Awareness and Attitudes of the Pakistani Population With Regard to Physician–Pharmaceutical Company Interaction: A Cross-Sectional Study

Abstract

Objective: To determine the awareness and attitudes of the Pakistani population regarding physician–pharmaceutical company interactions.Methods: The data were collected from primary health care clinics and pharmacy outlets located within cities of six randomly selected districts of the Punjab Province. Those individuals (age ≥18 years) who have just completed their visit to the physician and well understand Urdu language were approached. Descriptive analysis was performed for all variables by using SPSS (IBM version 26).Results: A total of 3,852 participants fully completed the study out of 4,301 (response rate 89.5%). Of those, 30.9% were female; two-thirds (66.7%) were aware of drug representatives’ visits to clinics. The majority were aware of pharmaceutical company material presence (or absence) in the physicians’ rooms (56.6%), company items with logos (66.8%), patient education materials (73.4%), and 60.8% thought that receiving gifts from companies was “wrong/unethical” practice for physicians, which was lower in comparison to other professions such as judges to accept gifts from lawyers (65.6%) and professional sports umpires to acknowledge gifts (64.3%). A minority said that they have lower trust on physicians for using drug company notepads or pens (16.7%), going on trips sponsored by the company (16.7%), accepting gifts <15,000 PKR (90.3 US$) (26.7%), and accepting gifts >15,000 PKR (90.3 US$) (40.0%).Conclusion: Survey participants were well aware of physician–pharmaceutical company interactions. Participants were more knowledgeable regarding the pharmaceutical company presence (or absence) in physicians’ offices than about gift-related practices of physicians. Trust on the physician was not affected by small gifts but by the large gifts.

Healthcare Consumers’ Perceptions of Incentive-Linked Prescribing: A Scoping Review of Research

“…The types of incentives that pharmaceutical companies typically provide to physicians were mentioned by HCCs in 5 studies (10, 19, 20, 24, 25). For example, in Ammous et al’s study in Lebanon, a majority of participants did not know whether their physicians take any incentives/benefits from pharmaceutical companies, although 44% of them believed gifts might influence their physicians’ prescribing behaviour.…”

“…(10) In Pakistan, HCCs believed physicians take a range of incentives/benefits from pharmaceutical companies such as items valued at USD 90 or more (16.8%), participation in social activities organised by pharmaceutical companies (30.1%), paid trips (13.3%), meals (20%), and notepads/pens (49.9%). (24) In Malaysia, HCCs pointed to free drug samples, educational materials, and the ownership of company stocks as other pharmaceutical incentives given to physicians. (20) In two US-based studies, HCCs spoke about the incentives they believed were acceptable or unacceptable for physicians to take from pharmaceutical companies (22, 27).…”

“…Also, in Pakistan, lecturing or researching for pharmaceutical companies in exchange for money was considered acceptable, for over half of the participants (53.3%). (24)…”

“…(26) Nevertheless, in some studies, a smaller number of HCCs reported a lower trust in their physicians, even though they thought incentivisation could influence their prescribing behaviours. (10, 20, 24). One of the reasons explained in those studies was that HCCs might find the relationship between physicians and pharmaceutical companies from the perspective of knowledge exchange.…”

“…One of the reasons explained in those studies was that HCCs might find the relationship between physicians and pharmaceutical companies from the perspective of knowledge exchange. (10, 24). However, differences in the level of trust were noted with respect to HCCs’ level of knowledge, race, and ethnicity.…”