Regulation of medicines advertisement in Zimbabwe: an assessment of the impact of pharmaceutical promotion on the prescribing behaviour of healthcare professionals

Background The pharmaceutical industry plays a key role in drug discovery and is considered useful regards to informing the health care workers health care workers about new medicines. Investigations concerning health care workers to industry interactions are less common. The objective of this study is to determine levels of knowledge, attitude and perception towards regulation of pharmaceutical promotion among healthcare practitioners in Zimbabwe. Methods A cross-sectional study was used and 330 healthcare practitioners were enrolled into the study. Data collection was done through combined face-to-face interviews and web-based online survey. The relative importance index score and used as a measure of knowledge, attitude and perception levels towards pharmaceutical promotion. Univariate and bivariate analysis was performed using STATA software package. Results Our study estimated that 95%, 67%, and 90% of the healthcare practitioners in Zimbabwe have a favourable (i.e. > 65%) relative importance index score of knowledge, attitudes, and perception, respectively, towards regulation of pharmaceutical promotion. Further exploration of the data indicated that the factors that had an association with the knowledge, attitude and perception levels towards regulation of pharmaceutical regulation at 5% level of significance include health care workers’ profession, gender, education level, the nature of the working institution and the number of prescriptions involved per week. Conclusion In conclusion, the findings of this study highlighted that in general the health care workers in Zimbabwe have higher levels of knowledge, attitude and perception towards regulation of pharmaceutical promotion, though the attitudes levels weres a bit lower compared to other domains.

The influence of direct-to-physician promotion towards physicians’ prescription behaviour in Malaysia

Purpose The purpose of this paper is to investigate the influence of direct-to-physician promotion on physicians’ prescription behaviour. There were very few studies which have investigated to what extent the pharmaceutical promotion directed towards physicians influences physicians’ prescription behaviour in the Malaysian context. Design/methodology/approach A research framework has been developed based on the buyer behaviour stimulus-response model. A survey method has been used to collect data from 154 medical practitioners from private health-care facilities located at Klang valley in Malaysia. IBM SPSS and SmartPLS statistical programs have been used to analyse the data and validate the model. Findings This study found that personal selling is the most significant promotional tool for physicians’ prescription behaviour, whereas advertising is the least significant one. Sales promotion and public relations are the second and third most significant promotional tools. Direct marketing is found to be not significant. Practical implications This paper will help the pharmaceutical companies develop more effective plans to gain a competitive advantage for their business by having a guideline for pharmaceutical marketers as an input to the more efficient allocation of their promotional budgets. Originality/value This study has introduced a comprehensive understanding of all the factors in the pharmaceutical promotion that influence physicians’ prescription behaviour in Malaysia and how these factors are interrelated, influencing physicians’ prescribing medicines for patients.

Regulation of Medicines Advertisement in Zimbabwe: An Assessment of The Impact of Pharmaceutical Promotion On The Prescribing Behaviour of Healthcare Professionals

BackgroundThe pharmaceutical industry plays a key role in drug discovery and is considered useful regards to informing the health care workers health care workers about new medicines. There are growing concerns related to regulating promotion of pharmaceutical products and there is notable evidence to suggest it has a significant impact health care workers’ decision-making. Investigations concerning health care workers to industry interactions are less common. The objective of this study is to determine levels of knowledge, attitude and perception towards regulation of pharmaceutical promotion among healthcare practitioners in Zimbabwe. MethodsA cross-sectional study was used and 330 healthcare practitioners were enrolled into the study. Data collection was done through combined face-to-face interviews and web-based online survey. The study was approved for ethics by the Joint Research Ethics Committee. We calculated the relative importance index score and use as a measure the of knowledge, attitude and perception levels towards pharmaceutical promotion. Univariate and bivariate analysis was performed using STATA software package. ResultsOur study estimated that 95%, 67%, and 90% of the healthcare practitioners in Zimbabwe have a favourable (i.e. >65%) relative importance index score of knowledge, attitudes, and perception, respectively, towards regulation of pharmaceutical promotion. Further exploration of the data indicated that the factors that had an association with the knowledge, attitude and perception levels towards regulation of pharmaceutical regulation at 5% level of significance include health care workers’ profession, gender, education level, the nature of the working institution and the number of prescriptions involved per week. ConclusionIn conclusion, the findings of this study highlighted that in general the health care workers in Zimbabwe have higher levels of knowledge, attitude and perception towards regulation of pharmaceutical promotion, though the attitudes levels was lower compared to other domains. Further studies aimed at understanding or evaluating various aspects for the regulation of pharmaceutical promotion are recommended in order to complement the findings of this study.

Attitude of Physicians and Patients towards Pharmaceutical Promotion in Healthcare: A Qualitative Study from Ethical Context

Pharmaceutical marketers generally target physicians as their customers and patients as their consumers. Pharmaceutical promotion influence physicians significantly to prescribe branded medicines within limited norms. Patients are also influenced by pharmaceutical promotional activities within regulatory bindings. The purpose of this study was to determine the attitude of physicians and patients towards pharmaceutical promotion from an ethical context. The study was carried out by qualitative content analysis. Face to face interview method was applied to collect data from six physicians and six patients in the metropolitan area of Malaysia using the judgmental sampling technique. The interviews data were transcribed and analyzed systematically using Nvivo software. The findings revealed that Physicians have a positive attitude towards pharmaceutical promotion as it fulfils their need and professional knowledge. Alternatively, patients have positive as well as negative attitude and mindset towards pharmaceutical promotion. This study will help medical regulatory policymakers to better understand physicians’ ethical dilemma with pharmaceutical marketers and patients’ perception of aggressive promotional tools. It will also help the policymakers to govern further proceedings by increasing ethical practices for better healthcare.

Conflict of interest policies at Belgian medical faculties: Cross-sectional study indicates little oversight

Background Medical students encounter pharmaceutical promotion from the very start of their training. Medical schools have an important role to play in educating medical students regarding the interactions between healthcare professionals (HCPs) and industry and in protecting them from commercial influence and conflict of interest (COI). In 2019, medical student associations in Belgium and abroad called for more preparation in dealing with COI and for a more independent medical training. As little information is available on the situation in our country, we undertook an assessment of conflict of interest policies at Belgium’s medical schools. We relied on a methodology already used in studies from USA, Canada, Australia, France and Germany and adapted it to the Belgian context. Methods We identified 10 medical schools in Belgium. We searched the website of each medical school in November 2019 with standardized keywords for COI policies and learning activities on COI in the curriculum. The deans of medicine were invited to participate by sending us information that we could have overlooked during our web-based searches. We also consulted personal contacts within faculties among students and teachers. Based on a list of 15 criteria adapted from North American and French studies, we calculated a total for each faculty of medicine with a maximum score of 30 points. Results By December 2019, we had gathered a set of written documents for four faculties of medicine (40%) containing policies with varying degrees of precision and relevance to our survey. We found elements of the curriculum addressing the COI issue for one faculty (10%). In all cases, these policies consisted of “moderate” initiatives with little or no “restrictive” elements. Only one faculty showed interest in our study by providing us with relevant information (10%). Half of the faculty notified us of their refusal to participate in the study (50%) and the other faculties either did not respond or did not provide us with any information (40%). The maximum score obtained was 3 out of 30 points with six faculties scoring 0 (60%). Conclusion There is little transparency regarding interactions between medical students and pharmaceutical companies at Belgian medical faculties, which may create COI issues. Initiatives to protect students from pharmaceutical promotion and to train them to manage their future interaction with pharmaceutical companies have a limited scope and are isolated. This is inconsistent with international recommendations from Health Action International, World Health Organization or the American Medical Students’ Association. The Belgian government has legislated in favor of more transparency in the relation between HCPs and pharmaceutical industry. Indeed, it made the disclosure of benefits granted by the industry compulsory and limited their value. Our results show that there is still some way to go to ensure an independent medical training for future Belgian physicians.

Pharmaceutical Marketing to Medical Students: The Student Perspective

It has been estimated that pharmaceutical companies spend $1.7 billion every year promoting their products to physicians in Canada. At least $21 billion are spent every year on drug promotion in the United States. Although pharmaceutical marketing campaigns are primarily directed toward practicing physicians and residents, medical students are targeted as well. The goal of this study was to assess medical student attitudes toward pharmaceutical promotion in a Canadian academic centre. A questionnaire was designed to assess the attitudes of medical students about pharmaceutical promotion, including the acceptability of receiving various gifts and incentives. The survey was administered to first, second, and fourth-year medical students at the University of Western Ontario (London, Ontario, Canada). Statistical methods were employed to compare subpopulations of students based on demographic and socioeconomic data. Some 81% of students were not opposed to interacting with drug companies in medical school. Medical students felt comfortable accepting gifts of low monetary value, such as lunches (75%) and penlights (74%), but were willing to accept gifts of higher monetary value if the gifts served an educational purpose, such as textbooks (65%) and drug company-sponsored educational seminars (66%). 17% of students said that if presented with a choice of drugs identical in terms of price, efficacy, and effectiveness, they would prescribe the drug from the company that provided them with financial incentives. Statistical analysis showed no differences in responses among the different years of medical students. There were some differences in responses between medical students who had a doctor parent compared to those who did not have a doctor parent. Medical students are generally not opposed to interacting with or receiving gifts from pharmaceutical companies. Insights gained from this study raises issues that may be of interest to medical educators concerning the attitudes of the future physicians in Canada.

Edirorial

Welcome to all readers of the BJB Vol 9 issue 3, 2018! The BJB team together with authors, reviewers and well- wishers have contributed their all-out support to bring out this issue despite many challenges. This issue spans several topics of Bioethics beginning from complementary feeding patterns, ethical beliefs and vaccine, the regulatory documents related to pharmaceutical promotion in Bangladesh and Intimate Partner Violence. All these topics are very important for Bangladesh as well other countries.

Pharmaceutical Promotion in Bangladesh: Assessing the Strength of Regulatory Documents

Pharmaceutical promotion is a negative influencing force for prescribing. However, very few regulatory initiatives are taken to overcome this unwarranted influence. The present research was conducted in such context with an attempt to review the regulatory documents related to pharmaceutical promotion in Bangladesh including Code of Pharmaceutical Marketing Practices (CPMP), and to compare CPMP with different global guidelines. The studied guidelines demonstrate effort to regulate promotion, though that varies to a great extent, particularly in enforcement aspects. Clearly defined ethical and legal prohibitions, provisions of punishment for violations and entrusted agency with defined authority are crucial.