Drug Promotion Research Articles

The role of Pharmaceutical Marketing in Prescribing Decisions in a Developing Country: A Comprehensive Study Exploiting Theory of Planned Behaviour

Background: Prescription medicines have become a major component of health systems in both developed and developing countries contributing to, may be, more than half of the total health care expenditure in the developing countries. Although literature directly attributing rise in medicines expenditure to prescribers’ decision, but still only a few researches had employed studies with sound theoretical foundations to comprehensively examine prescribing decision behaviours. Our objective was to investigate potentially modifiable factors, which may influence prescribing decisions of physicians employing theory of planned behaviour. Method: A quantitative survey approach was used to investigate the proposed hypotheses. Population was physicians in outpatient clinics in both private and governmental hospitals in Sana’a, capital city of Yemen. A structured questionnaire was designed to measure the influence of drug-promoting marketing techniques on physicians’ prescribing decisions. Data was collected through an anonymous survey questionnaire. The hypotheses were tested by multiple regressions analysis. Ethical approval was obtained from the Ethical Committee of the Ministry of Public Health and Population (MoPHP), and participants provided written consent before enrolling in the study. Result: Physicians admitted the presence of promotional influence on their prescribing decision. The study revealed that receiving low-value promotional items, belief of physicians that it is appropriate to accept both low- and high-value promotional items, physicians’ exposure to company-direct sources of information, and drug promotion-related factor all are positively and significantly related to physicians’ prescribing decisions (? = 0.438, p <0.001; ? = 0.089, p =0.027; ? = 0.157, p <0.001; ? = 0.093, p =0.032; and ?= 0.118, p = 0.007 respectively). Conclusion: This research clarified the role played by pharmaceutical companies to influence prescribing decisions of physicians. Therefore, could provide theoretical framework for policymakers in Yemen, and other countries with similar conditions, to develop a suitable policy and strategy in terms of drug promotion.

Evaluation of Drug and Herbal Medicinal Promotions on Social Media During the COVID-19 Pandemic in Relation to World Health Organization Ethical Criteria and South African Health Products Regulatory Authority Guidelines in South Africa: Cross-Sectional Content Analysis.

Consideration of ethics in the promotion of medications is essential to safeguard the health of consumers, particularly during health crises. The World Health Organization (WHO) and the South African Health Products Regulatory Authority (SAHPRA) have established stringent standards to ensure the integrity of pharmaceutical promotions and safeguard public health, including advertisements on the internet and social media platforms. However, the dynamic nature of online advertising poses challenges for monitoring and enforcing ethical standards. The study aimed (1) to examine the COVID-19 drug and medicinal promotions across online platforms and social media from 2020 to 2022 in South Africa and (2) to ensure that drug promotions adhere to ethical guidelines outlined by the WHO and SAPHRA. A cross-sectional content analysis was conducted to assess drug and medicinal advertisements across various internet and social media platforms. A systematic approach was used to identify and analyze promotional content, focusing on adherence to ethical guidelines outlined by WHO and SAPHRA. Data were collected and analyzed to determine the extent of compliance and identify any potential violations or areas for improvement. A total of 14 online drug advertisements were included in this analysis. Our findings show that most of the drugs advertised did not meet the regulations and guidelines provided by WHO and SAHPRA. There were omissions about active ingredients, proprietary names, adverse drug responses, precautions, and overdosage and adverse drug reactions. Traditional medicines were not fully consistent with the approved WHO ethical criteria data sheet. Our analysis highlights the critical importance of ensuring compliance with ethical guidelines in drug promotions on the internet and social media platforms. There is a need for continued vigilance and enforcement efforts to uphold ethical standards and protect the health of the public. Ongoing monitoring and collaboration between national drug regulatory agencies, pharmaceutical companies, and online platforms will be essential for promoting responsible advertising. In addition, safety monitoring and pharmacovigilance systems for herbal medicinal products are yet to be established.

3D/2D-Bismuth Oxybromide Spheres with Selenium-Doped Graphitic Carbon Nitride Sheets: An Efficient Electrocatalyst for the Detection of Arsenic Drug Roxarsone.

Heavy metals are crucial carcinogenic agents threatening the environment and living habituates. Among them, arsenic (As) is an important metalloid that is categorized as a group I toxic carcinogen. Roxarsone (RX) is an organoarsenic antibiotic compound primarily used as a veterinarian drug and growth promoter for poultry animals. The extensive usage of RX increased the accumulation of As in living beings and the ecosystem. Therefore, we have prepared an electrochemical sensor based on 3D bismuth oxybromide with 2D selenium-doped graphitic carbon nitride (BOB/SCN) electrocatalyst for the rapid detection of RX. The elemental and structural details were thoroughly investigated with several spectroscopic techniques. The electrochemical properties were measured by impedance and voltammetric measurements. The electrocatalytic behavior toward the RX was estimated with different voltammetric methods. Therefore, our BOB/SCN-based electrochemical sensor demonstrated a low detection limit (2.3 nM), low quantification value (7.7 nM), optimal sensitivity (0.675 μA μM-1 cm-2), and good linear ranges (0.01-77 and 77-857 μM). Additionally, this sensor showed good electrochemical performance and was applied to monitor the RX in various real samples with remarkable recoveries. Based on these results, our BOB/SCN sensor is a promising electrochemical platform for determining RX.

CRITICAL ANALYSIS OF CLAIMS IN DRUG PROMOTIONAL LITERATURE AVAILABLE TO MEDICAL PRACTITIONERS

Context: Objective: To ascertain whether the pharmaceutical companies are following the World Health Organisation (WHO) criteria for Ethical Medicinal Drug Promotion 2015 and Organisation of Pharmaceutical Producers of India (OPPI) Code of Pharmaceutical Marketing Practices, 2019 and to what extent. Also, to evaluate the therapeutic claims made by them in their drug promotional literature (DPL) and to classify them. Methods: DPL brochures were collected from different pharmaceutical companies from various medical practitioners and assessed for ethical promotion based on guidelines. Therapeutic claims made by them were classified as authentic, exaggerated, controversial, false, misinterpreted, and ambiguous. Results: A total of 100 DPLs were collected and critically analyzed for authenticity of the content. It was observed that the majority of the DPLs did not comply with the criteria mentioned in the WHO Criteria of Ethical Promotion 2015 and the OPPI Code of Pharmaceutical Practices 2019. International non-proprietary names and the brand name were mentioned by 100% of DPLs. The amount of active ingredients and approved therapeutic indications were mentioned by (99%) and (96%) respectively. The dosage form or regimen was mentioned by 87% of DPLs. Criteria like side effects, precautions/contraindications, and major interactions were mentioned in 28%, 29%, and 14% respectively. Based on the therapeutic claims 23% of the DPLs were found to be authentic and the remaining 77% were extravagant. Conclusions: This study enabled us to find out to what extent the pharmaceutical industries follow the standard criteria for DPL and evaluate the claims made by them. The majority of the DPLs did not follow ethical guidelines and were inadequate in terms of their adequacy, quality, and reliability.

Patients’ knowledge, attitude, and practices toward unused medications in Qatar: A cross-sectional survey

BackgroundGlobal evidence has linked unused medications and their inappropriate disposal to adverse health, economic, environmental, and ethical impacts. However, such evidence is scarce in Qatar. This study explored patients’ knowledge and attitude toward unused medications and their practices toward medication supply and disposal (KAP) in Qatar.Materials and methods Study designA cross-sectional survey using a pretested questionnaire was performed between February 2020 and October 2020. Descriptive statistics, Man Whitney U, and Kruskal–Wallis Rank-Sum tests were applied. The Chi square test assessed the association between socio-demographic characteristics and KAP scores. Characteristics that were found significantly associated with KAP (i.e., p-values <0.05) were further included as predictor variables in the multiple linear regression model. ResultsAll items pertaining to patients' knowledge were found to be good (mean score > 3), except for “awareness of unwanted medication return policy” (mean score < 3), i.e., the lowest level of patient agreement (31 %) (median (M) = 3, Interquartile Range (IQR) = 3). Their attitude was generally good (mean score > 3). Conversely, their practice toward medication supply was poor (mean score < 3). Possible future use was the most reported reason (79 %) for keeping medications at home, and home trash was the most widely disposing place of unused ones (76 %). Knowledge was significantly higher among non-laborers and other occupations than among patients with no work (p < 0.001) and (p = 0.005), respectively. The attitude was significantly lower among patients with healthcare providers (HCPs) in their household than among those without (p = 0.001). Practices were also significantly lower among those aged 40–49 years and those with HCPs in their household than those aged 18–29 years (p = 0.012) and those without HCPs, (p < 0.001), respectively. ConclusionsOverall, patients’ knowledge and attitude toward unused medications seem good, while their practices toward medication supply and disposal are bad. To mitigate the health, economic, and environmental impacts of unused medications, interventions including rationalizing drug supply, use, disposal, prescribing, manufacturing, and promotion are recommended.

Effect of pharmaceutical promotion and incentives offered by pharmaceutical companies on the prescribing pattern of medical students: a cross-sectional study from a developing nation Pakistan

BackgroundPharmaceutical companies continuously pursue healthcare professionals, starting from the medical college level, which can ultimately lead to irrational prescribing of drugs and antibiotics. Therefore, our main aim was to evaluate the opinions and attitudes of medical students toward pharmaceutical promotion.MethodsThis study utilized a cross-sectional online survey that applied the snowball sampling technique. Data were collected from three public and three private sector medical colleges in Punjab, Pakistan using snowball sampling. A modified version of a pre-structured questionnaire was used to collect data between October 2020 and January 2021. Medical students from the third year onward were captivated. The tool was made available on Google Forms and students could access it by clicking the link shared. The effect of promotion on prescribing pattern and future prescribing of antibiotics were measured. Descriptive statistics, chi-square, and t-test were used to analyze the data.ResultsA total of 1,301 students filled out the survey, but only 1,227 responses were acceptable. The average age was found to be 23.4 ± 1.59 years. Slightly more than half of the respondents were male participants (57.7%), and a significant proportion (84.1%) reported being aware of pharmaceutical promotion. A smaller number (27.7%) felt that physicians who meet medical representatives more frequently tend to prescribe more antibiotics and 46.3% indicated they would be willing to prescribe antibiotics under the promotional influence. Medical students who were male, in senior college years, attended government institutions, and had lower parental income showed significantly higher perception and attitude scores (p &amp;lt; 0.05) which, in turn, may show their inclination to promotional activities. Many students agreed with the view that pharmaceutical promotion (PP) activities may alter prescribing practices and also believed that they contribute to the increased irrational prescribing of drugs and antibiotics.ConclusionThe study revealed that only a small number of students are willing to engage in promotional activities and accept rewards, which influences their choice toward selection of drugs and antibiotics. This study highlighted the necessity of giving proper educational instructions regarding the promotion of drugs to medical students. This study also focused on the educational prerequisites of the students.

IJCM_220A: Proportion of self-medication among elderly in a tertiary hospital in southern Kerala - a cross sectional study

Background: The use of drugs, herbs, or home remedies on one’s own initiative, or on the advice of another person, without consulting a doctor. Over-the-counter availability of medicines, promotion of drugs, lack of proper awareness regarding the drug and its side effects, unheeded drug policies are all leading causes of antimicrobial resistance in today’s world. Objectives: To determine the proportion and determinants of self-medication among elderly individuals above 50 years of age visiting the district hospital in South Kerala Methodology: A hospital based cross sectional study was conducted in the inpatients above 50 years of age from the Medicine, Surgery, Pulmonology, Cardiology departments of the district hospital, Kollam. Minimum sample size was calculated to be 156 and convenience sampling was done. A semi-structured questionnaire was formulated, and data was collected in interview mode over the months of June-July 2022. Data was tabulated using MS-Excel and statistical analysis was done using SPSS software version 21. Descriptive statistics were expressed as frequencies and percentages. Chi square test was used to test any differences between proportions. Results: Among 156 participants more than half of the study participants (52.6%) with a history of self-medication described as more often (51.2%). 50% with history reported symptoms like gastritis, followed by diarrhoea, anxiety and sleep disturbances. The most commonly self-medicated drugs were Paracetamol (85.4%) followed by cetirizine (14.6%), cough syrups (12.2%) and antibiotics (9.7%) like Azithromycin and Amoxiclav Conclusion: Self-medication practices come with a lot of potential risks, like incorrect self-diagnosis, severe adverse reactions, delay in seeking medical care, incorrect choice of therapy and administration of drugs, drug interactions, masking of severe disease, dependence and abuse.

The use of tracker technologies on branded prescription drug websites: privacy, data acquisition and programmatic advertising

PurposeThe purpose of this study was to examine consumer data acquired by branded prescription drug websites and the ethics of privacy related to the interconnected web of personal information accessed, packaged and resold by tracker technologies.Design/methodology/approachThe research used the DMI Tracker Tool to collect data on the top 17 branded prescription drug websites, with a specific interest in the tracker technologies embedded in those websites. That data was analyzed using Gephi, an open-source data visualization tool, to map the network of trackers embedded in those branded prescription drug websites.FindingsFindings visualize the interconnections between tracker technologies and prescription drug websites that undergird a system of personal data acquisition and programmatic advertising vehicles that serve the interests of prescription drug marketers and Big Tech. Based on the theory of platform ethics, the study demonstrated the presence of a technostructural ecosystem dominated by Big Tech, a system that goes unseen by consumers and serves the interests of advertisers and resellers of consumer data.Research limitations/implicationsThe 17 websites used in this study were limited to the top-selling prescription drugs or those with the highest ad expenditures. As such this study is not based on a random sampling of branded prescription drug websites. The popularity of these prescription drugs or the expanse of advertising associated with the drugs makes them appropriate to study the presence of tracking devices that collect data from consumers and serve advertising to them. It is also noted that websites are dynamic spaces, and some trackers within their infrastructures are apt to change over time.Practical implicationsBranded prescription drug information has over the past three decades become part of consumers’ routine search for information regarding what ails them. As drug promotion moved from print to TV and the Web, searching for drug information has become a part of everyday life. The implications of embedded trackers on branded prescription drug websites are the subject of this research.Social implicationsThis study has significant social implications as consumers who are searching for information regarding prescription medications may not want drug companies tracking them in a way that many perceive to be an invasion of privacy. Yet, as the Web is dominated by Big Tech, web developers have little choice but to remain a part of this technostructural ecosystem.Originality/valueThis study sheds light on branded prescription drug websites, exploring the imbalance between the websites under study, Big Tech and consumers who lack awareness of the system that operates backstage.

Drug Promotions Between Ethics, Regulations, and Financial Interests.

The promotion of the latest medicines produced by the pharmaceutical industry is an important issue both from an ethical point of view (the level of accessibility, the way research is carried out) and from the point of view of marketing and especially from the lobbying issues raised. The ethical dilemmas raised by the promotion of new drugs revolve between the need to discover new molecules important for treating a wide range of diseases and the need to establish a battery of ethical rules, absolutely necessary for regulations in the field to be compliant with all ethical principles. A literature search was conducted through PubMed, MEDLINE, Plus, Scopus, and Web of Science (2015-2023) using combinations of keywords, including drugs, medical publicity, and pharma marketing plus ethical dilemma. The promotion of medicines is governed by advertising laws and regulations in many countries, including at EU level, based on the need for countries to ensure that the promotion and advertising of medicines is truthful, based on information understood by consumers. The ethical analysis of the issues raised is more necessary and complex as the channels used for promotion are more accessible to the population, and the information, easier to obtain, can be the cause of increased self-medication and overeating. Large amounts of money invested in the development of new molecules, but also the risk of scientific fraud through manipulation of data during clinical trials, selective or biased publication of information can have repercussions on the health of the population. The development of new pharmaceutical molecules is necessary to intervene and treat as many conditions as possible, but marketing must not neglect the observance of ethical principles. The promotion of medicines should be the attribute especially of the medical staff, which should also be a mandatory part of the mechanism for approving the marketing methods and means used by the pharmaceutical companies.

Vector Biology and Integrated Management of Malaria Vectors in China.

Malaria is an infectious disease caused by Plasmodium parasites, transmitted by Anopheles sinensis, Anopheles lesteri, Anopheles minimus, and Anopheles dirus in China. In 2021, the disease was eliminated in China after more than 70years of efforts implementing an integrated mosquito management strategy. This strategy comprised indoor residual spray, insecticide-treated bed nets, irrigation management, and rice-fish coculture based on an understanding of taxonomic status and ecological behaviors of vector species, in conjunction with mass drug administration and promotion of public education. However, China still faces postelimination challenges, including the importation of approximately 2,000-4,000 cases of malaria into the country each year, as well as widespread resistance to pyrethroid insecticides in An. sinensis; these challenges require long-term vector surveillance to understand the distribution, population density, and development of resistance in vector mosquitoes to prevent local epidemics caused by imported malaria cases.

Prevalence of medicare antiviral drugs use and related factors in HIV-infected people in Ningbo

Objective: To analyze the use of medicare antiviral drugs (ART) and related factors among HIV-infected people in Ningbo City. Methods: The retrospective data was collected related to infection and treatment of HIV-infected people in ART in Ningbo up to February 2023 through the National Infectious Disease Surveillance System. Binary logistic regression was used to analyze the factors related to medicare antiviral drug use in HIV-infected people. R 4.2.2 software was used for statistical analysis. Results: A total of 6 433 HIV-infected people with ART records were collected, among which 5 783 were in ART. The prevalence of medicare drugs use among people in ART was 24.8% (1 435/5 783, 95%CI: 23.7%-25.9%). Beilun District (8.7%, 43/497) and Fenghua District (5.7%, 14/247) had the lowest level in medicare drugs use. Among people in ART using medicare or out-of-pocket drugs, the prevalence of those who had at least one viral load test in the last year (84.9%, 1 352/1 593) was significantly lower than that of those using free drugs (91.4%, 3 829/4 190) (χ2=52.50, P<0.001). The results of multivariate logistic analysis showed that the factors influencing medicare drug use included low educational level (junior high school and below: aOR=0.24, 95%CI:0.17-0.34), farmer or worker (farmer: aOR=0.60, 95%CI: 0.39-0.91; worker: aOR=0.42, 95%CI: 0.27-0.64), low monthly income (<3 000 Yuan: aOR=0.29, 95%CI: 0.18-0.45), the longer interval time between diagnosis and treatment (≥21 days: aOR=0.47, 95%CI: 0.30-0.74). Conclusions: Significant regional differences on the prevalence of medicare antiviral drugs use in HIV-infected people exist in Ningbo City. Follow-up management program of patients should be improved to strengthen patient compliance to mobilize medicare drug promotion. Meanwhile, publicity of medicare drugs should be strengthened for farmers or workers with low education level and patients with delayed treatment.

Pharmaceutical Drug Promotion and Rational Drug Use: Assessment of Healthcare Workers Perspective.

Pharmaceutical drug promotion has the potential to improve rational drug use by creating awareness among healthcare workers and patients as well as increasing access to life-saving medicines. This study aimed to determine whether pharmaceutical drug promotion can improve rational drug use among healthcare workers. Semi-structured questionnaires were filled by selected dispensers and prescribers in central Uganda. Forms of pharmaceutical drug promotion, sources of drug information, and views on the influence of drug promotion on rational drug use were investigated. Associations amongst selected variables were tested at bivariate and multivariate levels. Of the 383 participants enrolled in the study, 49.6% were dispensers. More dispensers (49.0%, 92/188) favored 1 on 1 discussion whereas prescribers (32.0%, 61/191) preferred continuous medical education. Most dispensers (85.6%, 161/188) and prescribers (68.6%, 131/191) reported that drug promotion influences their choice of drug use, with most (dispensers: 85.1%, 160/188 vs prescribers: 72.3%, 1/191) admittedly relying on drug promotion as their primary source of drug information. Pharmaceutical drug promotion influences prescription and dispensing practices among health workers, and it should be strictly regulated to ensure accurate and essential information for health workers while prioritizing rational use of medicines.

An evaluation of drug promotional literature in clinical practice

Background: In current clinical practice, pharmaceutical companies use drug promotional literatures (DPLs) as a promotional tool to introduce new products entering into the market to medical practitioners. DPLs play a major role in providing important information about the drug to the health-care professionals and to convince them to prescribe the same. Aims and Objectives: The aims and objectives of the study are to evaluate the appropriateness of DPLs as per the World Health Organization (WHO) criteria for rational drug promotion and for other information such as the pictures given and the presence of self-boasting words, if any. Materials and Methods: A cross-sectional observational study was conducted from December 2022 to May 2023 at a tertiary care teaching institute in southern Rajasthan, India. 330 DPLs, using convenient sampling, were collected in the form of hard and soft copies of flyers, leaflets, brochures, and pamphlets from various registered medical practitioners from a variety of departments and were evaluated based on the WHO guidelines. Results: A total of 330 DPLs were evaluated. Generic name was present in 98.2%, brand name in 97.9%, amount of active ingredient in 90%, name of manufacturer in 100%, and reference to scientific literature in 57.6%. About 75.5% of DPLs depicted photographs and 53% mentioned self-boasting words or phrases. Conclusion: Only few DPLs fulfilled all eleven criteria laid down by the WHO. Hence, doctors should not rely solely on promotional literature and appropriate policies must be made for vigilance of the DPLs.

Bacteriostatic cells instead of bacteriostatic antibiotics?

This year we commemorate the centennial of the birth of the mature concept of bacteriostasis by John W. Churchman at Cornell University Medical School. The term bacteriostasis has primarily been applied to antibiotics (bacteriostatic antibiotics). In this Opinion paper, we are revisiting this concept by suggesting that bacteriostasis essentially reflects a distinct cellular status (or "cell variant") characterized by the inability to be killed as a consequence of an antibiotic-induced stress impacting on bacterial physiology/metabolism (growth). Note that the term "bacteriostasis" should not be associated only with antimicrobials but with many stressful conditions. In that respect, the drug promotion of bacteriostasis might resemble other types of stress-induced cellular differentiation, such as sporulation, in which spores can be considered "bacteriostatic cells" or perhaps as persister bacteria, which can become "normal cells" again when the stressful conditions have abated.IMPORTANCEThis year we commemorate the centennial of the birth of the mature concept of bacteriostasis by John W. Churchman at Cornell University Medical School. The term bacteriostasis has primarily been applied to antibiotics (bacteriostatic antibiotics). In this Opinion paper, we are revisiting this concept by suggesting that some antibiotics are drugs that induce bacteria to become bacteriostatic. Cells that are unable to multiply, thereby preventing the antibiotic from exerting major lethal effects on them, are a variant ("different") type of cells, bacteriostatic cells. Note that the term "bacteriostasis" should not be associated only with antimicrobials but with many stressful conditions. In that respect, the drug promotion of bacteriostasis might resemble other types of stress-induced cellular differentiation, such as sporulation, in which spores can be considered "bacteriostatic cells" or perhaps as persister bacteria, which can become "normal cells" again when the stressful conditions have abated.

Branded response to generic entry: Detailing beyond the patent cliff

The literature on pharmaceutical marketing devotes little attention to the promotion of branded drugs after generic competitors enter the market. This paper addresses this gap in the literature and explores how the sales of branded drugs respond to specific promotional strategies following generic entry. We focus on physician detailing, and specifically, firms’ post-generic-entry decisions regarding overall detailing spending and physician-level allocation (i.e., which physicians to visit). We utilize a novel, custom-built dataset containing information on aggregate-level sales, prescriptions, and promotional budget for 72 brands and their competitors; our dataset further includes detailed physician-level data on detailing visits and prescription behavior for 25 of these brands. We first describe the detailing strategies that brands use in practice, and then analyze the outcomes associated with changes in detailing spending and allocation. Our analyses reveal that, on average, brands’ detailing spending decreases after generic entry, yet the ROI on such spending increases compared to before generic entry. Refocusing of detailing efforts after generic entry such that physicians with higher brand preference are targeted is more likely to lead to an increase in detailing ROI than other allocation strategies post entry. However, in practice, many brands do not undertake such reallocation and do not enhance their ROIs. Our findings are of clear practical relevance to manufacturers of branded drugs, as well as to policy makers who wish to curb detailing efforts for branded drugs when generic alternatives are available, so as to lower healthcare costs.

Analysis of the Physical Characteristics of an Anhydrous Vehicle for Compounded Pediatric Oral Liquids.

The paucity of suitable drug formulations for pediatric patients generates a need for customized, compounded medications. This research study was set out to comprehensively analyze the physical properties of the new, proprietary anhydrous oral vehicle SuspendIt® Anhydrous, which was designed for compounding pediatric oral liquids. A wide range of tests was used, including sedimentation volume, viscosity, droplet size after dispersion in simulated gastric fluid, microscopic examination and content uniformity measurements to evaluate the properties of the anhydrous vehicle. The results showed that the vehicle exhibited consistent physical properties under varying conditions and maintained stability over time. This can be attributed to the unique blend of excipients in its formulation, which not only maintain its viscosity but also confer thixotropic behavior. The unique combination of viscous, thixotropic and self-emulsifying properties allows for rapid redispersibility, sedimentation stability, accurate dosing, potential drug solubility, dispersion and promotion of enhanced gastrointestinal distribution and absorption. Furthermore, the vehicle demonstrated long-term sedimentation stability and content uniformity for a list of 13 anhydrous suspensions. These results suggest that the anhydrous oral vehicle could serve as a versatile base for pediatric formulation, potentially filling an important gap in pediatric drug delivery. Future studies can further investigate its compatibility, stability and performance with other drugs and in different clinical scenarios.

Knowledge attitude and practices of drug promotional literature: a clinician’s perspective

Background: Promotion of drugs by pharmaceutical industries is fully regulated by drug regulators. Doctors are focus of intense marketing by representatives of pharmaceutical companies (MR). It is reported that very few physicians are equipped with the necessary skills and knowledge to critically assess the information delivered in drug promotional literature (DPL). Hence this study was carried out with the objective to determine knowledge, attitude and practices of doctors about the DPL Methods: This was a questionnaire-based study population included clinicians working in a government set up and others doing private practice. Questionnaire was circulated online on social media platforms via Google forms. Results: The 32.11% participants were aware of regulations and guidelines of DPL in India 80.7% participants searched for cost of medicine on DPL, 54.12% respondents perceive that the product claims made on DPL are balanced and supported by good evidence, 56.88% participants opined that their integrity is compromised by accepting gift from MR, 43.1% participants are exposed to drug advertisement through social media and 51.06% of them opined that their prescribing habits are influenced through this. Writing brand names while prescribing is significantly more in private practitioners as compared to doctors employed in government set up. Conclusions: DPL serves to update the knowledge of the busy clinicians of the latest developments in the medical field. Quality check of drug promotion on social media is the need of the hour as this is influential. Private practitioners need to be addressed regarding enforced laws for rational prescribing.

An Updated Review of Food and Drug Administration Warning and Untitled Letters for Clinical Outcome Assessment Claims Between 2013 and 2021

ObjectivesWe aimed to ascertain the frequency and types of Food and Drug Administration (FDA)-identified clinical outcome assessment (COA) violations in US pharmaceutical promotional materials from 2013 to 2021 by updating the review by Symonds et al (covering the period 2006-2012 for patient-reported outcomes [PRO] measures), expanding to infringements across all types of COAs, and grouping by efficacy or overall patient experience. MethodsWarning letters (WLs) and untitled letters (ULs) issued by the FDA’s Office of Prescription Drug Promotion were reviewed for COA violations and classified by their type: (1) COA measure not fit for purpose, (2) issue with study design or interpretation of results, and (3) inadequate statistical analysis. ResultsFrom 2013 to 2021, the FDA issued 22 WLs and 65 ULs. Year 2013 showed the highest number of letters issued (n = 24). Of the total 87 letters reviewed, 22 (25%) contained a COA violation, consisting of 6 WLs (27%) and 16 ULs (25%), including 20 (23%) with a PRO-related violation. The most common violations cited “study design or interpretation of results” (21 of 22 [95%]). ConclusionsOverall, the absolute number of WLs and ULs issued declined when comparing 2006 to 2012 with 2013 to 2021. Despite the overall reduction, this review still identified 25% of letters citing COA infringements (23% with PRO issues), which was similar to the prior review (19% PRO infringements). This may be due to increased FDA attention to patient-focused drug development.

Assessing the mediating role and multiple group analysis in physicians’ habit persistence toward prescribing behavior using SmartPLS software

PurposeAlthough there is evidence that the efforts of pharmaceutical marketing exert a positive and significant influence on physician prescription decisions, the specific mechanisms by which this impact occurs remain uncertain. To address this issue, this study aims to investigate whether the physician’s habit persistence may explain the relationship between marketing efforts such as brand attributes and drug promotion and prescribing behavior. This study also explores whether there was any significant difference between specialists and general practitioners (GPs) regarding the effect of brand attributes and drug promotion on physician’s habit persistence, which influences prescribing behavior.Design/methodology/approachA survey instrument was administered to physicians, encompassing specialists in a particular field and GPs who provide primary care services. A nonparametric partial least squares multigroup analysis was used to analyze 393 valid responses using partial least squares-structural equation modeling.FindingsThe results indicate that the decision to prescribe the drug may be affected by the physician’s habit persistence in the presence of vital brand attributes and drug promotion. The relationship between physician’s habit persistence and prescribing behavior is significant in GPs and specialist groups. The findings also reveal that brand attributes are the most influential and significant determinant of physician’s habit persistence in the GPs group. In addition, physician specialists are more aware of the influence of drug promotion initiatives than GPs. Furthermore, this study discovered that the relationship between drug promotion and physician’s habit persistence indicates a significant difference between specialists and GPs.Originality/valueAlthough several marketing scholars discuss the factors influencing prescribing behavior, a few studies have shown the role of brand attributes and drug promotion and their effect on physician’s habit persistence. This study will specifically contribute by examining the mediating role of physician’s habit persistence between marketing efforts and prescribing behavior. In addition, so far, no studies have effectively made a comparative analysis across physicians regarding the effect of marketing efforts on physician’s habit persistence and prescribing behavior.

Perception, knowledge and attitudinal assessment of drug promotional literature among second year, medical undergraduate students: a questionnaire-based study

Background: WHO defines drug promotion literature (DPL) as “all informational and persuasive activities by manufacturers, the effect of which is to induce the prescription, supply, purchase and/or use of medicinal drugs”. Benefit driven marketing of new drugs by drug companies may lead to erroneous prescription due to insufficient understanding, knowledge of safety and therapeutic benefits of the drugs in the community. All these promotional activities influence the prescribing pattern of doctors. 2nd year of undergraduate medical course is the appropriate time to educate the medical undergraduate students about fundamentals of DPL and to train them accordingly for improving their prescribing behaviour eventually. Methods: A prospective questionnaire-based study was conducted in Goa Medical College. The study participants consisted of 150 II-year undergraduate medical students. Approval from Institutional Ethics Committee was obtained. The feedback forms were collected from the students after they were completed and data was analysed and represented as counts and percentages. Results: Among respondents 36% of students opined that the quality of details provided by medical representatives is biased and too commercial followed by others. 40.7% of students were of the view that the most important intervention needed to reduce the impact of drug promotion on prescribing was to formulate policies and guidelines for the health care authorities. Conclusions: Promotional activities by manufacturers influence the attitude and prescribing pattern of doctors. So, it is of utmost importance to train medical graduates in order to enable them to develop the skill of critical analysis of DPL and consequently rational prescribing.