Promotion overdose

How much influence do drug companies have on what your GP prescribes you?
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02.CHOICE GP survey

Doctors are the key targets of pharmaceutical marketing in Australia, because direct to consumer advertising is prohibited and because doctors have the power to prescribe drugs. We asked 180 GPs about the extent of industry influence in Australia today.

How do GPs get the latest drug info?

Our survey showed GPs use a range of sources to inform their decision about whether or not to prescribe a new drug, including their colleagues’ opinion, medical trade press such as Australian Doctor and Medical Observer and the government-funded National Prescribing Service (NPS), an independent nonprofit organisation for quality use of medicines.

According to our survey, the most commonly used information source, after clinical evidence, is drug companies or their reps — 73% of GPs surveyed use them as a source of information. And they’re the main source of information for 16% of GPs when they’re deciding whether or not to prescribe a new drug.

Given that the pharmaceutical industry reaches GPs through multiple avenues including representatives, direct mail, drug launch meetings, conferences, advertisements in journals and prescribing software, it’s not surprising that as an information source it’s top of mind.

GP contact with drug companies

We asked our survey participants — all practicing GPs — about their contact with drug companies.

  • They received 7 visits a month from drug reps , on average. One visit a week may be more than enough for a busy GP but 65% of GPs are seeing more than one drug rep a week, and 34% of GPs saw 10 or more reps in an average month — that’s at least two drug reps a week. Three per cent of those surveyed said they see 20 or more reps in one month.
  • The NPS provides independent information to doctors, including a small program of educational visiting by NPS drug detailers (the independent equivalent of drug company reps). But only half of the GPs we surveyed were aware of the NPS. And while 67% of GPs who were aware of this service actually saw NPS drug detailers, the frequency of visits from drug company reps was significantly greater as the chart below illustrates.
  • They received 10 promotional mailings a week from drug companies, on average. 62% of the GPs we surveyed receive 10 or more promotional mailings a week — ranging from two to four mailings every day. A mountain of promotion in just one month shows the sheer volume one GP received.
  • 40% of GPs were sponsored by a drug company to attend a conference, seminar or training in Australia — and 3% overseas — in the last 12 months.

Drug marketing known to influence prescribing

Contact with pharmaceutical companies is known to influence GP prescribing of new drugs, and not always in a way that’s beneficial to patients.

  • A UK survey of 1097 practitioners found that GPs who report weekly contact with drug reps are more likely than those who have less frequent contact to prescribe drugs without first checking for published clinical evidence of effectiveness.
  • Another study of 1019 GPs from the Netherlands found that more frequent visits from drug reps were associated with a lower quality of prescribing.
    When correctly prescribed, medicines provide enormous benefits. But used incorrectly or inappropriately, they have the potential to cause significant harm.

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