicians who practiced for over 30 years said they would sometimes or often accede to patients' demands for brand-name drugs, compared with 31% of physicians who have practiced for 10 years or less.

Of the physicians who received free food and/or beverages from a drug company, 39% gave in to patient requests sometimes or often, which was significantly more than their counterparts who had not received any such dietary perks (33%).

A similar trend was observed among those who received drug samples (40%) versus those who did not (31%).

Physicians who met with industry representatives were also more prone to accede to patient wishes (40%), compared with those who did not have such meetings (34%).

"It's really a testament to [what] people in marketing and social sciences have known for a very long time; giving people small gifts changes their behavior," Campbell said. "It shows that drug company marketing works. Denying that that is the case is like denying that gravity exists."

Campbell pointed out that the marketing issue applies to patients too, when, for example, drug companies provide gifts and funds to disease groups.

The added costs created by unwarranted brand-name drug requests heightens the demand that already stretches Medicare's and Medicaid's resources. Yet, according to Campbell, physicians wrongly view costs as outside their jurisdiction. "Some doctors don't consider money at all in decisions they make," he said. "Think how much costs would go up if all doctors thought that way."

Despite finding that a majority of doctors do not prescribe brand-name drugs based on promotional influences, Campbell still perceived an unethically disproportionate influence of industry on unwarranted prescribing decisions. "[Prescribers] are passing off the price of their lunches to the American public in the form of higher drug prices," he said.

By Peter Sergo, medwireNews Reporter