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Pharmaceutical Marketing: Medical and Industry Biases

Pharmaceutical sales representatives provide useful information about products, but they have incentives to be overly positive. The literature written by physicians about pharmaceutical marketing and promotion generally focuses on the harmful aspects of promotion, and misses the benefits. This suspected harm occurs because physicians who have contact with pharmaceutical sales representatives sometimes change their prescribing behavior. However, this result has few implications about the benefits of this change in behavior. The response might be because of the information provided, or because of the excessive optimism of sales representatives. Physicians might be self selected to interact with representatives promoting drugs that the physicians are already interested in. Some physicians might spend more time learning about drugs by reading the professional literature than do others, who would learn from salespeople. Pharmaceutical representatives are interested in selling drugs, not directly in providing information. Thus, in some instances promotion will be harmful; in some, beneficial; and in some, ambiguous. The existing research has not tried to distinguish among these possibilities. Pharmaceutical companies are in the best position to provide information to physicians about drugs. What appear to be bribes may merely be methods of seeking attention or compensating physicians for their time. This article sets forth some additional hypotheses that could be tested regarding the positive and negative effects of promotion.