From this total of 2,269 doctors, 1,386 had an email address registered with the Bavarian Association of Statutory Health Insurance Physicians, and these were contacted by email. on-patent and off-patent branded drugs as well as generics, was analysed in detail, and 2) prescribing behaviour was analysed not only in connection with the frequency of PSR visits, but also in connection with the doctors’ subjective opinions with regard to the adequacy of the information received and the extent to which they felt that they had been influenced.įrom a pool of approximately 20,000 prescribing doctors covered by the Bavarian Association of Statutory Health Insurance Physicians, the mean prescription volume from the first three quarters of 2010 was used to form a sub-group of 368 psychiatrists or neurologists with a prescription volume of >€100,000 per quarter, 1,826 GPs or internal medicine specialists working in general practice with a prescription volume of >€100,000 per quarter, and 75 cardiologists with a prescription volume of >€20,000 per quarter (by limiting the prescription volumes to the German average, we sought to exclude physicians with very low prescription volumes). The key features of this study are that 1) the impact on the prescribing data for various product categories, i.e. The objective of this study was to use a questionnaire sent to German GPs and practice-based specialists to record the types of contact and their perceptions of these contacts and to determine what effects doctor-PSR contact and the doctors’ perceptions of these contacts might have on prescribing habits. have shown that contact between doctors and pharmaceutical companies is associated with more frequent prescriptions, higher expenditure and lower prescription quality (for a systematic review see ). With a few exceptions, studies from other countries, such as the seminal study by Avorn et al.
Whether PSR visits and the perceptions or subjective opinions of the doctors regarding these visits have an impact on objective prescribing data is not yet known for Germany. Based on these subjective assessments by the doctors, we can assume that PSRs have at least a certain degree of influence on medical prescribing habits. We were also able to show that 53% of doctors believed that their prescribing habits were occasionally, frequently or always influenced by PSRs, while 45% believed that this was rarely or never the case. We showed that drug samples, stationery and dinner invitations were the most frequently accepted gifts. In an earlier study, we were able to demonstrate that 77% of doctors in Germany were visited by PSRs at least once a week, and 19% of doctors were visited daily. During these visits, the PSRs inform the doctors about their company's products and new publications, and they use a variety of marketing strategies to motivate the doctors to prescribe their products. It is estimated that approximately 15,000 PSRs carry out some 20 million visits to medical practices and hospitals in Germany every year. The prescribing behaviour of doctors is influenced by a number of factors, one of which being visits from the pharmaceutical sales representatives (PSR) of pharmaceutical companies. Acceptance of office stationery was associated with higher daily doses. The eschewal of sponsored CME was associated with a lower proportion of on patent-branded drug prescriptions, lower expenditure on off-patent branded drug prescriptions and a higher proportion of generics. Doctors who believed that they received accurate information from PSRs showed higher expenditures on off-patent branded drugs (thus available as generics) and a lower proportion of generics. Practices that saw PSRs frequently had significantly higher total prescriptions and total daily doses (but not expenditure) than practices that were less frequently visited. 43% of doctors believed that they received adequate and accurate information from PSRs frequently or always and 42% believed that their prescribing habits were influenced by PSR visits occasionally or frequently. 5 physicians (3%) accepted no benefits at all. 69% accepted drug samples, 39% accepted stationery and 37% took part in sponsored continuing medical education (CME) frequently. 84% of the doctors saw PSR at least once a week, and 14% daily.
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