The results of the 2,938 eligible doctors surveyed showed that 37% of physicians sometimes or often give in to patients’ demands for brand-name drugs. Length of time in practice also influenced whether a doctor was more or less likely to acquiesce to patient demands. Physicians who had been in practice for more than 30 years gave in to patients’ demands for brand-name drugs 43% of the time compared with 31% of physicians in practice for 10 years or less (p = 0.001). The speciality of the doctor also had a role to play. Physicians specialized in internal medicine or psychiatry gave in to patients’ demands for brand-name drugs 50% of the time compared with paediatric physicians, who acquiesced in only 17% of cases.

This is good news for originator drug manufacturers who invest billions of dollars in direct-to-consumer advertising, but bad news for patients; leading to higher co-payments.

Other influences, which increased the likelihood for doctors to prescribe brand-name drugs when asked by patients included when food and/or beverages in the workplace (39% vs 33%) and free drug samples (40% vs 31%) were provided by the pharmaceutical industry.

Doctors who met with pharmaceutical industry reps to gain information about drugs were also more likely to give in to patients’ demands than those who never or rarely met with reps (40% vs 34%). Doctors in small practices also let patients persuade them more often than physicians in hospitals or medical schools (46% vs 35%).

Speaking or consulting fees, gifts or travel reimbursement, reading medical journals and attending lectures had no significant influence on whether a doctor was likely to prescribe a brand-name drug or not when asked by a patient.

Conflict of Interest
The authors of the report reported no conflict of interest.

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Reference

1.  Campbell EG, Pham-Kanter G, Vogeli C, Iezzoni LI. Physician acquiescence to patient demands for brand-name drugs: results of a national survey of physicians. JAMA Intern Med. 2013 Jan 7:1-3. doi: 10.1001/jamainternmed.2013.1539. [Epub ahead of print].

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