TITLE:
Gift Acceptance and Its Effect on Prescribing Behavior among Iraqi Specialist Physicians
AUTHORS:
Ehab Mudher Mikhael, Dhulfiqar Nidhal Alhilali
KEYWORDS:
Drug Promotion, Gifts, Prescribing Behavior
JOURNAL NAME:
Pharmacology & Pharmacy,
Vol.5 No.7,
June
24,
2014
ABSTRACT: Background: The interaction
between physicians and medical representatives (MRs) through gift offering is a
common cause for conflicts of interest for physicians that negatively influence
prescribing behaviors of physicians throughout the world. This study aimed to evaluate
the interaction between MRs and Iraqi specialist physicians through the acceptance
of MRs gifts and the effect of such acceptance on physician’s prescribing patterns.
Methods: A survey in a questionnaire format for specialist physicians was done during
March-October 2013 in Iraq, Baghdad. The questionnaire involves four major parts
regarding the approximate number of patients and medical representatives, gift acceptance,
medical conferences, and prescribing pattern. Results: In Iraq specialist physicians
were visited by 1 - 3 MRs/day. 50% of the Iraqi physicians like to get the educational
information by attending conferences outside Iraq. Regarding Gift acceptance, 41%
of participated physicians showed a general acceptance to promotional gifts, and
91% of physicians accept low cost gifts but only 41% of them accept high cost recreational
gifts. Free samples were used by 59% of Iraqi physicians to treat some people. 77%
of physicians prefer prescribing new medications, while more than 95% of participated
physicians stated that they stop prescribing these new drugs either due to their
ineffectiveness or due to their side effects. On the other hand physicians significantly
change their prescribing behavior through shifting not only among generic drugs,
but also from brand to generic drugs in their prescriptions. Gift acceptance is
directly correlated with such shift and change in prescribing behavior. Conclusion:
Iraqi physicians accept various types of gifts from pharmaceutical companies; this
can influence physician prescribing pattern and result in early adoption to prescribe
newly medications depending on promotional information even in absence of clinical
evidence about the drug effectiveness or side effects, which may result in undesirable
outcomes to the patient.