Insights

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Pharmaceutical industry medical affairs physicians have more influence over customer prescribing than their sales force.

Introduction

Traditionally, the pharmaceutical industry has used ‘promotional personal engagement’ activities, which involve interactions between sales forces and prescribers, in order to generate ‘sales’—or prescriptions—of their new medicinal product(s). There appears to be now a favouring of ‘non-personal engagement’ (external information sources or activities existing outside the direct control of the company) and ‘non-promotional personal engagement’ activities (focused around creating peer-to-peer relationships between prescribers and pharmaceutical physicians).

Objectives

The purpose of this study was to examine the influence of non-personal engagement and non-promotional personal engagement activities on the prescribing habits of British healthcare professionals, using the traditional promotional personal engagement activities as a comparator.

Methods

A questionnaire was distributed to 122 prescribers (physicians, nurses and pharmacists) working with two selected products for pulmonary arterial hypertension. The participants were asked to rate the influence that the listed activities had on their decision to prescribe each of the two products using a scale of 0–10, where 0 = ‘no influence’ and 10 = ‘most important influence’.

Results

Of the 122 targeted healthcare professionals who received the questionnaire, 34 (27.9%) responded within the 2-week time limit (24 physicians, 5 nurse prescribers and 5 pharmacists). The findings of the survey had a confidence level of 90% and a margin of error of 12%, given that 34 of 122 people responded. All proposed activities were scored by the respondents as having some influence on their prescribing. Personal engagement activities are effective for influencing prescribing, but non-promotional personal engagement activities may be more influential than promotional personal engagement activities. Furthermore, non-personal engagement activities may be more effective in influencing prescriptions of a product than either non-promotional or promotional personal engagement activities.

Conclusions

Key points from our RWE original research

Pharmaceutical companies employ a range of prescriber engagement activities, including promotional personal, non-promotional personal and non-personal activities.

Prescribers rated non-personal engagement activities as the most influential on their prescribing habits, followed by non-promotional personal engagement activities and, lastly, promotional personal engagement activities.

Medical Affairs engagement

All personal engagement activities affect HCP prescribing behaviours; however, they appear to be more influential when performed on a non-promotional basis by representatives of the company’s medical department. Perhaps counter-intuitively, activities with an explicit promotional purpose were seen to be less effective at influencing prescribing than non-promotional activities. However, non-personal engagement activities may be a more important driver than any personal engagement activities, highlighting the importance of high-quality clinical and RWE research, timely publication of key results and product-related information, and promotion of communication and experience sharing between prescribers. However, further research is required in this area, for example to determine the relative influence of pharmaceutical-funded publications compared with publications funded by other sources.

Learn how we can ensure that a medical plan is developed with the full engagement of all stakeholders.

Coordinating and collecting feedback in an efficient way to ensure the items included in the plan are agreed by the internal stakeholders can be a challenge.
Our approach involves using a novel group awareness and consensus methodology to generate and agree, the SWOT, Critical Success Factors (CSFs), Aspirational Statement before we go away and design the tactics themselves.

Insights generation

The complementary role of expert opinion in science

by Solomon Christopher

Expert opinions complement systematically collected patient-level data in various ways. They can be based on mechanistic interpretations, for example, a certain viewpoint of the pathophysiology of disease or treatment action. These interpretations would require further functional studies that may not be feasible or limited in scope.

Expert opinions are also well founded on personal clinical practice experience. A certain clinical observation may have not yet been rigorously studied. This information from multiple experts is crucial additional information that should add to scientific data and inform the scope of further studies.

Mere patient-level data and their analysis, especially those based on real world evidence (RWE) alone, can be an empirical account of associations at worst. This might be due to unobservability of certain data or lack of experimental evidence.

Bayesian statistical viewpoint has always facilitated subjective information to be included in data analysis. After all, most scientific studies, however rigorous, involve subjectivity at the design and interpretation. Bayesian statistics account for this subjectivity by quantifying the uncertainty of information at various levels.

Together, systematically collected patient-level data, expert opinions and rigorous statistical analysis along with quantified uncertainty at various levels of information are powerful tools to scientific progress.