Abid Shahzad, Bacha Khan University Charsada (BKUC),
KP, Pakistan. Email: mrabid5.awan@gmail.com
Muhammad Wahab, Institute of Management Sciences,
Peshawar, Pakistan
Abstract: The aim of study to
empirically evaluate the health care professional attitude towards the
pharmaceutical products in context to the Pakistan pharmaceutical market
current situation, that why are national companies’ brands more consider than
multinationals, based on primary data
collected through self-administered questionnaire by field visits to 250 health
care professional. Results of explanatory sequential method indicates that
product efficacy is the primary factor to considered, followed by sales
representative, promotional material and price factor including; some influence
of new launches, packaging and availability of the products are reported.
However the bio equivalence report and patient demands are rarely considered by
HCP.
Key Words: Generic brands, Research brands, Promotional mix, Health care
professionals.
Introduction
Pharmaceutical industry is among the most scientific
industries of the world. It is estimated by the intercontinental marketing services prognoses (2016) that the
pharmaceutical market around the globe in terms of revenues is approximately
1.2 trillion US dollars. In which the majority of revenues about 50% are
generated by western markets. However, it is forecasted by IMS (2016) future growth
trends of pharmaceutical industry favor the Asia Pacific market. According to
IMS health (2013) this economic shift of growth from western markets to Asian
markets is indeed, due to the shift of global spending on pharmaceutical
products from branded to generic based brands (copy product). It is expected
that generic products shares will achieve 63% of the market share by the end
2017, which was 58% in the year 2012. Further this growth trend of generic
brands is bigger than research brands, which seems uniform regardless of the
markets either pharmerging or merged markets (developing or developed markets).
According to business monitoring international (2015)
Pakistan pharmaceutical industry is the part of pharmerging markets. Its market
size is approximately 2.3 billion US dollars. This is expanding with 12%
cumulative annual growth rate (CAGR). According to research and markets (2016)
national companies in Pakistan holding 60% of the market shares, the rest of
40% are with multinational companies, which was 40:60 in late 90’s. National
companies businesses primarily depends on generic products (copy product),
while multinational mainly depends on their research products (branded). Hence
Pakistan pharmaceutical market current situation makes the problem under
investigation, that why are national
pharmaceutical companies brands more consider than multinationals in case of
Pakistan’s pharmaceutical?
Pharmaceutical companies in Pakistan promote their
products to the health care professional (HCP) through direct and indirect
marketing activities. The HCP get informed and influenced from the
pharmaceutical companies in different manners to prescribe any product.
Thereby; this study mainly documents the HCP perspective in context to
marketing activities of pharmaceuticals, that how HCP consider the
pharmaceutical marketing practices, while prescribing any product
(Generic/Branded) to treat their patients.
Literature
Review
Worldwide
literature on pharmaceutical industry marketing is widely available, however,
in Pakistan prospects are that research work can be further expanded regarding
pharmaceutical marketing practices. Below are some relevant published papers on
pharmaceutical marketing practices As Tajdar et al (2015) HCP prescribing behavior can be influenced by many
factors e.g. Medical representative, product price and efficacy of the drug
including companies’ indirect marketing activities. They have investigated that
the product price, medical representative and country of origin of the product
significantly impact on the HCP prescribing behavior. It has seen in study of
Ahmed et al (2014) promotional
material also can influence over the prescribing behavior of HCP. They have
also highlighted the importance of other factors that HCP generally consider
like patient demands, new launches and sales representative of the
pharmaceutical companies. According to Shamim et al (2014) new drug launches and the promotional materials, which
are being used by pharmaceutical companies, have differentiating impact over
the HCP. Jamshed et al (2011)
stresses on HCP to prefer generic brands for patient’s affordability, he
further suggested HCP should consider equally important bio equivalence or
clinical reports, before to prescribing any generic product (copy product)
directly into patients. Below (Appendix
C) comprehend a summarized form of relevant literature specifically
highlighting methodology, variables and key findings of the studies.
Literature Gaps
The above
mentioned and (Appendix C) published
studies have their own attributes and contribution towards the development of
literature for pharmaceutical marketing practices. However there is need to
fill the gaps of some studies and their effects on HCP prescribing behavior.
For example, the term promotional material is being used by authors for
pharmaceutical promotional materials as a broad term. There is need to define
the term promotional material that; what actually it consist or what sort of
material comes under this definition? It is important to know that what factors
actually stimulates the HCP to consider any product, in context to the 4 P’s of
marketing mix. More importantly, from the literature it has been observed that the
studies have identified many variables and has established their influencing
role over HCP prescribing/considering behavior. For example; product price,
country of origin of the product, sales representative, new launches and bio
equivalence or clinical reports including patient demands. However, it is
important to give an ordinal sequence to all those identified variables, to
know the preferences of HCP among these identified variables that how HCP will
rate these variables on ordinal scale on the basis of their importance, while
prescribing/considering any product (generic/branded) to treat patients.
Rep
Knowledge Patients Indication New Launch Low Price Research
Promotion Generics
Promotion Rep Visits Patient Worried Research Cost Dosage Safety HCP Prescribing Behavior Quality Packaging Senior Influence
Figure
1. Pre Conceptual Framework
Patient Demands New Launch Promotional Mix Sales Rep Price Bio Equivalence HCP Prescribing Behavior Research
Promotion Patients Indication New formula Low price Generics
Promotion Rep Visits Rep
Knowledge Generic Cost Research
Cost Dosage Safety Obligation Comparative
trials Patient Worried Rep Rapport Packaging Consideration Company Image Efficacy Senior Influence Availability Quality
Figure 2 Post Conceptual
Framework
From the
literature review, it has been revealed
that there are many factors that can possibly stimulate health care
professional to prescribe a product. However,
for better understanding and confirmation of these variables, few interviews
were conducted with pharmaceutical industry experts. Some variables are identified after
conducting interviews (see figure 1.2 bold circled
items) that can possibly stimulate the health care professional to prescribe a
product. On the basis of literature review and interviews with industry
experts, the conceptual frame work has been
classified as pre-conceptual
framework (figure 1) and post-conceptual
frame work (figure 2). Pre-conceptual frame work
primarily depends on the factors that were identified during a literature review. While the post-conceptual frame work consists of the literature review as well as
interviewed-identified variables. After a
thorough review of literature and interviews, these identified variables
were reclassified (see appendix A) on the
basis of their nature and scope of marketing in the context of 4 - Ps of the marketing mix. This classification has helped to draft questionnaire theme based on
six variables. The variables are sales
representative, price factor, promotional material, new launch, bioequivalence and patient demands; that
possibly can stimulate HCP to prescribe a product.
Besides through
interviews the term ‘promotional material’ is
explained in detail which means that there are 35 types (see appendix B)
of different goods and services, which pharmaceutical companies are using named
as promotional material/mix
Hypotheses
According
to Ahmed et al. (2012), the
importance of generic products cannot be denied due to the affordability of
generic products as compared to multinational brands. Therefore, generic
products should be more preferred than multinational brands. However, the bioequivalence report of the generic brands is
equally important and should be considered by the HCP in same manners like
affordability is considered for generic brands. It has also endorsed by the
Ahmed and Saeed (2014) that the qualities of national companies’ products have
been remarkably improved. National companies’ products are providing clinical
results to the HCP for their patients. However, the clinical trials are
essential for generic products before
using generic brands directly into patients.
This direct use of generic products cannot be allowed only on the basis
of pharmaceutical equivalence (physical resemblances). This study has selected
the bioequivalence or clinical reports
(interchangeably use words) variable to test the practices of HCP and
pharmaceutical companies about bioequivalence
or clinical reports. To know how well HCP are aware and consider these
important reports during practice below hypothesis is being set to establish the fact about bioequivalence reports and, its ordinal number
among other identified variables.
H1: Generic brands are prescribing
because of bio equivalence (BE)
Moreover,
in views of different authors like Lanjouw (2005) and Ahmed et al.
(2012), the role of new launches either in the form of new packaging or
new molecular formula has got importance to influence the HCP prescribing
behavior. According to Shafiq et al.
(2011), new product launch “marketing campaigns messages” are being exaggerated
by the pharmaceutical marketers to influence the HCP. In views of Baig (2016),
to exaggerate the brand campaign
messages, they draft it in an emotional
context by using the words like “halal” and
“free from alcohol” targeting spiritual beliefs
and values to influence the HCP prescribing behaviors towards the new product launch. This is also endorsed by the Chandra sekaran (2013). However, there
is need to identify the amount of influence of the new product launch on HCP
prescribing behavior. Therefore; the following hypothesis has been designed to
find the ordinal number and the impact of new product launch either in the form
of new packing or a new molecular formula on the prescription behavior of HCP;
H2: Generic brands are prescribing
because of new launches (NL)
According
to Narendran and Narendranathan (2013),
pharmaceutical companies’ promotional material significantly influences the HCP
prescribing behavior. In views of Tahir et
al. (2013), HCP generally takes different
kinds of gifts from pharmaceutical companies including expensive goods
like perfumes and wrist watches. HCP also
demands different types of goods and
services which could be anything either of ethical or unethical nature.
According to Siddiqi et al. (2011),
“HCP prescription is significantly influenced by the scientific tools than all
other things”, which is contrary to what Ahmed et al. (2011), maintains. According to Kremer et al. (2008) “direct to HCP promotional material has very high
elasticity than direct to price elasticity in studies where the price has been taken as an independent
variable”. Thus, to investigate the relationship between HCPs prescribing
behavior and the promotional materials used by the pharmaceutical companies,
the following hypothesis is being set to
establish the ordinal number of promotional material among the other identified
variables.
H3: Generic brands are prescribing
because of promotional mix (PM)
Ahmed
and Sattar (2014) have found that “medical representative plays an important
role while developing a relationship with
HCP on behalf of pharmaceutical company”. Similarly,
Fugh and Ahari (2007) has provided the evidence that how pharmaceutical
representatives scripted and trained to make a relationship
with customers in order to influence them for prescription.
This is also explained by Tajdar et al.
(2015) that “a medical representative’s has a very
influencing role over HCP prescribing behavior. According to Shetty &
Gujarathi (2013), the employee personal branding has got very much importance
while branding the organization or organizational brands to the market. In this
ongoing trial, the below hypothesis is
being set in order to know the sequential order of ‘medical representative’ as
an influencing factor among all other selected factors?
H4: Generic brands are prescribing
because of sales representative rapport SR)
According
to Najmi et al. (1998), most of the
time HCP feels neither under-pressure nor monitored by the country health system, that whether HCP
prescribe the product in an appropriate way or not, to treat the patients. Even
lack of demand and knowledge is observed in patients to ask about medicines
from HCP. This shows that the sole decision maker is HCP to prescribe any
product. While contrary to the findings of Nejmi
et al., Ahmed et al. (2012) stated that the importance
of ‘patient demand’ for particular products usually is well entertained by the
HCP. Therefore, to hypothetically test
the situation and establish the ordinal sequence following hypothesis has been set,
H5: Generic brands are prescribing
because of patient demands (PD)
Furthermore,
‘affordability’ is the key factor while treating patients with medicines.
According to Chintagunta and Desiraju (2005), pricing has a strategic importance all over the world. This is aligned with research results of Tajdar et al. (2015) which has demonstrated high importance of the role of price on
HCP prescribing behavior. It is also mentioned by Ahmed et al. (2012) and Jamshed et
al. (2011). In views of Vogler (2012), medicines prices are kept low for generic products to increase
the accessibility and affordability for those patients who pay out of their
pockets. However, in the reimbursement cases,
theprice is notmandatory concern
for stakeholders. Kremer et al. (2008) maintains that price does
impact on HCP prescribing behaviors as an independent variable. In this investigation, the below hypothesis has been
set to testify and know the ordinal number of price factors on the sequential ladder that can possibly influence
or not the HCP prescribing behavior.
H6: Generic brands are prescribing
because of price factor (RS)
Methodology
This
research is based on mixed method of research adopted from Creswell (2014)
explanatory sequential design. The primary data was collected from HCP by
dividing them into two broad categories; practicing physicians and practicing
surgeons from the 3 teaching hospital of Peshawar (lady reading hospital,
Khyber Teaching Hospital and Hayatabad Medical Complex) each category has 20
units on an average and 5 consultants in each unit along with 10 residence
medical officers as well 8 house officers. 50% of sample size of the total
population (Approx 220 respondents) was conveniently selected, besides 30 top
class general practitioners (GPs) who had participated as freelancers. Data was
collected through self-administered questionnaire composed of 19 closed ended
questions and one open ended question, questionnaire theme was based on post
conceptual frame work. Initially through literature review one preliminary
questionnaire was developed which later restructured according to the local
practices and industry experts opinions. The reliability of the questionnaire
was equal to “Cronbach Alpha 0.71”. For
the analysis of data multiple regressions were applied through SPSS. In second
phase, for qualitative analysis the follow up explanation model was conducted.
In which randomly visited to 20 physician, 20 surgeons and 10 general
practitioners to validate the quantitative interpretations in view of market
practices.
Results
Table 1 Regression
Model Summary
|
Model |
R |
R Square |
Adjusted |
Std. Error of the Estimate |
|
1 |
0. 647a |
0.418 |
0.404 |
0.56642 |
a: (Constant) Predictor: PM, SR, RS, NL, BE, PD.
Result of R-square suggests that approx. 42% (0.418)
of the variation is explained by the independent variables in the dependent
variable, representing
the amount of change occurring in HCP prescription behavior due to the
predictors / marketing activities of pharmaceutical companies (Table 1).
The ANOVA test values (Table 2) are indicating that
the overall model is statistically significant (0.000).
Table 2 ANOVA
|
Model |
Sum of Squares |
Df |
Mean Square |
F |
P-value. |
|
|
1 |
Regression |
56.062 |
6 |
9.344 |
29.12 |
0.000a |
|
Residual |
77.963 |
243 |
0.321 |
|||
|
Total |
134.025 |
249 |
|
|
|
|
Table 3 Coefficient
|
Model |
Un
Std |
Std
Coefficients |
T |
P-value. |
|
|
B |
Std. Error |
Beta |
|||
|
(Constant) |
0.946 |
0.273 |
3.469 |
0.001 |
|
|
Promotional Mix (PM) |
0.242 |
0.067 |
0.208 |
3.61 |
0 |
|
Sales Rep (SR) |
0.354 |
0.055 |
0.386 |
6.454 |
0 |
|
Product
Price (RS) |
0.171 |
0.075 |
0.144 |
2.265 |
0.024 |
|
New
launch (NL) |
0.098 |
0.049 |
0.104 |
2.011 |
0.045 |
|
Patient Demand (PD) |
-0.047 |
0.046 |
-0.05 |
-1.014 |
0.312 |
|
Bio
Equivalence (BE) |
-0.035 |
0.04 |
-0.043 |
-0.869 |
0.386 |
b: (Dependent variable): HPB.
Findings of the coefficient results (table 3)
indicated that the HCP prescribing behavior has a direct dependence on investigated variables which are sales representative (SR), promotional mix
(PM) and price factor (RS) including new launches (NL) of the products
(significant at 5% confidence interval). However, bioequivalence (BE) and patient demands (PD) are immaterial to
health care professionals and has no
dependence (insignificant at 5% confidence interval). The significant along
with insignificant results have been re-confirmed in qualitative analysis, that
were follow-up visits to HCP, in which it
has been revealed through open-ended
questions that in practice, health care professionals do not ask from
pharmaceutical companies to provide bioequivalence
or clinical reports. The HCP emphasize on pharmaceutical equivalence or
empirical results of the generic products instead of bioequivalence or clinical reports. HCP also mentioned that they do
not entertain patient demands for particular product. Because HCP generally follow the prescribing protocols approved by
the food and drug administration (FDA) or health regularity entities. Moreover, the availability of the product in
nearby pharmacy or institution has somewhat influence over the prescription of
HCP.
Discussion
Previous studies show that the prescribing behavior of
HCP depends on many factors. Pharmaceutical companies are using different tools
to influence the prescribing behavior of health care professionals in order to
increase their business shares. The aim of the research study was to understand
that why national companies are more prescribing than multinational companie incase
of Pakistan pharmaceutical industry. For this research purpose, 250 participants’ responses were analyzed on the basis of
identified variables and set hypothesis. The overall result of the study was
significant and aligned with previous literature diagnosis in regards to the
marketing practices of pharmaceutical companies. Further, it has been inferred why national companies are more growing than
multinationals on the basis of results that give an ordinal sequence which is
product efficacy on priority followed by a sales
representative, promotional mix and price factor including new launches in
terms of new packaging or advancement in formula and availability of the
products.
On the basis of ordinal sequence, we can say that
quality of national companies’ products has
been improved to compete with multinational products. Therefore, HCP are prescribing national companies' brands more
as stated by Ahmed & Sattar (2014). National companies’ sales representatives
are more successful in building a good
rapport with customers. They are more frequent to provide and remind the right
information about their products as compared to a multinational sales representative. Theresearch
study results are contrary to
Siddiqi et al. (2011) who mentioned
that scientific tools are more influencing than other promotional tools.
Although scientific tools come under the
umbrella of promotional tools because any type of investment on HCP with
objectives to yield prescription comes
under the marketing expenditure for companies. National companies are spending
more on the promotional mix (tools) to
support sales representatives to aggressively promote their brands in the
market. While on other hand, multinational companies having limited promotional
tools list pre-approved from international federation of pharmaceutical
manufacturer association (IFPMA) and the central
office of the company. Beside this, the
national companies’ products are more economical than multinational brands.
This is another reason for getting more prescriptions from national brands than
multinationals. Another very important aspect for the organization prosperity
is organic growth that is also favoring the national companies. Because
national companies new launching are at a higher side with advancement in drug
molecule, manufacturing technique and product packagings
for patient’s compliance. These are the factor that goes into national
companies favor. Therefore, their market expansion rate is higher than
multinationals. The two factors go probably into multinational favor which is bioequivalence and patient demands, unfortunately, are immaterial for HCP
in Pakistan pharmaceutical market.
According to Tajdar (2015) who has proven that the
price and medical reps having significant influence over HCP prescribing
behavior. The research study results are in line with
additional explanation that is the degree of significance of these variables on
HCP prescribing behavior in terms of the ordinal
sequence. Moreover, Ahmed et al.
(2014) also found that medical reps and promotional tools have significant influence on HCP prescribing
behavior. In this regard, this study has provided a detailed list of promotional tools that pharmaceutical companies
are using in Pakistan market (Appendix B). Apart
from this, Jamshed et al.
(2011) have stated that the price and medical reps play an important role in influencing the HCP prescribing behavior.
This research results show alignment with
above findings with further explanation of HCP preferences. It has also been
proved that patient demand and bioequivalence
has a very limited role in influencing the HCP prescribing behavior as
described by Ahmed et al. (2012).
Conclusion
The results of this study witnessed that in Pakistan
pharmaceutical market, national companies products are more considered than
multinationals by the HCP. On the basis of results it can be inferred that help
to give an ordinal sequence to all those factors which have been tested.
According to the ordinal sequence, at 1st,
there is the product efficacy to cure the disease or disease symptoms, followed
by the sales representative role on 2nd and at 3rdthe
promotional mix are highly influencing factors for the health care
professionals. Besides these, the product price is at 4th and new
launches are at 5th either in the form of new packing or new
molecules, including product availability (nearby institution/formulary) at 6th
have low influencing effects on HCP prescribing behavior.
Contribution of the Study
The study will have a practical impact based on
conclusion presented, which could help to give an ordinal sequence (see
conclusion for ordinal sequence) to all those pharmaceutical marketing factors,
which can possibly influence the HCP. This ordinal sequence will help to
understand HCP preferences in terms of ordinal number, when HCP prescribe
product (generic/branded) to treat
patients.
Pharmaceutical multinationals in Pakistan can resume
their contribution shares by adapting the national companies marketing
approach. In which national companies are more HCP centric than patients. While
multinational companies are more patients centric than HCP. Earlier this study
has proved that patient demands are rarely consider by HCP. The sole authority
to prescribe a product is with HCP. Hence shifting the centre of activities can
help to resume the market shares. In case of constraints to adapting national
companies approach, as contingencies; multinational should outsource (give marketing rights) their products to the
national companies can help to achieve the productivity of business operations
in Pakistan market.
There are some factors which are beyond the scope of
the study. For example, Pakistan’s political, economic and law order
situations. These factors can impact the businesses in either way as barrier or
driver. Besides companies standard operating procedure (SOP) can also affect
the decision-making process of business
operations in Pakistan.
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Appendix: A
Stimulation
factors from marketing prospects:
|
4 - P’s |
Attributes |
Categories |
|
Product |
1. Product Efficacy |
1. Bio Equivalence (BE) |
|
2. Product Quality |
||
|
3. Product Safety |
||
|
4. Product dosage |
||
|
5. Comparative trials |
||
|
6. New Molecule |
2 New Launches (NL) |
|
|
7. New Packing |
||
|
8. Availability |
||
|
Price |
9. Affordability |
3. Product Price (RS) |
|
Promotion |
10. Type of material |
4. Promotional Material (PM) |
|
11. Type of campaign |
||
|
12. Company image |
||
|
13. Sales representative |
5. Sale Representative (SR) |
|
|
14. Senior
influence |
||
|
Place |
15. Patient Need |
6. Patient Demand (PD) |
|
16. Patient Disease |
||
|
17. Patient obligation |
Appendix B
Promotional
materials named as promotional mix
Source: Literature review and industry
expert interviews
|
Promotional Mix (Tools) |
|
|
1.
Drug samples. 2.
Product brochures. 3.
Medical books. 4.
Clinical reports. 5.
Brand presentations. 6.
CME: Local / Int. 7.
Foreign trips. 8.
Events, celebrations. 9.
Events are sponsored. 10.
Medical journals. 11.
Special events 12.
Family events. 13.
New Year calendars. 14.
Diagnostic equipments. 15.
Magazines Add. 16.
Instruments. 17.
Round table discussions. |
18.
Product pens. 19.
Paper pads / Slips. 20.
Table organizers. 21.
Office equipments. 22.
Personalized gifts. 23.
Stationary. 24.
Free drug camps. 25.
Free diagnostics camps. 26.
Food, refreshments. 27.
Free hotelling / Picnics. 28.
Cash donations. 29.
Office renovation / Decoration. 30.
Ward renovation / Decoration 31.
Free registration for events. 32.
Trade schemes / Bonuses. 33.
Printings. 34.
Speaker presentation. 35.
Personnel relationship |
Appendix: C
Summary of Previous Studies
|
Research |
Methodology |
Variable |
Findings |
|
Tajdar
et al, (2015) |
Self-administered questionnaire, Samples Size 100
from local Peshawar hospitals. Technique - Chi Square, frequency tables. |
Country of origin (COO), Price, and medical
representative. |
Prescription of physician can influence by many
factors, including price, medical rep, and country of origin along with
companies senior management. |
|
Ahmed
et al, (2014) |
1. Self-administered questionnaires, Samples
size 100, all were doctors. Technique - Multiple Regressions. |
Physician Prescribing Behaviors- |
|
|
Shamim
et al, (2014) |
Primary data via questionnaire |
Physician Prescribing Behaviors. |
Result suggested that new drug, promotional tools
and drug samples significantly affect the prescribing behavior of physicians.
|
|
Ahmed
& Sattar, (2014) |
Secondary data on current pharmaceutical marketing
Mix (Tools) using by companies in Pakistan to promote their Products. |
Strategies & approaches. |
The quality of medicines and effectiveness of
marketing teams has remarkably improved to compete the multinationals. Direct
to consumer marketing is yet to gain ground in Pakistan. |
|
Ahmed
& Saeed, (2014) |
Primary data via questionnaire, Samples size 300
from Karachi. Technique - Multiple Regression |
Unethical practices in pharmaceutical industry. |
Pharmaceutical companies and doctors both are
responsible for unethical practices. However the levels of unethical
practices are higher at rural area than the urban area of Karachi. |
|
Narendran
& Narendranathan, (2013) |
Primary data via
questionnaire |
Physician Prescription Behavior: |
Pharmaceutical marketing significantly |
|
Khan et al, (2013) |
Primary data via. Self-administered questionnaire, samples size
400. |
Emergence of unethical practices and influencing
factors like Doctors, Companies, sales promotion officer and Patients |
35% doctors believe that doctors are responsible for
the emergence of unethical practices while 46% replied that pharmaceutical
companies are responsible. |
|
Akhtar
et al, (2013) |
Primary data via questionnaire. Sample size 20 GP
200 patients. Technique - Spearman,
non-parametric. |
Generic prescription, price and drug prescribing
protocol. |
Result suggested that 0% generic prescription and no
single prescription was prescribed in accordance with national drug
prescribing policy or FDA – WHO |
|
Ahmed
et al, (2012) |
Primary data via questionnaire. Samples size 250
doctors from Karachi area GP & Physicians. Technique-Chi-Square, Mega state software. |
Physician prescription behavior: |
General practitioner & Physician prescribe generic
drugs mainly because of drug representative regular visits & cheaper
drugs. |
|
Jamshed
et al, (2011) |
Primary data semi structured long interviews. Sample
size 11 dispensing doctors 9 males& 3female. Technique
- descriptive analysis. |
Level of knowledge about generic, attitude towards
generic, perception about generic and marketing practices of companies for
generics. |
The generic should be more prefer. However bio
equivalence testing and rigorous guideline are required before prescribing
generic. |
|
Zaman,
(2011) |
Secondary data from IMS and PEC. Technique -
descriptive analysis. |
Current pharmaceutical marketing strategies and
future pharmaceutical marketing strategies. |
Right marketing strategy can bring results for
companies, Like: Digital marketing, internet and multi channels. |
|
Siddiqi
et al, (2011) |
Cross sectional survey. Sample size 200 doctors and
200 medical representatives. Primary data via questionnaire adapted from
Girish et al Technique - Regression analysis. |
Physician Prescription Behavior:Influencing factors
on physician prescribing behavior. |
Physician prescription more influenced by scientific
tools than any other promotional tools. Medical representative had similar
perception. |
|
Ahmed
et al, (2011) |
Sample size 400 doctors and 100 pharmaceutical
companies. Primary data via self-administered questionnaire. |
Physician perception about marketing tactics using
by pharmaceutical companies in ethical contexts. |
58% of doctors believe that pharmaceutical marketing
practices are unethical. |
|
Hakonsen,
(2011) |
Sample size 83 Pakistani with an average age of 58
years. |
Branded medicines, Substitute medicines with
different names and the satisfaction of patients. |
Substitute or generic medicines may have negative
effects on Pakistani immigrants in Oslo. |
|
Masood
et al, (2009) |
Secondary data,to provide a detailed basis to
understand pharmaceuticals marketing practices. |
Types of tools using by pharmaceutical companies and
their abuse used. |
All the codes of conduct, self-regulations and laws
developed to control pharmaceutical promotion and marketing seem ineffective. |
|
Lanjouw,
(2005) |
The descriptive and explanatory research, Secondary
data, Sample size 22 countries by dividing on the basis of income classes.
Technique (s) - Regression analysis. |
Patents, Price Control, |
Patents and price can affect the patient access to
new molecules in poor countries; however, in high income earning countries
does not matter. |