Physician and Medical Representative Interaction in Iraqi Private Sector: A Qualitative Study

Authors

  • Samer Imad Mohammed Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, Iraq.
  • Ahmed Majed Hameed Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, Iraq.
  • Fatima Zuhair Ali Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, Iraq.
  • Tabark Qais Khazaal Department of Pharmaceutical Pharmacognosy, College of Pharmacy, University of Baghdad, Baghdad, Iraq.

DOI:

https://doi.org/10.31351/vol33iss(4SI)pp1-11

Keywords:

Physician, Medical representative, pharmaceutical promotion, Pharmacist, Challenges

Abstract

 

Pharmaceutical companies assign a budget for activities and promotions that aim to change the prescription habits of the physicians to choose the most suitable medications for their patients, which will eventually grow their sales.

The study's objectives were to explore physicians' and medical representatives' perspectives on the criteria of impactful professional PP and the factors influencing the interaction between physicians and medical representatives.

Qualitative in-depth interviews with flexible probing techniques were carried out in 2023. A semi-structured, open-ended interview questionnaire was used to interview physicians and medical representatives (MRs) from different private clinics in several governorates in Iraq.

Ten physicians and ten MRs participated in this study. For physicians, pharmaceutical promotion was a beneficial profession. The number of patients in the clinic of patients and the obtained benefits of the medication were the most important factors interfering with physician acceptance of MR visits, and they usually refused the visit if the MR was from a new or unknown company. The majority requested to be updated about the advantages of the drug, the price, and recent studies about the medications. Regarding MR overviews, most MRs believed that PP enhanced the link between the physician and the patients. The scientific knowledge of the representative was the most important factor affecting the relationship between the physician and MR. For that, most MRs need the company to improve their scientific data about advertised medications and their communication skills. The nature of a company (brand or generic) was the most important factor that affected the decision to accept the visit by a physician. If the physician is busy or the company is new, this sometimes leads to the physician's rejection. Both the physicians and MRs acknowledged that MR could enhance physicians' knowledge of medications. However, some believe this role is limited to scientific MR rather than encompassing all MR.

Finally, we can conclude that various factors and considerations may influence the nature of the physician-MR relationship. Some of these were associated with the company itself, which ought to have equipped MRs with proficient scientific expertise and effective communication skills. The increasing number of generic medications, the presence of numerous medical companies, and the inadequate training of MRs all contribute to the complexities of MR's job and potentially have a negative impact on the future of medical advertising.

How to Cite

1.
Mohammed SI, Ahmed Majed Hameed, Fatima Zuhair Ali, Tabark Qais Khazaal. Physician and Medical Representative Interaction in Iraqi Private Sector: A Qualitative Study. Iraqi Journal of Pharmaceutical Sciences [Internet]. 2025 Feb. 15 [cited 2025 Feb. 20];33((4SI):1-11. Available from: https://bijps.uobaghdad.edu.iq/index.php/bijps/article/view/3341

Publication Dates

Received

2024-01-25

Revised

2024-02-05

Accepted

2024-04-07

Published Online First

2025-02-05

References

Matej M. Statista. 2022. Pharmaceutical market worldwide revenue 2001-2021 | Statista.

Murshid MA, Mohaidin Z. A systematic review of the influence of medical representatives and promotional tools on prescribing: A comparison between developed and developing countries. Vol. 11, International Journal of Pharmaceutical and Healthcare Marketing. Emerald Group Publishing Ltd.; 2017. p. 361–94. DOI:10.1108/IJPHM-09-2016-0047

Kobashi Y, Watanabe M, Kimura H, Higuchi A, Ozaki A. Are pharmaceutical company payments incentivising malpractice in japanese physicians? [Internet]. Vol. 8, International Journal of Health Policy and Management. Int J Health Policy Manag; 2019. p. 627–8. DOI:10.15171/ijhpm.2019.60

Al-Areefi MA, Hassali MA, b Mohamed Ibrahim MI. Physicians’ perceptions of medical representative visits in Yemen: a qualitative study. BMC Health Serv Res. 2013 Dec 20;13(1):331. DOI:10.1186/1472-6963-13-331

Salmasi S, Ming LC, Khan TM. Interaction and medical inducement between pharmaceutical representatives and physicians: A meta-synthesis [Internet]. Vol. 9, Journal of Pharmaceutical Policy and Practice. J Pharm Policy Pract; 2016. p. 37. DOI:10.1186/s40545-016-0089-z

Mikhael E. Evaluating the reliability and accuracy of the promotional brochures for the generic pharmaceutical companies in Iraq using World Health Organization guidelines. J Pharm Bioallied Sci. 2015 Jan 1;7(1):65–8. DOI:10.4103/0975-7406.148781

Fickweiler F, Fickweiler W, Urbach E. Interactions between physicians and the pharmaceutical industry generally and sales representatives specifically and their association with physicians’ attitudes and prescribing habits: a systematic review. BMJ Open. 2017 Sep 27;7(9):e016408. DOI:10.1136/bmjopen-2017-016408

Mudher Mikhael E. Evaluating the effect of medical representative on physician prescribing pattern in Iraq. Asian J Pharm Clin Res. 2014;7(1):222–3.

Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101. DOI:10.1191/1478088706qp063oa

Venkatesh V, Brown SA, Sullivan YW. Guidelines for conducting mixed-methods research: An extension and illustration. J Assoc Inf Syst. 2016;17(7):435–95. DOI:10.17705/1jais.00433

Kantor J. Physician Advertising and Self Promotion. In: Dermatoethics. Cham: Springer International Publishing; 2021. p. 333–9. DOI:10.1007/978-3-030-56861-0_32

Al-Areefi MA, Ibrahim MIM, Hassali MAA, Alfadl AA. Perceptions of Yemeni physicians about interactions with medical representatives. J Pharm Heal Serv Res. 2017 Dec 1;8(4):255–60. DOI:10.1111/jphs.12195

Moser HR. A longitudinal assessment of consumers’ attitudes toward physicians’ advertising. J Hosp Mark Public Relations. 2008 Oct 11;18(1):3–19. DOI:10.1300/J375v18n01_02

Moser HR, Stevens R, Loudon D. An empirical analysis of ethical and professional issues in physicians’ advertising: A comparative cross-sectional study. Health Mark Q. 2016 Aug 11;33(3):255–73. DOI:10.1080/07359683.2016.1199225

Tomycz ND. A profession selling out: Lamenting the paradigm shift in physician advertising [Internet]. Vol. 32, Journal of Medical Ethics. Institute of Medical Ethics; 2006. p. 26–8. DOI:10.1136/jme.2005.012617

Andrzejewska M, Religioni U, Piątkiewicz P, Barańska A, Herda J, Czerw A, et al. Public Perception of Pharmacists in Poland. Int J Environ Res Public Health. 2022 Mar 1;19(5). DOI:10.3390/ijerph19052515

Moser HR. A longitudinal assessment of consumers’ attitudes toward physicians’ advertising. J Hosp Mark Public Relations. 2008 Oct 11;18(1):3–19. DOI:10.1300/J375v18n01_02

Moser HR, Colvard RG, Austin MJ. Consumers’ attitudes toward advertising by accounting professionals. J Prof Serv Mark. 2000 Nov 10;20(2):5–18. DOI:10.1300/J090v20n02_02

Elrod JK, Fortenberry JL. Advertising in health and medicine: using mass media to communicate with patients. BMC Health Serv Res. 2020 Sep 15;20(1):1–8. DOI:10.1186/s12913-020-05599-3

Balhara YPS, Mathur S, Anand N. A study of attitude and knowledge of the psychiatry resident doctors toward clinician-pharmaceutical industry interaction. Indian J Psychol Med. 2012 Jan;34(1):61–5. DOI:10.4103/0253-7176.96162

Atia A, Gismallah M, Almogadmi E. Influence of Medical Representatives on Prescribing Practices in Tripoli. J Adv Pharm Res. 2022 Jan 1;6(1):28–33. DOI:10.21608/aprh.2021.95357.1140

Al-Areefi MA, Hassali MA, Ibrahim MIBM. Physicians’ perceptions of medical representative visits in Yemen: A qualitative study. BMC Health Serv Res. 2013 Aug 20;13(1):331–331. DOI:10.1186/1472-6963-13-331

Richards BJ, Taylor M, Sage Jacobson S. The role of medical device representatives in healthcare. In: Technology, Innovation and Healthcare. Edward Elgar Publishing eBooks; 2022. p. 64–83. DOI:10.4337/9781788973144.00011

Chaudhry S. E media and training of pharmaceutical sales representatives in Covid era. J Manag Res Anal. 2021 Jul 15;8(2):97–9. DOI:10.18231/j.jmra.2021.020

Martinez CYM, Yango AR. Ethical dilemmas of the medical sales representatives in pharmaceutical marketing and sales. Tech Soc Sci J. 2023 Jun 9;44:910–26. DOI:10.47577/tssj.v44i1.9035

Mukattash TL, Alattar M, Abu-Farha RK, Alsous M, Jarab AS, Darwish Elhajji FW, et al. Evaluating Scientific Research Knowledge and Attitude Among Medical Representatives in Jordan: A Cross-sectional Survey. Curr Clin Pharmacol. 2017 Oct 31;12(4):245–52. DOI:10.2174/1574884712666170828124950

Al Thabbah DH, Almahairah MS, Naser AY, Alrawashdeh HM, Araidah M. The effect of pharmaceutical companies’ marketing mix strategies on physicians prescribing practices in Jordan: a cross-sectional study. BMC Health Serv Res. 2022 Dec 1;22(1):1–12. DOI:10.1186/s12913-022-08664-1

Koumamba AP, Bisvigou UJ, Ngoungou EB, Diallo G. Health information systems in developing countries: case of African countries. BMC Med Inform Decis Mak. 2021 Aug 4;21(1):232. DOI:10.1186/s12911-021-01597-5

Idris KM, Mustafa A., Yousif MA. Pharmaceutical representatives’ beliefs and practices about their professional practice: a study in Sudan. East Mediterr Heal J. 2012 Aug 1;18(8):821–6. DOI:10.26719/2012.18.8.821

Alssageer MA, Kowalski SR. Doctors’ opinions of information provided by Libyan pharmaceutical company representatives. Libyan J Med. 2012 Jan 28;7(1):19708. DOI:10.3402/ljm.v7i0.19708

Siddiqi AA, Shah SZA. Physicians’ attitude towards direct to consumer advertising of pharmaceutical drugs. Int J Pharm Healthc Mark. 2017 Apr 6;11(1):37–48. DOI:10.1108/IJPHM-10-2015-0049.

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Published

2025-02-15