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Background: The interactionbetween physicians and medical representatives MRs through gift offering is acommon cause for conflicts of interest for physicians that negatively influenceprescribing behaviors of physicians throughout the world. This study aimed to evaluatethe interaction between MRs and Iraqi specialist physicians through the acceptanceof MRs gifts and the effect of such acceptance on physician’s prescribing patterns.Methods: A survey in a questionnaire format for specialist physicians was done duringMarch-October 2013 in Iraq, Baghdad. The questionnaire involves four major partsregarding the approximate number of patients and medical representatives, gift acceptance,medical conferences, and prescribing pattern. Results: In Iraq specialist physicianswere visited by 1 - 3 MRs-day. 50% of the Iraqi physicians like to get the educationalinformation by attending conferences outside Iraq. Regarding Gift acceptance, 41%of participated physicians showed a general acceptance to promotional gifts, and91% of physicians accept low cost gifts but only 41% of them accept high cost recreationalgifts. Free samples were used by 59% of Iraqi physicians to treat some people. 77%of physicians prefer prescribing new medications, while more than 95% of participatedphysicians stated that they stop prescribing these new drugs either due to theirineffectiveness or due to their side effects. On the other hand physicians significantlychange their prescribing behavior through shifting not only among generic drugs,but also from brand to generic drugs in their prescriptions. Gift acceptance isdirectly correlated with such shift and change in prescribing behavior. Conclusion:Iraqi physicians accept various types of gifts from pharmaceutical companies; thiscan influence physician prescribing pattern and result in early adoption to prescribenewly medications depending on promotional information even in absence of clinicalevidence about the drug effectiveness or side effects, which may result in undesirableoutcomes to the patient.


Drug Promotion, Gifts, Prescribing Behavior

Cite this paper

Mikhael, E. and Alhilali, D. 2014 Gift Acceptance and Its Effect on Prescribing Behavior among Iraqi Specialist Physicians. Pharmacology & Pharmacy, 5, 705-715. doi: 10.4236-pp.2014.57080.

Autor: Ehab Mudher Mikhael, Dhulfiqar Nidhal Alhilali



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