A REVIEW ON PROMOTIONAL

STRATEGY AND REGULATION OF

PRESCRIPTION DRUGS

LEARNING GROUP-5:
I NG! 1. MOHD. SHAHANAWAZ
RTIS
E 2. MARIYA BISWAS
ADV
L
H ICA 3. MOHD. REHAMATULLAH
ET
O UN SHAH
N OT
SAY 4. DR. PRIYA BHASIN
5. MACHUT ZIMIK
6. MANOJ KUMAR SINGH
 CONTENTS
1. Introduction
2. Aim of the study
3. Objectives
4. Research Methodology
5. Literature review
6. Interaction
7. Analysis
8. Limitations
9. Conclusion
10.Recommendation
11.Bibliography
 INTRODUCTION
Drug promotion is a global concern.
Contributes to irrational use of drugs
Drugs which are marketed as “breakthrough”
represents only a small fraction of improvement than
the existing ones.
Unethical promotion of drugs a common phenomena.
Most countries rely on industry self-regulation
Corporate responsibility
Regulations
 Putting the patient first and
implementing promotion responsibly
through truthful information is
essential if we want promotion and
education at same time
 AIM

“The AIM of this project is to interpret

the current scenario on promotion of
prescription drugs and to highlight the
regulatory framework for promotional
practices through an international
perspective”.
 OBJECTIVES OF THE STUDY
 To determine the perception of health care professionals on prescription

drug promotion.

 To understand the roles and responsibilities of medical representatives on

drug promotion.

 To determine the promotional activities of pharmaceutical companies for

prescription drugs and identify the variations in promotional practices

among the companies.

 To highlight the regulatory frameworks on drug promotion through

international perspective.

 To annotate on the control of drug promotion by identifying the right

practice-both regulations and pharmaceuticals promotional activities.

 DRUG PROMOTION
According to WHO, Drug Promotion can be defined as “all
informational and persuasive activities by manufacturer and
distributers to induce/influence the sale and use of medicinal
drugs”
Rational use of drugs depends on the activities of drug
promotion.
Two major objectives of promotional program:
1) to inform
2) to persuade
Promotion is usually performed by a well-trained “Medical
Representatives”
Pharmaceutical Promotional Strategy
DRUG
COMPANIES

MR, GIFTS,
DTCA INTERNET CONFERENCES,
etc.,

CONSUMERS DOCTORS
 Other forms of Promotion
Journals
Direct mail & e-mail
Bill boards
Newspapers
TV
Radio
Salespeople (dealers and wholesalers)
Newsletters
Directories & reference books (PDR)
Electronics (video material, internet)
Word of mouth.
 RESEARCH METHODOLOGY

Dr. Reddy
Qualitative Marketing
Interview Head Panacea

Primary Ranbaxy
Research
130 HCPs
Research Survey
& 25 MR
Methodology HCPs, MR (3 MR
Questionnaire from each
company)
Secondary Websites &
Research Literature
 INTERACTION
Panacea
Medical
Representatives
Non-Research
Products
PROMOTIONAL
Conferences
STRATEGY

Research
Products Seminars
Dr. Reddy

Seminars

PROMOTIONAL Medical
STRATEGY Representatives

Continued
Medical
Education
Ranbaxy

Medical
Representatives

PROMOTIONAL
STRATEGY Seminars

Conferences
ANALYSIS
 Health Care
Professionals
 Do Medical Representatives approach you for the pharmaceutical
products?

100%
90%
80%
70%
60% 0.65
0.93
50% Column1
40% no
30%
20%
10% 0.35
0.07
0%
Private Practioners
Hospitals
 93 %( 52) Private Practitioners says Medical representatives approach them however, 7 %( 8)
says Medical Representatives don't approach them.
 65 %( 21) doctors from hospitals says Medical Representatives approach them while 35 %( 39)
say no MRs don’t approach them.
 Information provided by MR
35%

48%
Helpful
Not Sure
Don't Agree

17%

 
48 %( 58) doctors said that the information provided by the Medical
Representatives was helpful while 17 %( 19) were not sure and 35 %( 43) said
that they don’t agree with the information provided by MRs
 Do MRs play important Role in promotion of drugs?
60%

50%

40%
Yes
30% 0.54 No
0.48 Can't Say
20% 0.38
0.3
0.08 0.22
10%

0%
  Private Practitioners Hospitals

 54% (32) Private practioners think that the Medical Representatives play an important role in
promotion of drugs while 38 %( 23) disagree.
 30 %( 18) Doctors from hospitals says that the Medical representatives play an important role
in promotion of drugs while 22 %( 13) disagree.
 Offers made by pharmaceutical companies

60

51
50 47

40 Gifts
Meals/Drinks
Entertainment
30 Medical Text
25 Equipment
23 Samples
21
20 19 Personal Items
16 Never Offered

10 7 8
5 4 5
2 2 23
0
Private Practitionares Hospitals
Most frequent source of information about new
drugs
50
45 43
40 38
35
30 Medical Represeantatives
Internet
25 Conferences/Seminars
20 Medical Texts
Others
15 12
10 8 7
5 4
1 2 1
0
Private Practitioners Hospitals

43% Private Practitioners and 38% doctors form the hospitals agree that the most common source of
information for them is medical representative from the pharmaceutical company.
 Do You think MRs should be provided more training?

100%
90%
80% 47
54
70%
60%
Column1
50% no
40%
30% 53
46
20%
10%
0%
Private Practitioners Hospitals
 Medical
Representatives
 How do MRs approach health care professionals?

80%

70% 0.67
0.6
60% 0.57

50%
Company's Reference
40% By own
0.32
30% Others
0.23
0.20.2
20%
0.11 0.1
10%

0%
Ranbaxy Panacea Dr. Reddy
Do HCPs need more training
30%

YES
NO

70%
 Do you think offers made to health care
professionals influence them?
20%

40%

YES
NO
can't say

40%
Does your company provide training before
approaching the doctors?

8%

YES
NO

92%
 Items offered by pharmaceutical
companies for promoting drugs?
60%

50% 0.48
0.42
0.4
40%
Gifts
0.31 Samples
30% 0.29 Medical texts
Equipments
20% 0.17 Conferences and Seminars
0.15 0.15 0.15
0.12
0.1 0.1
10% 0.08
0.08

0
0%
Ranbaxy Panacea Dr. Reddy
 Regulatory
Frameworks
 Current Scenario of Regulating
Prescription Drug marketing in India
• India currently has only one relevant clause of its
own that relates to promotion of prescription drugs.
• Drug companies sets their own standard of drug
promotion
• At present only three major documents for
regulating prescription drug promotion
-The Drugs and Cosmetics Act, 1940
-The Drugs and Cosmetics Rules, 1945
-The OPPI Code of Conduct, 2007
• Recently the Medical Council of India (MCI) put out a statement
asking the doctors to stop receiving gifts.
• Some of the provisions laid down by MCI are:
Medical Practitioner shall not receive
-Any gift
-National/International travel facility
-Paid vacations (self or family)
• Punishment ranges from censure (accepting gifts valued between
Rs.1,000-Rs.5,000) to removal from Indian or State medical Registry
for more than one year
• MCI wants the government to regulate the pharmaceutical companies
 CONCLUSIONS
Medical representatives are the most common tool for the
pharmaceutical companies to approach doctors.
The doctors find the information helpful provided by the medical
representatives.
Gifts and samples are the most common items offered by the
pharmaceutical companies to the doctors in private practice while
medical text is the most common source for promotion in the
hospitals.
All the 3 companies provide References for the medical
representatives to approach the health care professionals.
Ranbaxy and panacea offer gifts and samples more than Dr. Reddy.
Own company regulations- self industry regulations
63% Medical representatives think that the doctors should be
given training to interact with the medical representatives.
40% of the Medical Representatives say that the promotional
activities do not influence the doctors and only 20% say that
the offers do influence the doctors.
The medical representatives are given training before
approaching doctors.
 Variation between the codes and the national regulations and
industry codes for gifts and hospitality
Indicators WHO Ethical IFPMA EFPIA (EU) 2007 ABPI (UK) 2008 PhRMA (US) OPPI (IN) 2007
Criteria 1988 (International) 2006 2008

Ban inducement to Have basic Have basic standard Have basic Have basic No basic standard Have basic
prescribe standard standard standard standard
Gifts
Ban all kinds of gifts No No No No No No

Restriction on the No specific Weak guidance Stringent guidance Stringent guidance Very stringent No specific
nature/purpose of guidance guidance guidance
gifts
Specific restrictions Does not set a Does not set a Does not set a Set value for only Set value for only Does not set a
on value specific value specific value specific value some kinds of some kinds of specific value
gifts gifts
Specific restriction Occasionally or Occasionally or Occasionally or Occasionally or Occasionally or Occasionally or
on frequency infrequent infrequent infrequent infrequent infrequent infrequent

Record-keeping None None None Only certain gifts All gifts that add None
(expensive gifts) up more than $100
per year

Public disclosure None None None None All gifts that add None
up to >$100 per
year
Ban of all Strong limitations Strong limitations No clarification If ban implicit If ban explicit Strong limitations
entertainment on types of events on types of events on types of events
allowed allowed allowed
 LIMITATIONS
• Time Constraint
• Due to low-response rates from the companies much of
information gaps came into picture which had limited our
knowledge.
 RECOMMENDATIONS
• A strong Infrastructure for new code of conduct is needed.

• Independent active monitoring bodies should be established to police

marketing codes of practice with real penalties

• More attention should be paid to the education of the consumers of

pharmaceutical advertisement

• Need improvement on current industry codes particularly the clause on

gifts because it is difficult to define different kinds of gifts.

• Gifts should be ban as the evidence have shown that it influences the

prescribing behavior of the doctors.

 BIBLIOGRAPHY

• http://apps.who.int/medicinedocs/en/d/Js16520e/
• http://www.ifpma.org/EthicalPromotion
• http://www.efpia.org/content/Default.asp?PageID=615
• http://www.pmcpa.org.uk/?q=getcopiesofcode
• http://www.phrma.org/code_on_interactions_with_healthcare_
professionals
• http://www.indiaoppi.com

 
• Rhein RW. Law enforcement and the Internet superhighwaymen. Scrip
Magazine. 1996. Dec: 18-22
• Henry J. Kaiser Family Foundation, Prescription Drug Trends: A
Chartbook, Menlo Park, CA, July 2000
• Alperstein, N. and M. Peyrot, "Consumer Awareness of Prescription
Drug Advertising," Journal of Advertising Research, July/August 1993,
vol. 33, #4 pp. 50-
• Prevention Magazine, "International Survey on Wellness and Consumer
Reaction to DTC Advertising of Prescription Drugs," Vol. 1, 2000/2001,
Emmaus PA: Rodale, 2001.
• Borzo, G., "Consumer Drug Ads Booming: FDA Reviews Restrictions,"
American Medical News, 40(6):1, 37, February 10, 1997.
 YO U
A N K
T H