More Prescriptions Through Learning: The Doctor's Choice

A new study published last week in the Journal of Management Science argues that the best way for drug manufacturers to market their drugs is to look at side effects. If the risks are high, push more spend into professional advertising and detailing. If the risks are low and the benefits are high, ramp up consumer spend.

The study—"The Debate on Influencing Doctors' Decisions: Are Drug Characteristics the Missing Link?"—"was done to determine the influence Big Pharma had on physician prescribing habits. More important, the study team sought to bring solid empirical evidence to the public concern that physicians are prescribing drugs on the basis of a sales rep's spiel and not on academic research.

What the team found was the complete opposite: Marketing directly to the physicians through sales force and indirectly through patients (who see the ads on television, etc.) wasn't a surefire way to get the doctor to prescribe a drug. "Doctors listen to the sales person and patient requests, but they are not necessarily influenced or swayed by the communication," said Sriram Venkataraman, assistant professor of marketing at Emory University and one of the authors of the study. "Instead, we found that doctors rely purely on science."

Venkataraman told Pharm Exec on Monday that sales reps are most useful in helping physicians stay informed about new drug indications and to alleviate concerns regarding side effects. He said that if firms do not engage in using the sales force to communicate these findings, the physician would walk away thinking that the side effects are in fact quite severe and might choose not to prescribe the drug.

The report noted that overdoing marketing efforts can actually come back and bite a pharma company. Physicians who receive a lot of visits for a drug that is largely ineffective tend to prescribe far fewer units of that particular drug than if they receive fewer visits for a similar drug.

Are Docs Pushovers? Hardly
"There is concern that physicians are uninformed about what they are prescribing and that Big Pharma is taking advantage of them," Venkataraman said. "We find, from our data, that there is very little support for that theory."

The same goes for consumer requests for drugs. The study states that patients can inform doctors about drugs they saw in DTC advertising, but not necessarily sway them to prescribe the drug. If the drug information is favorable, doctors will be more inclined to respond to a patient request.

For older drugs, Venkataraman recommends that firms go as far as pulling the plug on DTC and put most of their efforts (and cash) into reeducating the physician population about the benefits of the drug.

"A pharma company with a big presence in a particular category, where the brand is effective, will get a far larger bump from sponsoring a meeting than it would if the drug was less effective," Venkataraman continued. "Physicians are using all these contact points with Big Pharma to learn more about the brand. Gone are the days where you could walk in after a free lunch and convince a physician to prescribe your brand. You have to educate. As soon as you stop educating, the physician is going to tune out and start paying attention to your competitors."