PHYSICIANS, PHARMACEUTICAL SALES REPRESENTATIVES, AND THE COST OF PRESCRIBING

Objective: To evaluate the influence of primary care physicians' attit udes toward and use of information provided by pharmaceutical represen tatives on prescribing costs in ambulatory practice. Design: A mailed questionnaire collected information about physician demographic and pr actice characteristics and attitudes toward and use of information pro vided by pharmaceutical representatives. Participants: Kentucky physic ians practicing primary care adult medicine (family medicine, general practice, general medicine; n=1603). Main Outcome Measure: Relative co st of prescribing, based on physician responses to treatment choices f or ambulatory clinical scenarios in primary care. A multivariable regr ession model assessed predictive relationships between independent var iables and prescription costs. Results: Four hundred forty-six returne d questionnaires were suitable for analysis. No significant difference s were noted in age, gender, days worked per week, or years since grad uation between responders and a sample of nonresponders. A significant positive correlation was found between physician cost of prescribing and perceived credibility, availability, applicability, and use of inf ormation provided by pharmaceutical representatives (P<.01, Pearson's Product-Moment Correlation Coefficient). Physicians in academic or hos pital-based practice settings had significantly lower prescribing cost s than physicians in nonacademic and nonhospital practices (P=.001, an alysis of variance). Frequency of use of information provided by pharm aceutical representatives (P=.01, multiple linear regression) and the group practice setting (P=.02, multiple linear regression) remained si gnificant, independent positive predictors of cost in the multivariabl e regression model. Conclusions: Frequency of use of information provi ded by pharmaceutical representatives and the group practice, nonacade mic and nonhospital setting may be associated with increased primary c are physician prescribing costs.