TY - JOUR
T1 - What happens when private general practitioners receive incentivisation offers from pharmaceutical sales representatives? A qualitative study in Pakistan
AU - Noor, Muhammad Naveed
AU - Rahman-Shepherd, Afifah
AU - Khan, Sabeen Sharif
AU - Hasan, Rumina
AU - Siddiqui, Amna Rehana
AU - Azam, Iqbal
AU - Bhutto, Faiza
AU - Isani, Afshan Khurshid
AU - Siddiqi, Sameen
AU - Khan, Robyna Irshad
AU - Shakoor, Sadia
AU - Khan, Mishal
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/7
Y1 - 2024/7
N2 - Objectives: Pharmaceutical incentivisation of physicians for profit maximisation is a well-documented health system challenge. This study examined general practitioners’ (GPs) reactions to pharmaceutical incentivisation offers in one region in Pakistan. Methods: We used the Standardised Pharmaceutical Sales Representative (SPSR) method and qualitative interviews with GPs. SPSRs were field researchers representing mock pharmaceutical companies who recorded their observations of 267 GPs’ responses to pharmaceutical incentivisation offers. We triangulated SPSR data using qualitative interviews with a subset of the same GPs to gather information about how they interpreted different interaction outcomes. Results: We found four major outcomes for GPs being offered incentives by pharmaceutical companies for prescribing medications. GPs might agree to make incentivisation deals, reject incentivisation offers, disallow PSRs to access them, or remain indeterminate with no clear indication of acceptance or rejection of incentivisation offers. GPs rejecting SPSRs’ incentivisation offers indicated having active commitments to other pharmaceutical companies, not being able to work with unheard-of companies, and asking SPSRs to return later. Conclusions: The GP-pharmaceutical sales representative interaction that centres on profit-maximisation is complex as offers to engage in prescribing for mutual financial benefit are not taken up immediately. The SPSR method helps understand the extent of distortion of practices impacted by incentivisation. Such an understanding can support the development of strategies to control unethical behaviours.
AB - Objectives: Pharmaceutical incentivisation of physicians for profit maximisation is a well-documented health system challenge. This study examined general practitioners’ (GPs) reactions to pharmaceutical incentivisation offers in one region in Pakistan. Methods: We used the Standardised Pharmaceutical Sales Representative (SPSR) method and qualitative interviews with GPs. SPSRs were field researchers representing mock pharmaceutical companies who recorded their observations of 267 GPs’ responses to pharmaceutical incentivisation offers. We triangulated SPSR data using qualitative interviews with a subset of the same GPs to gather information about how they interpreted different interaction outcomes. Results: We found four major outcomes for GPs being offered incentives by pharmaceutical companies for prescribing medications. GPs might agree to make incentivisation deals, reject incentivisation offers, disallow PSRs to access them, or remain indeterminate with no clear indication of acceptance or rejection of incentivisation offers. GPs rejecting SPSRs’ incentivisation offers indicated having active commitments to other pharmaceutical companies, not being able to work with unheard-of companies, and asking SPSRs to return later. Conclusions: The GP-pharmaceutical sales representative interaction that centres on profit-maximisation is complex as offers to engage in prescribing for mutual financial benefit are not taken up immediately. The SPSR method helps understand the extent of distortion of practices impacted by incentivisation. Such an understanding can support the development of strategies to control unethical behaviours.
KW - medical ethics
KW - pharmaceutical incentivisation
KW - prescribing
UR - http://www.scopus.com/inward/record.url?scp=85184229197&partnerID=8YFLogxK
U2 - 10.1177/13558196241230853
DO - 10.1177/13558196241230853
M3 - Article
AN - SCOPUS:85184229197
SN - 1355-8196
VL - 29
SP - 173
EP - 181
JO - Journal of Health Services Research and Policy
JF - Journal of Health Services Research and Policy
IS - 3
ER -