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[‘ Unlike other markets Pharmaceutical market is highly regulated and competitive market. It
is driven by mixture of scientific and technological approach. Unlike other industries and
markets the scenario of pharmaceutical market is totally different. In pharmaceutical
market concept of customer and consumer is different. Here medical practitioners are the
customers and patient is consumer in case of prescription drugs, while patient is customer
in case of OTC drugs. Medical representatives go to the medical practitioners as company
representative and detail their product by giving scientific information. They provide
literatures containing detailed information of product and its benefit backed by data of
clinical studies conducted by the company. The sales of the prescription drug are affected
by medical practitioners who prescribe the company¶s product. There are many other
sources which give information regarding new as well as existing therapies. The
perception and preference of medical practitioners about information sources is vastly
different. Each practitioner has different perception in selection of information sources.

[‘ The objective of study was to find out the perception of physician regarding source of
information for the new therapies. This study also includes the perception of medical
practitioner regarding the easily available sources and most reliable sources. We included
Age, Area of practice and Place of practice wise difference in pattern for selection of
information sources.

The study was carried out at three different places namely Manipal, Udupi and Manglore
by using sample size of 100. In the initial study we started with literature review then
followed by research methodology which includes source of information that is primary
and secondary sources, sample size and sampling technique. Then we set questionnaires
which contains 10 questions. The question was like, the type of practice, age of physician,
easily available sources preferred sources and the most reliable sources. For the collection
of data we used the convenient sampling technique, data which was obtained from the
study was analysed and interpreted by tables, graphs and charts. Based on interpretation
we derived conclusion and some recommendations.
(  #)
The general aim of this work was to study the use, by practising physicians, of drug
information at present available and their information needs for the future. By asking general
practitioners for their views, information was obtained from those who had first-hand
knowledge of the difficulties involved in updating their own information about drugs. The
study was also designed to see where particular sources of information had their main impact.
A total of 252 questionnaires (52%) was completed and returned. A chi-squared table was
constructed to test the representativeness of the respondents. Data which were available for
both respondents and non-respondents, such as age distribution, sex, education, number of
years qualified and number of partners, were used. There was no significant difference shown
at the 5% significance level using these criteria. Other parameters were not used.

The list of information sources, which can be subdivided in a number of ways, was divided
between 'industrial' and 'professional'. Nine sources emanating directly from the
pharmaceutical industry are referred to as industrial. All other sources except the media are
termed 'professional' (Prof), though it is not intended to suggest that information leaving the
industry is any less professional. The professional sources included colleagues, consultants,
medical journals (which are clearly medical) and also the Prescribers µJournal and the British
National Formulary (BNF).The media formed an additional category. There were nine
'industrial' sources, professional sources and the media sources were further subdivided into
'active' information and 'passive' information. This classification depended upon whether or
not the information had been actively sought by the prescriber. The consultant, if contacted
by the general practitioner must be considered 'active', but when action is taken from
information supplied by a consultant's letter, the consultant, as a source, becomes 'passive'.
This gives the 'active/passive' category for a consultant.

From the list of sources in the questionnaire, each doctor was asked to rate each source on a
five point scale from 'very good' to 'very poor'. The order of the various sources in this table
was derived by multiplying each 'very good' rating by 5, each 'good' by 4, etc., to 1 for each
'very poor' with 0 for no response. A refinement was added in which the doctor was asked to
specify, in rank order, the five sources he found most useful in general. These results are
shown in Table 2 and indicate the more personal view of the practical usefulness of
information sources.

The general practitioner needs to treat patients. Information on a particular therapy may be
required while the patient is sitting in the surgery, and telephoning at this stage could be
embarrassing for both parties. A quick, concise source of drug information, providing a
certain amount of detail about contraindications, cost and incompatibilities on new and
established drugs, is required. The majority regard Mims as filling this requirement.
The other sources in the top five highlight the doctor's need for more detailed reliable
information on which to base a prescribing decision or from which to gain reassurance before
prescribing new drugs. Apart from the consultant, all sources in the top five are µpassive¶ and
the consultant's information is often in the form of a letter which also is passive˜

It is often assumed that drug adoption is a process (Coleman et al. 1966). The process
consists of cognitive stages through which a potential prescriber must pass. Two of these
stages are 'awareness' and 'evaluation¶. Awareness of a new product is generally considered
to be a passive activity (Has singer 1959). In the case of new drugs, the pharmaceutical
industry is usually left to inform doctors of a new product's existence by means of the data
sheet followed by a visit from the drug firm representative and direct mail. However, some
new drugs are mentioned on radio or television before they are advertised to the prescriber.
For the evaluation of a new product, different sources of information are used. It might be
assumed that more 'professional' sources would be chosen at this stage. Evaluation is
orientated towards a more personal approach: 'How will the new drug help me in my
practice?' Rogers calls this stage a 'mental trial' (Rogers 1962). Two questions were asked in
the questionnaire to find which sources were used at which stage1. The results are shown in
Using the 'industrial'/'professional' classification, the first five sources chosen for 'awareness'
contain three 'industrial' sources which included the first two places. Where 'evaluation' was
needed the first five sources chosen were all 'professional'. This reliance on the industry to
supply information on new products is not- repeated when product evaluation is necessary,
which perhaps shows a healthy scepticism. Cross-tabulation of the sources of information
against divisions of the characteristics previously listed (variables) were constructed and
tested for significance using the chi-squared test or the proportion test (Strickland-Hodge
1979, appendix 3, p 283). Using this latter test, it was found that, for drug evaluation, single-
practice doctors cited the representative significantly more often than did joint-practice
doctors. The use of sources of information at the 'awareness' and 'evaluation' stages were
cross tabulated with the 'medical age' of the general practitioners subdivided into three groups
according to the number of years qualified. The results are shown in Tables 5 and 6. There
are two aspects from which the major differences shown in Table 6 arise. Consultant
recommendations are used more at this stage by the older doctors; Drug and Therapeutics
Bulletin is used more by newly qualified doctors.

It is concluded that at the evaluation stage newly qualified doctors use Drug and Therapeutics
Bulletin significantly more than their older colleagues. Since 1976, Drug and Therapeutics
Bulletin has been given to all final year medical students, doctors up to four years after
qualifying, trainee GPs and to new principals in general practice. Established general
practitioners would have received the journal only after subscribing. Newly qualified doctors
will therefore have had more opportunity to hear favourable reports of Drug and Therapeutics
Bulletin and are more likely to have used it than their older colleagues. It would be
interesting to see if the percentage citations given in the µ0-5 years¶ group are maintained as
the doctor¶s progress through the '6-30 years' and eventually the '31 or more years' groups.
The consultant is used more by the '31 or more years' group than by either of the earlier
groups. These results are also in agreement with Wilson (1963). The general practitioner
refresh is patients to a consultant when specialist treatment or advice is required. The
reputation of the consultant in the eyes of the general practitioner will only increase over time
as more patients are seen. The newly qualified practitioner needs time to evaluate the worth
of a‘ consultant's advice. By referring patients to a particular consultant, a personal
relationship can be developed which will increase the likelihood of contact when a problem
associated with new drug therapy is encountered.

The more qualified doctors, such as MRCGP, MRCP or FRCS, used Prescribers' Journal
more than the 'first degree only' doctors. Also, those doctors who were Members of the Royal
College of General Practitioners used Drug and Therapeutics Bulletin significantly more than
their colleagues. This might be because this group would have contained more trainers (of
trainee GPs). Similar tests were used for each division of all the other variables under
consideration. It was found that industrial information (defined as all information emanating
from the pharmaceutical industry) was cited significantly more often by older, single-practice
doctors who had a first degree only, did none of their own dispensing and who did not
specialize. 'Industrial' information is used at the awareness stage of drug adoption almost to
the exclusion of the other forms, while 'professional' sources (defined basically as other
sources but excluding the media) were used to evaluate new drugs. However, certain
divisions of some of the variables did not fit this general rule.

The complete list of sources was considered for each subdivision of each variable. A chi
squared test was carried out giving the estimated values of each 'cell' and certain sources of
information were selected for further analysis. These further sources were each tested by the
proportion test. Within the variable 'partnership number', single-practice doctors rated direct
mail, the BNF, controlled circulation journals and the consultant to be significantly more
useful than did joint-practice doctors, which was again in agreement with Wilson
(1963).Newly qualified doctors rated Drug and Therapeutics Bulletin to be significantly more
useful than did their older colleagues, whereas doctors who had been qualified longest rated
the representative, Mims, the consultant and textbooks more highly than did their newly
qualified colleagues. Doctors qualifying from a university local to their practice area rated the
Data Sheet Compendium and Prescribers' Journal to be significantly more useful than did
other doctors. This latter group rated colleagues and articles in medical journals to be
significantly more useful than did the 'local' doctors. Doctors who have 'higher qualifications'
rated articles in medical journals to be more useful than their colleagues. The 'first-degree
only' doctors rated all sources of information more favourably than did their more highly
qualified colleagues, perhaps implying less discernment by the former. Whether or not a
doctor is a 'dispensing doctor' did not appear to influence his or her choice, or rating of
sources of information. The 'specialists' (self-designated) rated the BNF and Prescribers
µJournal to be significantly more useful than did the non-specialists who rated the
representative and the consultant more highly.
!#


!#
[‘ The primary objective of the study is to find out the perception of the medical
practitioner regarding source of information for new therapies.


 
!#
The secondary objectives of the study are as below:

[‘ To find age and place of practice wise difference in selection of information sources.

[‘ To find out the perception of doctors regarding Medical Representative, as a source of

information.

[‘ To find out the perception of doctors regarding preferences of source of information.

[‘ To find out the perception of doctors regarding easily availability of source of

information.

[‘ To find out the source which doctors believes most.

,  





 



[‘Data was collected from secondary and primary sources. Secondary sources were
journals, news papers and internet sources. Primary data was collected from medical
practitioners in Manipal, Udupi and Manglore by self administered questionnaires.


 

[‘Medical practitioners


  

[‘Journals, Magazines, newspaper articles and internet sources



   


 
   


[‘The data for pilot study was collected from various places in Manipal and data for
major study was collected from various medical practitioners working as private
practitioners, working in medical college and private hospitals in various places of
Manipal, Udupi and Mangalore.


 1

[‘We have selected Non Probability Convenience technique and quota sampling for the
collection of data. We directly approached medical each medical practitioners and
asked to fill the questionnaire according to their perception.


 2

[‘ For major study, we selected 100 medical practitioners and divided them between
general practitioners and specialists.

l
 

[‘Structured questionnaire containing both open ended and close ended questions were
prepared for medical practitioner.


 

[‘Pilot study was done by collecting the data from 10 medical practitioners in Manipal
before starting major survey.

       & 


[‘The data collected from major study has been analysed and interpreted in the form of
tables, line charts and pie charts.
   
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25
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20
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,

As shown in the charts: 5, 6 and 7

[‘ The medical practitioners working as #   

 mainly prefer 5
followed by medical journals, MIMS, professional contacts and textbooks.
[‘ The medical practitioners working in
  
 mainly prefer
  !
 
followed by, textbooks, CMEs and MIMS.
[‘ The medical practitioners working in #  
  mainly prefer
  !
 
  followed by textbooks, MIMS, CMEs and professional contacts
l"#
  
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!#

[‘ Based on the question No. 6, we asked medical practitioners to give their opinion about
why they rely or do not rely on the information given by medical representatives. All of
them responded in different manner and gave vary opinions. Some of them even did not
give their opinions. We categorised their opinions based on whether they said Yes or No
in Q-6.
[‘ The main objective behind asking this question to the medical practitioners was to identify
their perception towards medical representatives as sources of information regarding the
new therapies.
[‘ Few common reasons given by practitioners who said that 6 they rely on information
given by medical representatives:

1.‘ Do not completely rely on medical representatives or rely after evaluation of

information by other sources.
2.‘ They support their information by ample research and valuable data.
3.‘ They are representatives of company who has actually done drug trials.
4.‘ Detailed information given by them only.
5.‘ They give latest information about new therapies and drug.
6.‘ Information given by them is authentic.
7.‘ Rely only on who are regular, tested and tried.

[‘ Few common reasons given by practitioners who said that 8

they do not rely on
information given by medical representatives:

1.‘ They are biased towards their product and company.

2.‘ They are only for promotion of their products.
3.‘ Show fake clinical data.
4.‘ Information given by them is incomplete. Sometimes they do not know much about
drug or disease.
5.‘ Other sources like medical journals, text books, CMEs are more reliable than Medical
Representatives.
l 0 )
 

 


 

 
!#

[‘ This question was asked to the medical practitioners in order to identify that which other
sources of information (other than medical representative) they prefer. However this was
asked to know that how many information sources are used and how frequently they are
used.

 3 %9 
 


 

  
   #



 -


-
-





 

 
 -


 
  -




Total sample
size= 100

,

[‘ As shown in above chart, it was found that
  !

  is the  preferred
sources of information with score of 0- out of 100, followed by :

 

  5 with almost similar scores of 79, 78 and 76 respectively.
[‘ Other sources like & 

  
   

  
 



 
  ; !
  stood at 
  

 with
scores of 52, 51, 35, 30 and 28 respectively.
[‘ Rest of sources like drug information unit (hospital), direct mail CCJs, advertisements
and drug firm exhibition showed leas preference as shown in above chart.
l ) 

 


    #  
!#

[‘ The objective of asking this question was to know the perception of medical practitioners
about easy availability of sources. We asked to mention three sources those are easily
available to them in priority. They responded vary among three options as shown below.

 3 . 5 
 #  
 


  8
 

 8

  





% 
 ' 
 * 


1 Internet +9 16 %.
2 Medical journals 16 21 %.
3 CMEs 14 16 10
4 Text books 13 *% 11
5 MIMs 8 5 10
6 Medical 7 3 4
representatives
7 Professional contacts 2 3 8

 3 %% 5 
 #  
 


 
 <% 
=

5 
 #  
 


 
<%  
=
40
40
35
30
25 Internet

20 Medical journals
16
14 13
15 CMEs
10 8 7 Text books
5 2
MIMs
0
Medical
representatives
Professional contacts

Total sample
size= 100
 3 %' 5 
 #  
 


 
 <' 
=

5 
 #  
 


 
<'  
=

40
35 31
Internet
30
25 21  
edical ournals
20 16 16

15  s
10 5
5 3 3 Text books
0 
I s

edical
representatives

Total sample
size= 100

 3 %* 5 
 #  
 


 
 <* 
=

5 
 #  
 


 
<% 
=

40
35 Internet
30 
25 edical ournals


20 16 16 s
15 10 11 10
10 8 Text books
4 
5 I s
0 
edical representatives
Professional contacts

Total sample
size= 100

,

Based on above data for the easy availability of information sources, we interpreted the result
as below.

[‘ In the % 

, i was rated the highest with score 0f +97%99 followed by

  !
  with score of 16/100 and 5 14/100.
[‘ In the ' 
, :

was rated the highest with score 0f *%7%99 followed by

  !
  with score of 16/100 and 5 and  14/100.
[‘ In the * 
,
  !
  and i were rated the highest with score 0f
%.7%99 followed by :

with score of 11/100.

l %9 
   


 
 
 
 



!#

[‘ The primary objective behind asking this question was to know the perception of medical
practitioners about their priority in selection of information sources. We asked to mention
three sources those on they rely. They responded vary among three options as shown
below.

 3 / 
 


  8
 

 


 8

  

% ' 
 *

 

1 Medical journals '. *% 13
2 Text books 24 15 %/
3 Professional contacts 16 8 11
4 CMEs 14 20 14
5 Internet 12 5 16
6 MIMs 3 7 6
7 Consultant recommendation 2 4 5
8 Medical representatives 1 4 4
9 Drug symposia 1 5 3

 3 %+ 
 
 <% 
=

 
 †
 
35
30 26 Medical journals
24
25
Text books
20 16
14 Professional contacts
15 12
CMEs
10
5 3 Internet
2 1 1
0 MIMs
Consultant
recommendation
Medical representatives

Total sample
size= 100
 3 %- 
 
 <' 
=

r‘
 

‘† ‘

35 edical ournals
31
30 Text books

25 rofessional contacts
20
C Es
20
15 Internet
15
8
I s
10 7
5 4 4 5 Consultant recommendation
5 
edical representatives
0
Drug symposia

Î
 s
siz 

 3 %. 
 
 <* 
=

r‘
 

Ԡ   

edical ournals
35
30 Text books
25
20 17 16 Professional contacts
13 14
15 11 
C Es
10 6 5 4 3
5 Internet
0 
I s

Total sample
size= 100

,
Based on above data for the easy availability of information sources, we interpreted the result
as below.

[‘ In the % 

,
  !
  was rated the highest with score 0f '. out of 100
followed by :

and 

  
  with score of 24 and16 respectively.
[‘ In the ' 
,
  !
  was rated the highest with score 0f *%out of 100
followed by 5 and :

with score of 20 and 15..

[‘ In the * 
, :

  5 and
  !

  were rated almost
similar with score 0f %/ 16, 14 and 13 respectively.



 After comprehensive analysis and interpretation of the data collected from medical
practitioners from various places of Manipal, Udupi and Mangalore and we have derived
wonderful conclusion.

 
  

Based on data analysis we found difference in pattern of selection of information sources

as per the place of practice e.g

[‘ Private practitioners prefer 5 and
  !

 .
[‘ The medical practitioners working in medical college mainly prefer
  !
 
and :


[‘ The medical practitioners working in private hospitals mainly prefer
 
!
   

   #  


 



[‘ We have collected data from 100 medical practitioners and asked about their perception
towards information provided by medical representatives. There is vast difference in
pattern of selection of information sources. Out of 100 medical practitioners 93 said that
medical representative visit regularly. Out of 100 medical practitioners 63 said that they
do not rely on the information given by medical representatives by giving reasons that
they are biased or provide fake data etc. However 37 practitioners said yes, they rely on
medical representatives by giving reasons that they provide latest information based on
clinical research.


 
)  

 



  
   #
[‘ Amongst various sources of information
  !
  is preferred highest followed
by textbooks, internet and CMEs. Other sources like MIMS, professional contacts, drug
symposia, consultant recommendations and prescriber¶s journals stood at intermediate
position. The least preferred sources are drug information unit (hospital), direct mail
CCJs, advertisements and drug firm exhibition.

5 
 #  
 


 


[‘ In the % 

, i was preferred highest followed by medical journals and
CMEs. In the ' 
, :

was preferred highest followed by medical journals,

CMEs and internet In the * 
,
  !
  and i were preferred
the highest followed by textbook.


  


[‘ In the % 

,
  !
  was preferred highest followed by textbook and
professional contacts.
[‘ In the ' 
,
  !
  was preferred the highest followed by CMEs and
textbook
[‘ In the * 
, :

  5 and
  !

  were rated almost
similar.
,


 

After studying the result we found some suggestions for pharmaceutical companies,
medical representatives and medical practitioners.

1.‘ During the study we found that the most of medical practitioner they don¶t rely on the
information given by medical representative because they believe that medical
representatives do not much about product. So medical representative should be from
medical back ground with qualifications like B. Pharm and D. Pharm.

2.‘ Considering the busy time schedule and convenience of physician, E-detailing should
be included as a part of scientific education and promotional activity and however
accessibility of physician to computer and internet should be considered.

3.‘ Company should change their reputation from only promotion oriented to provide
detailed scientific information about their product to the medical practitioners by
medical representatives, CMEs and symposia.

4.‘ Medical practitioners should change their attitude towards and ask for more
information to the company medical department.

 
1.‘ B Strickland-Hodge, M H Jeqson, December 1980, µUsage of information sources by
general practitioners¶, Journal of the Royal Society of Medicine Vol. 73, pp. 857-862,
Viewed on 20th August, <http://www.ncbi.nlm.nih.gov/pmc/articles
/PMC1438219/pdf /jrsocmed00266-0029.pdf>.

2.‘ J D Haug, July 1997, µ Physicians' preferences for information sources: a meta-
analytic study¶, ¦ull Med Library Association., vol. 85, no. 3, pp. 223±232, Viewed
on 20th August, 2010,< http://www.ncbi.nlm.nih.gov/pmc/articles/PMC226263/>.

3.‘ A A Verhoeven, E J Boerma, B Meyboom-de Jong, January 1995, µUse of

information sources by family physicians: a literature survey¶ ¦ull Med Library
Assoc., vol. 83, no. 1, pp. 85±90, Viewed on 25th August, 2010,
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC226003/>.

4.‘ Raj Kumar, 2004, µMedical Websites: Potential Tools for Education, Research and
Patient Care in India¶,  th IFLA General Conference and Council 22-27 August,
World Library and Information Congress, Buenos Aires, Argentina. Viewed 25
August 2010, < http://archive.ifla.org/IV/ifla70/papers/015e-Kumar.pdf>

5.‘ Gruppen LD, Wolf FM, Van Voorhees C, Stross JK, 1987 µInformation-seeking
strategies and differences among primary care physicians¶, Mobius, vol. 7, no. 3, pp.
18-26, Viewed on 25th August, 2010, <http:// www.ncbi.nlm.nih.gov/pubmed/
10284694?ordinalpos=1&itool=PPMCLayout.PPMCAppController.PPMCArticlePag
e.PPMCPubmedRA&linkpos=1>.

6.‘ Lindberg, Donald A. B. Lindberg, 2001, µThe National Library of Medicine Website
for physicians and patients¶, JAMA, vol. 285, no. 6, pp. 806-807, Viewed on 16th
August, 2010, < http://jama.ama-assn.org/cgi/reprint/285/6/806.pdf>

7.‘ Naresh K. Malhotra, 2001, Marketing research an applied orientation, 3rd edition,
Person education, India.

8.‘ David A AAKER, V Kumar, George S. Day, 2001, Marketing research, 7th edition,
John Willy and Sons Inc.