Demographics, Practices, and Prescribing Characteristics
INTRODUCTION
As total expenditures related to health care grow each year, pharmaceuticals play an ever-increasing role in medical care. Prescription drugs now account for a larger percentage of health care costs than ever before. Physicians remain the gatekeepers to the widespread use of a new drug. Although a fairly large amount of research has focused on factors that influence a physician’s decision to adopt a new drug, little research has examined the demographics, practices, and prescribing characteristics of physicians who are the first to adopt new drugs. This article examines that issue.
A substantial amount research has addressed the channels of information concerning new drugs and the factors that influence an individual physician’s decision to prescribe. Sometimes the research refers to a new drug on the market or to an existing drug first prescribed by the physician. A wide variety of research has shown that interpersonal communication between opinion leader-physicians and their peers can be (and many times has been) the critical factor in the rapid, wide-scale acceptance of innovative drugs.
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A report in the Journal of the American Medical Association from 2000 estimated that of the $11 billion spent each year by pharmaceutical companies for promotion and marketing, almost 50% of that went to sales representatives. The same study found that interactions with drug salespeople had a very strong impact on preference and rapid prescribing of new drugs. Many other studies have echoed these findings, listing the pharmaceutical sales representative as one of the most important factors in influencing doctors’ adoption of a new drug, even if physicians sometimes minimize the importance they place on pharmaceutical salespeople.
Many research studies highlight the role that medical bulletins and journals play as sources of information on new drugs. Although some researchers have debated the value of peer-reviewed journals as a source of information on these drugs, other data indicate that medical bulletins and journal articles do represent an important channel of information about both old and new drugs.
Specialist meetings, presentations, conferences, and symposia form a communication channel that appears to be particularly important for disseminating information about new drugs. The literature indicates that these forums provide a highly valued source of information and facilitate interaction among physicians and can have a noticeable influence on the adoption of new drugs.
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Direct-to-consumer (DTC) advertising, although it is allowed only in the U.S. and New Zealand, has also become an important tool for pharmaceutical companies in marketing their new drugs, especially antidepressants, antihista-mines, antihyperlipidemic agents, and anti-inflammatory agents. Whether DTC advertising is actually effective in getting physicians to write prescriptions, however, is still being debated. Even though many pharmaceutical companies have dramatically increased their spending on DTC advertising, visits by sales representatives who bring free samples still constitute a much larger percentage of U.S. pharmaceutical company promotional spending and has proved to be more effective.
The limited research that has been done in the area of physician characteristics and their adoption of new drugs suggests that the following categories of physicians tend to prescribe new drugs early on:
- young physicians—or at least those who have been practicing for a shorter period of time
- male physicians, when compared with female physicians
- board-certified doctors
- physician graduates from the most recently established medical schools
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Drawing upon multivariate models, this paper describes the characteristics of U.S. physicians who are the first to adopt new drugs in their prescribing practices. The research focuses on those characteristics as they relate to the adoption of both ther-apeutically novel drugs (i.e., first-in-class drugs) and later follow-on drugs in drug classes already established.
