Physicians' perceptions of medical representative visits in Yemen: a qualitative study

The pharmaceutical industry invests heavily in promotion, and it uses a variety of promotional strategies to influence physicians' prescribing decisions. Within this context, medical representatives (MRs) are the key personnel employed in promoting their products. One significant consequence of the interactions between physicians and medical representatives is a conflict of interests which may contribute to the over prescribing of medications and thus negative effects on patients' health and economics. There is limited detailed information published on the reasons why physicians interact with pharmaceutical representatives. This study aims to qualitatively explore physicians' attitudes about interactions with medical representatives and their reasons for accepting the medical representatives' visits.

In-depth interviews were used to gain a better understanding of physicians' perceptions of medical representative visits. A total of 32 physicians from both private and public hospitals were interviewed. The recordings of the interviews were transcribed verbatim and subject to thematic analysis using a framework analysis approach.

The present qualitative study found that the majority of the physicians had positive interactions with medical representatives. The physicians' main reasons stated for allowing medical representatives' visits are the social contacts and mutual benefits they will gain from these representatives. They also emphasized that the meeting with representatives provides educational and scientific benefits. A few physicians stated that the main reasons behind refusing the meeting with medical representatives were lack of conviction about the product and obligation to prescribe medicine from the representative company. Most of the physicians believed that they were under marketing pressure to prescribe certain medicines.

Although physicians are aware that the medical representatives could influence their prescribing decision, they welcome representatives to visit them and consider receiving free samples, gifts and various kinds of support as a normal practice. The findings provided insight into possible target areas for educational interventions concerning pharmaceutical marketing. Such a finding will provide the basis for policymakers in the public and private health sector in Yemen to develop a suitable policy and regulations in terms of drug promotion.