Communication Drivers for Drug

Adoption in An Uncertain World

Dipanjan Goswami Sakun Boon-itt Neera Jain D.R
Agarwal
2016
Presented by Ana Asmara

INTRODUCTION
Health-care value chain (Porter and Lee, 2013),
centred on competing branded medicines, is
exposed to complex interactions between
various players such as government bodies,
health-care providers and manufacturing firms
(Pitta and Laric, 2004; Midttun, 2007)
Doctors are the decision-makers for drug
prescriptions and not the end-consumer patients
(Kim and King, 2009)
The nature and relative importance of marketing
communication as a source of uncertainty in
forming adoption intentions remains a subject of
debate.

INTRODUCTION
Firms marketing efforts, influencing doctors
prescription intention (PBI) has been referred in
the health-care adoption literatures in the
context of the indirect communication
strategies of competing pharmaceutical firms
(Greving et al., 2006; Litvin et al., 2008; Gonul
and Carter, 2012).
Experience dimension acts as a mediating
variable between marketing communication
and doctors PBIs (Baron and Kenny, 1986)
It is expected that PBIs will be the drivers of
word-of-mouth (WOM) communication among
doctors, leading them to adopt or reject a drug.

INTRODUCTION
This paper predicts doctors
prescribing intentions based on
communication relationship among
factors for late entrant branded drugs,
compared with pioneering brand
choice, for treating chronic diseases
such as hypertension.

LITERATURE REVIEW
Marketing communication and doctors
behavioural prescription intentions
Firms create perceived usefulness
Perceived usefulness considered as a
performance-enhancing dimension that
leads to more efficient decision-making
(doctors decision-making)
Perceived usefulness due to marketing
communication is influencing doctors PBIs
of late entrant branded drug.

LITERATURE REVIEW
Word-of-mouth communication
Imitation theory (Bass, 1969) or consumption
externality theory(Berndt et al., 2003).
Prescription by a senior doctor or consultant is
followed by junior, less experienced doctors, due
to imitation effects.
Consumption externalities arise when the use of
a drug by others influences perceptions and
affects adoption rates due to viral
communication effects.
Consumers rely on WOM communication when
there is perceived risk and uncertainty, which
are often associated with service purchase
decisions.

HYPOTHESIS DEVELOPMENT AND

FRAMEWORK

This study proposes a causal path, exploiting TAM constructs

(perceived usefulness, behavioural intentions and social influence),
integrating with the mediating effect of physicians experience on
developing adoption intentions
(Venkatesh et al., 2003; Libana-Cabanillas et al., 2014; Martins et
al., 2014).

HYPOTHESIS DEVELOPMENT AND

FRAMEWORK

H1. Perceived drug usefulness for late entrant brand adoption is positively related to
the doctors PBIs.
H2. Doctors experiences mediate the relationship between perceived drug
usefulness and their PBIs.
H3. Controlling for doctors experience and WOM communication, marketing
promotional communication positively affects drug adoption either directly or
indirectly through doctors PBIs.

HYPOTHESIS DEVELOPMENT AND

FRAMEWORK

H4. The higher the doctors PBIs for late entrants, the lower will be the social
influence in decision-making.
H5. Social influence, in the form of WOM communication among the doctors,
impacts negatively the late entrant branded drug adoption.
H6. Controlling for marketing promotional communication and doctors experience,
PBI positively affects drug adoption either directly or indirectly through WOM
communication.

DATA COLLECTION
Questionnaire consists of three items for each construct completed
by a total sample of 151 doctors working within private healthcare institutions located in the National Capital Region of India.
Non-response bias was tested using the extrapolation method,
t-testing and common method variance (Wong et al., 2011), and a
null effect was found.
The respondents were chosen using a non-probabilistic method.
In choosing senior and junior doctor, a multiplicity sampling
method was used to ensure that 54.9 per cent of the population
comprised senior doctors/consultants).
Because a particular domain of hypertension treating, drugprescribing practitioners are chosen, multiplicity sampling,
where referral to other doctors take place, has been used.

RESULTS:
Descriptive statistics

MODEL FIT STATISTICS FOR EACH

HYPOTHESIZED MEASUREMENT MODEL
(M1 AND M2)

Multiple fit indices were evaluated for both M1 and

M2 models (Anderson and Gerbing, 1988). The
comparative fit measures were tested using
normed fit index (NFI), incremental fit index (IFI),
TuckerLewis index (TLI) and comparative fit index
(CFI).

Second order, threefactor measurement

model (M2) for drug
adoption
In absence of an established
drug adoption model, we owe
responsibility to present the most
appropriate model.
Hence, a second order CFA model
(M2) was evaluated and, finally,
found to be most
suitable

CONVERGENT VALIDITY AND AVERAGE

VARIANCE EXTRACTED USING FACTOR
LOADINGS FOR THREE FACTOR SECOND
ORDER CFA

Because the composite reliabilities for each construct are greater than
the AVE, the convergent validity is deemed acceptable
Hence, the composite reliabilities, despite starting from a
lower range, have been deemed acceptable.

DISCRIMINANT VALIDITY AMONG

CONSTRUCTS

Computed correlation matrix between

the constructs (table IV) supports
discriminant validity among the
constructs

Insignificant
Significant

HYPOTHESES TESTS FOR DRUG

ADOPTION

MANAGERIAL
IMPLICATIONS
The study has several implications for
managers of pharmaceutical firms:
ensuring the quality of communication to, and
training for, doctors.
improving social relationship with doctor team,
comprising young and experienced doctors, can
be effective here because unstandardized
communication dimensions lead to lower
composites reliabilities.
this study shows that the price sensitivity is not
a driver for hypertension treatment