A physician survey of the effect of drug sample availability on physicians' behavior
A physician survey of the effect of drug sample availability on physicians' behavior
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DOI：
10.1046/j.1525-1497.2000.08014.x
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发表时间：
2000-07-01
影响因子：
5.7
通讯作者：
Lessler, DS
中科院分区：
文献类型：
--
作者：
Chew, LD;O'Young, TS;Lessler, DS
目的：制药公司经常在门诊护理环境中使用药物样品作为一种营销策略。关于药物样本的可获得性如何影响医生的处方实践，人们知之甚少。我们的目标是评估：(1)在什么情况下以及为什么医生分发药物样本，(2)药物样本是否导致医生使用他们喜欢的药物以外的药物，以及(3)与药物样本使用相关的医生特征。设计：横断面调查。设置：一个学术医学中心的大学诊所。伙伴：154名全科医生和家庭医生。测量和主要结果：医生在3种临床情况下的自我报告开药模式，包括他们首选的药物选择，他们是否会使用药物样本并随后开出样本药物，以及决定分发药物样本所涉及的因素的重要性。在154名医生中，共有131名(85%)做出了回应。当向一名患有简单下尿路感染的投保妇女提供时，22名(17%)受访者报告他们会分发药物样本；22名样本使用者中有21名(95%)表示他们将分发与他们首选的药物不同的药物样本。对于患有高血压的未参保男性，35名(27%)受访者表示他们会分发药物样本；35名样本使用者中有32名(91%)表示他们会分发药物样本，而不是他们首选的药物。对于患有抑郁症的未参保妇女，108名(82%)受访者报告他们会分发药物样本；108名样本使用者中有53名(49%)表示他们将分发与他们首选的药物不同的药物样本。在所有三种情况下，避免患者的成本是分配药物样本的最一致的动机。在两种情况下，居民报告使用药物样本的可能性比主治医生更高(P<；0.05)。当选择两种或三种情况的药物样本的受访者与从未选择使用药物样本或只选择一种情况的药物样本的受访者进行比较时，只有较年轻的年龄与药物样本的使用独立相关。结论：在自我报告中，药物样本的可用性导致医生分发并随后开出与他们首选的药物选择不同的药物。医生最常报告说，使用药物样本是为了避免患者付出代价。
OBJECTIVE: Pharmaceutical companies often use drug samples as a marketing strategy in the ambulatory care setting. Little is known about how the availability of drug samples affects physicians' prescribing practices. Our goal was to assess: (1) under what circumstances and why physicians dispense drug samples, (2) if drug samples lead physicians to use medications other than their preferred drug choice, and (3) the physician characteristics that are associated with drug sample use.DESIGN: Cross-sectional survey.SETTING: University-based clinics at one academic medical center.PARTICIPANTS: 154 general medicine and family physicians.MEASUREMENTS AND MAIN RESULTS: Physicians' self-reported prescribing patterns for 3 clinical scenarios, including their preferred drug choice, whether they would use a drug sample and subsequently prescribe the sampled medication, and the importance of factors involved in the decision to dispense a drug sample. A total of 131 (85%) of 154 physicians responded. When presented with an insured woman with an uncomplicated lower urinary tract infection, 22 (17%) respondents reported that they would dispense a drug sample; 21 (95%) of 22 sample users stated that they would dispense a drug sample that differed from their preferred drug choice. For an uninsured man with hypertension, 35 (27%) respondents reported that they would dispense a drug sample; 32 (91%) of 35 sample users indicated that they would dispense a drug sample instead of their preferred drug choice. For an uninsured woman with depression, 108 (82%) respondents reported that they would dispense a drug sample; 53 (49%) of 108 sample users indicated that they would dispense a drug sample that differed from their preferred drug choice. Avoiding cost to the patient was the most consistent motivator for dispensing a drug sample for all 3 scenarios. For 2 scenarios, residents were more likely to report using drug samples than attendings (P < .05). When respondents who chose a drug sample for 2 or 3 scenarios were compared to those who never chose to use a drug sample, or chose a drug sample for only one scenario, only younger age was independently associated with drug sample use.CONCLUSION: In self-reports, the availability of drug samples led physicians to dispense and subsequently prescribe drugs that differ from their preferred drug choice. Physicians most often report using drug samples to avoid cost to the patient.