Commercial detailing techniques used by pharmaceutical representatives to influence prescribing

Aim: To determine the use of influence techniques by pharmaceutical representatives in their encounters with medical practitioners. Method: We identified six influence techniques from the marketing literature which are thought to be commonly used by sales people. These have been termed the principles of reciprocity, friendship/liking, commitment/consistency, social validation, authority, and scarcity. We examined the use of these techniques by analysing audio-recordings of pharmaceutical representatives' presentations to medical practitioners. Results: Sixteen recordings, detailing 64 medicines, were obtained from seven medical practitioners. Reciprocation was the most commonly observed method of influence. Samples, gifts, printed material, patient information leaflets or invitations were offered in all encounters. Appeals to authority figures, where promotional claims were supported by reference to professors or specialists, specialist groups and specialist hospitals, were recorded. Social validation acts, where reference was made to the peer group were also common. Commitment acts were observed to occur in two ways; the first was as a direct request to use the product detailed and the second was as a series of questions or statements which gradually moved from pre-agreed areas to solicitation of a commitment to prescribe the drug. Conclusion: influence techniques were found to be commonly used by pharmaceutical representatives when they detailed products to medical practitioners. Medical practitioners may not be aware of the potential effect these techniques can have on their prescribing practices. Knowledge of these techniques must be incorporated into educational programmes designed to provide health professionals with critical appraisal skills.