Steinman Michael A, Harper G Michael, Chren Mary-Margaret, Landefeld C Seth, Bero Lisa A
Affairs Medical Center, San Francisco, California, United States of America.
PLoS Med. 2007 Apr;4(4):e134. doi: 10.1371/journal.pmed.0040134.
Sales visits by pharmaceutical representatives ("drug detailing") are common, but little is known about the content of these visits or about the impact of visit characteristics on prescribing behavior. In this study, we evaluated the content and impact of detail visits for gabapentin by analyzing market research forms completed by physicians after receiving a detail visit for this drug.
Market research forms that describe detail visits for gabapentin became available through litigation that alleged that gabapentin was promoted for "off-label" uses. Forms were available for 97 physicians reporting on 116 detail visits between 1995 and 1999. Three-quarters of recorded visits (91/116) occurred in 1996. Two-thirds of visits (72/107) were 5 minutes or less in duration, 65% (73/113) were rated of high informational value, and 39% (42/107) were accompanied by the delivery or promise of samples. During the period of this study, gabapentin was approved by the US Food and Drug Administration only for the adjunctive treatment of partial seizures, but in 38% of visits (44/115) the "main message" of the visit involved at least one off-label use. After receiving the detail visit, 46% (50/108) of physicians reported the intention to increase their prescribing or recommending of gabapentin in the future. In multivariable analysis, intent to increase future use or recommendation of gabapentin was associated with receiving the detail in a small group (versus one-on-one) setting and with low or absent baseline use of the drug, but not with other factors such as visit duration, discussion of "on-label" versus "off-label" content, and the perceived informational value of the presentation.
Detail visits for gabapentin were of high perceived informational value and often involved messages about unapproved uses. Despite their short duration, detail visits were frequently followed by physician intentions to increase their future recommending or prescribing of the drug.
医药代表进行的销售拜访（“药品推广”）很常见，但对于这些拜访的内容以及拜访特征对处方行为的影响却知之甚少。在本研究中，我们通过分析医生在接受加巴喷丁的推广拜访后填写的市场调研表格，评估了加巴喷丁推广拜访的内容和影响。
通过一场指控加巴喷丁被用于“未获批”用途的诉讼，获取了描述加巴喷丁推广拜访的市场调研表格。这些表格来自97位医生，记录了1995年至1999年间的116次推广拜访。四分之三的记录拜访（91/116）发生在1996年。三分之二的拜访（72/107）时长为5分钟或更短，65%（73/113）被评为具有高信息价值，39%（42/107）伴有样品发放或赠送承诺。在本研究期间，加巴喷丁仅被美国食品药品监督管理局批准用于辅助治疗部分性癫痫，但在38%的拜访（44/115）中，拜访的“主要信息”涉及至少一种未获批用途。在接受推广拜访后，46%（50/108）的医生表示打算在未来增加加巴喷丁的处方量或推荐量。在多变量分析中，未来增加加巴喷丁使用或推荐的意向与在小组（而非一对一）环境中接受推广以及该药物的低基线使用量或无基线使用量有关，但与其他因素无关，如拜访时长、“获批”与“未获批”内容的讨论以及对展示内容的信息价值感知。
加巴喷丁的推广拜访被认为具有较高的信息价值，且常常涉及未获批用途的信息。尽管拜访时长较短，但推广拜访后医生常常打算在未来增加对该药物的推荐或处方量。
