Effect of Exposure to Small Pharmaceutical Promotional Items on Treatment Preferences
Effect of Exposure to Small Pharmaceutical Promotional Items on Treatment Preferences
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DOI：
10.1001/archinternmed.2009.64
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发表时间：
2009-05-11
影响因子：
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通讯作者：
Kahn, Barbara E.
中科院分区：
文献类型：
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作者：
Grande, David;Frosch, Dominick L.;Kahn, Barbara E.
背景：关于药品促销的政策讨论通常假设小的促销项目不太可能影响处方行为。我们的实验测量了接触这些项目是否会导致对上市产品更有利的态度，以及限制药品营销的政策是否会减轻这种影响。方法：这是一项随机对照实验，对象是美国两所医学院的352名三年级和四年级的医学生，他们对药品营销采取了不同的政策。被分配到治疗的参与者被暴露在立普妥(阿托伐他汀)的小型品牌促销物品中，而不知道这种暴露是研究的一部分。我们用内隐联想测验(IAT)测量了暴露组和对照组对立普妥和佐科(辛伐他汀)的内隐(即，无意识)态度的差异。结果：与对照组相比，接触立普妥促销品的迈阿密大学米勒医学院四年级学生对该品牌药物的内隐态度更有利(IAT效应：0.66比0.47；P=.05)，而宾夕法尼亚大学医学院则相反(IAT效应：0.22比0.52；P=.002)，限制药品营销的限制性政策到位(交互效应：P=.003)。在三年级学生中没有观察到明显的影响。在“怀疑论”量表上，迈阿密大学的学生比宾夕法尼亚大学的学生对药品营销持更积极的态度(0.55比0.42；P<；.001)，但结果与之前发表的一项全国性研究结果相似(0.42比0.43；P=.53)。结论：微妙地接触小型药品促销物品会影响医学生对营销产品的内隐态度。我们观察到，在限制性政策的设置和学校层面对营销的更负面态度方面，这种影响发生了逆转。
Background: Policy discussions concerning pharmaceutical promotion often assume that small promotional items are unlikely to influence prescribing behavior. Our experiment measures whether exposure to these items results in more favorable attitudes toward marketed products and whether policies that restrict pharmaceutical marketing mitigate this effect.Methods: This is a randomized controlled experiment of 352 third- and fourth-year medical students at two US medical schools with differing policies toward pharmaceutical marketing. Participants assigned to treatment were exposed to small branded promotional items for Lipitor (atorvastatin) without knowledge that the exposure was part of the study. We measured differences in implicit (ie, unconscious) attitudes toward Lipitor and Zocor ( simvastatin) in exposed and control groups with the Implicit Association Test (IAT). Self-reported attitudes were also measured, and a follow-up survey was administered measuring attitudes toward marketing.Results: Fourth-year students at the University of Miami Miller School of Medicine exposed to Lipitor promotional items had more favorable implicit attitudes about that brand-name drug compared to the control group ( IAT effect: 0.66 vs 0.47; P=.05), while the effect was reversed at the University of Pennsylvania School of Medicine ( IAT effect: 0.22 vs 0.52; P=.002) where restrictive policies are in place limiting pharmaceutical marketing (interaction effect: P=.003). No significant effect was observed among third-year students. On a "skepticism" scale, University of Miami students held more favorable attitudes toward pharmaceutical marketing compared to University of Pennsylvania students (0.55 vs 0.42; P < .001) but the results were similar to those of a previously published national study ( 0.42 vs 0.43; P=.53).Conclusions: Subtle exposure to small pharmaceutical promotional items influences implicit attitudes toward marketed products among medical students. We observed a reversal of this effect in the setting of restrictive policies and more negative school-level attitudes toward marketing.