The Pharmaceutical Journal
Vol 270 No 7233 p106
25 January 2003

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Family Practice abstract (more)

Reps heavily influence prescribing

Pharmaceutical representatives have significant influence on a general practitioner's decision to prescribe a new drug, a recent study reports.

The research involved 107 GP practices in the north west of England, selected to represent high, medium and low levels of new drug prescribing. Although poor efficacy or adverse effects of current therapy were reasons for prescribing new drugs in 25 per cent of cases, the influence of a pharmaceutical representative was a factor in some 40 per cent of decisions.

Hospital consultants and observation of hospital prescribing were cited as the next most frequent influences. This was a good reason for trusts and primary care organisations to introduce new drugs jointly across primary and secondary care, the authors say.

Patient requests for a drug as well as patient convenience and acceptability were also likely to influence new drug uptake. Patient requests often led to "uncomfortable" decisions about prescribing, which the authors predict will increase with direct-to-consumer advertising (Family Practice 2003;20:61).

Helen Prosser, research fellow at Liverpool University's prescribing research group and one of the study authors, told The Journal that GPs were probably unaware of the large influence of representatives. However, she pointed out that the study had been carried out between 1998 and mid-1999 and, since then, the introduction of primary care trust prescribing advisers and more local guidelines may have changed the situation. The National Institute for Clinical Excellence was another new authority that might affect prescribing.

Ms Prosser emphasised that while the study focused on prescriptions of new products, the main volume of prescribing remained "tried and tested" medicines.