Eleshaday Thesis

ST.
MARY’S UNIVERSITY
SCHOOL OF GRADUATE STUDIES
THE ROLE OF PROMOTIONAL TECHNIQUES IN INFLUENCING PHYSICIANS’

DECISIONS ON PRESCRIPTION: THE CASE OF LEWI PHARMACEUTICAL
COMPANY AND SOME SELECTED PHYSICIANS IN ADDIS ABEBA
BY: ELESHADAY MEKONNEN

SGS/0250/2008A
MAY, 2017
ADDIS ABABA, ETHIOPIA
BY: ELESHADAY MEKONNEN
SGS/0250/2008A
A THESIS SUBMITTED TO ST.MARY’S UNIVERSITY, SCHOOL OF GRADUATE

STUDIES IN PARTIAL FULFILLEMENT OF THE REQUIREMENTS FOR THE
DEGREE OF MASTER OF BUSINESS ADMINISTRATION
MAY, 2017
ADDIS ABABA, ETHIOPIA
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ST. MARY’S UNIVERSITY
FACULTY OF BUSINESS

BY
ELESHADAY MEKONNEN
SGS/0250/2008A
APPROVED BY BOARD EXAMINERS
-------------------------------- ---------------------------------
Dean, Graduate studies Signature & Date
------------------------------- ----------------------------------
Advisor Signature & Date
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External examiner Signature & Date
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Internal Examiner Signature & Date
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Acknowledgement
First and for most I would like to thank the Almighty God for everything. I would like to express
my heartfelt gratitude to my advisor Terefe Feyera (PhD) for his devoted advises. His
constructive feedback and guidance to my fruitful work throughout the entire process leave me a
deep impression. Thanks to all my informants who gave their valuable time and information to
complete my work. Besides them I want to thank all the people who directly or indirectly gave
me support to continue my work.
My sincere appreciation and acknowledgement also go to Ato Mesfene Assefa, Lewi

pharmaceutical company medical director, for his support and kindness. Finally, I wish to extend
my deepest gratitude to my beloved family and friends for their great support while I was
studying in St. Mary’s University.
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Abstract
The study aimed at describing the role of promotional techniques in terms of influencing the
medical practitioners prescribing behavior. The purpose of the study is to explore the different
promotional techniques being used by Lewi pharmaceutical company, and to determine the
attitude of medical practitioners toward promotional techniques. The target populations of the
research are the medical practitioners, medical representatives and medical director of the
company. There are around 70 medical practitioners in the selected six private hospitals, and
only thirty seven voluntary respondents are considered in the thesis, while all the medical
representatives of the company and the medical director is participating on the interview. The
data were collected through survey questionnaires distributed to medical practitioners. The
result of this survey was analyzed using descriptive statistics (percentage and mean) with the
help of SPSS version 20. And a qualitative data were used using an interview with medical
director and medical representatives of Lewi pharmaceutical company. The paper discussed the
role of promotional techniques which influenced the medical practitioners prescribing decisions.
The finding revealed that promotional technique that Lewi pharmaceutical company is using
have an effect on the medical practitioners’ prescription decision. However, medical
practitioners would like to gather medical information from medical representatives by
participating on sponsored educational presentations, and promotional events. And promotional
materials that Lewi pharmaceutical company is using have an effect on medical practitioner
prescribing decision. Though the company needs other promotional materials to present to them
other than what the company is currently providing.
Key terms: Medical practitioner, Medical Representatives, Pharmaceutical Company,

Pharmaceutical promotion, prescribing decision.
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Table of Contents
Acknowledgement ............................................................................................................. iii
Abstract .............................................................................................................................. iv
List of Tables .................................................................................................................. viiv
CHAPTER ONE ................................................................................................................. 1
INTRODUCTION .............................................................................................................. 1
1.1 Background to the study .......................................................................................... 1
1.2 Statement of problem ............................................................................................... 2
1.3 Basic research question ............................................................................................ 4
1.4 Objective of the study .............................................................................................. 4
1.4.1 The general objective ........................................................................................... 4
1.4.2 The specific objectives ......................................................................................... 5
1.5 Definition of terms ................................................................................................... 5
1.6 Significance of the study.......................................................................................... 6
1.7 Delimitation and scope of the study......................................................................... 6
1.8 Organization of the study ......................................................................................... 7
CHAPTER TWO ................................................................................................................ 8
REVIEW OF RELATED LITERATURE .......................................................................... 8
2.1 An overview of promotional technique ................................................................... 8
2.2 The role of promotional techniques in making influences on the medical
practitioner .......................................................................................................................... 9
2.2.1 Impact of pharmaceutical promotion on attitudes and knowledge of medical
practitioners....................................................................................................................... 10
2.2.2 Impact of pharmaceutical promotion on prescription decisions behavior of
health professionals ........................................................................................................... 10
2.3 Common types of promotional techniques used by pharmaceutical industry ....... 11
2.3.1 Public relations/ publicity................................................................................... 11
2.3.2 Sales promotion .................................................................................................. 12
2.3.3 Personal selling .................................................................................................. 12
2.3.4 Advertising ......................................................................................................... 13
2.3.5 Direct marketing ................................................................................................. 14
2.4 The role of sponsored educational programs/ presentations .................................. 14
2.5 The role of medical representatives and information to health care providers ...... 15
2.6 The role of promotional tools to medical practitioners .......................................... 15
2.6.1 The role of Samples to medical practitioners ..................................................... 15
2.6.2 The role of gifts to medical practitioners ........................................................... 16
2.6.3 The role of promotional events, Symposia and other scientific meetings ......... 16
2.7 Ethical issues in promoting pharmaceutical product ............................................. 17
2.8 Empirical studies .................................................................................................... 17
CHAPTER THREE .......................................................................................................... 20
RESEARCH DESIGN AND METHODOLOGY ............................................................ 20
3.1 Research Design..................................................................................................... 20
3.2 Population and Sampling Techniques .................................................................... 20
3.3 Methods of data collection and data collection tools ............................................. 21
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3.3.1 Questionnaire ..................................................................................................... 21
3.3.2 Interview............................................................................................................. 21
3.4 Response rate ......................................................................................................... 21
3.5 Methods of data analysis ........................................................................................ 22
3.6 Ethical considerations ............................................................................................ 22
CHAPTER FOUR ............................................................................................................. 23
RESEARCH RESULT AND DISCUSSION ................................................................... 23
4.1 Personal characteristics of the respondents............................................................ 23
4.2 Promotional techniques in influencing physicians’ decisions on prescription ...... 25
4.3 Interview with medical representatives and medical directors .............................. 33
4.3.1 Interview with medical director ......................................................................... 33
4.3.2 Interview with medical representatives .............................................................. 33
4.4 Triangulation of qualitative and quantitative data ................................................. 34
CHAPTER FIVE .............................................................................................................. 36
SUMMARY, CONCLUSION AND RECOMMENDATION ......................................... 36
5.1 Summary of major findings ................................................................................... 36
5.2 Conclusions ............................................................................................................ 38
5.3 Recommendations .................................................................................................. 39
Reference .......................................................................................................................... 40
Appendix-1 .......................................................................................................................... I
Appendix-2 ....................................................................................................................... IV
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List of Tables
Table 1: Response rate of respondents of hospital.....................................................22
Table 2: Characteristics of the respondents ...............................................................24
Table 3: Professional characteristics of medical representatives

and how they provide information .............................................................................26
Table 4: Promotional practices of medical representatives/

Pharmaceutical company ...........................................................................................28
Table 5: Medical practitioner’s response regarding the

Appropriateness of promotional products, events and
From pharmaceutical company ..................................................................................29
Table 6: The extent of promotional products to be

Delivered as a gift ......................................................................................................31
Table 7: Medical practitioners’ response through

Promotional events.....................................................................................................32
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CHAPTER ONE
INTRODUCTION
1.1 Background to the study

Promotion is regarded as one sub-category of the marketing management mix of price,
product and place. To meet consumers’ needs, businesses must produce the right product,
at the right price, make it available at the right place, and let consumers know about it
through right promotion. Promotion is defined as the coordination of all seller initiated
efforts to set up channels of information and persuasion in order to sell goods and
services or promote an idea. The basic tools used to accomplish an organization’s
communication objectives are often referred to as the promotional mix. Promotional mix
has included five elements: advertising, sales promotion, public relations, direct
marketing and personal selling. Promotion is an integral part of our social and economic
systems. In our complex society, promoting has evolved into a vital communications
system for both consumers and businesses. Companies ranging from large multinational
corporations to small retailers increasingly rely on promotion to help them market
products and services (Belch & Belch 2003). Promotion can be thought of as the way to
keep a company, product, or service in front to a customer. It can help to generate more
demand for the product as well. A business must choose a method of promotion which is
the most effective in its particular market and for its own product.
According to world health organization, promotion is defined as all informational and

persuasive activities by manufacturers and distributions, the effect of which is to induce
the prescription, supply, purchase and / or use of medicinal drugs (WHO Geneva, Ethical
criteria for medical drug promotion). Promotional activities are essential as a means of
informing healthcare professionals about the availability and use of new medicines and to
advise on new uses for existing medication. The purpose of a promotion and thus its
promotional plan can have a wide range, including sales increase, new product
acceptance, creation of brand equity and creation of a corporate image. The
pharmaceutical companies especially those that deal with prescription drugs operate in a
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very competitive environment because of the existence of various brands of generic
drugs. A competitive nature of the business makes them to develop and implement strong
promotional techniques in order to communicate with the target market.
The pharmaceutical industry is one of the most research intensive industries in the world.
Due to this, it spends a huge amount of money. There must be a clear interaction between
the physicians and the pharmaceutical industry to ensure the free flow of valid scientific
information. The pharmaceutical industry is the primary source of information about its
products. Most of the pharmaceutical industries are concentrating on research and new
products development. The pharmaceutical industry generally adopts marketing strategies
for promoting their products through medical representatives. Medical representatives are
backbone of pharmaceutical industry. They are responsible for sale of pharmaceutical
product, presenting and demonstrating of company products to health care professionals
and maintaining relationships with healthcare professionals. They are the key point of
contact between pharmaceutical companies and health professionals. Academic literature
describing and analyzing the relationship between medical sales representative and
physicians can be categorized into two stream of discourse, that is, marketing and
medical. Marketing describes ‘the task of creating, promoting, and delivering goods and
services to consumers and business’ (Kotler, 2003).
Lewi pharmaceutical company is a private limited company based in Addis Ababa,

Ethiopia. Lewi import and distribute pharmaceuticals. Lewi imports over 10 products
from Switzerland that are in turn distributed throughout Ethiopia. Lewi imports from
Grossman pharmaceuticals in Switzerland. The list of medicines that Lewi imports from
Grossman pharmaceutical are Calliomon, Cegrovit, Vitarin, Begrocit, Ancopir tablet,
Ancopir injection, Grofenac 50mg, Grofenac 100mg, Grofenac suppository, Grofenac
injection and Syntoclav 1gm.
1.2 Statement of problem

Pharmaceutical companies are for profit entities, which espouse a dedication to improve a
community’s health. Thus it is argued that there is common interest between the
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pharmaceutical companies and health professionals to ensure that a mutually beneficial
relationship exist (Kerridge, Maguire, Newby, McNeill, Henry, Hill, MacDonald, Stokes,
and Henderson, 2006).
Promotional expenditures in international markets have grown. For instance, promotion

expenditures outside the United States increased from $55 billion in 1980 to nearly $214
billion by 2002 (Belch & Belch, 2003). Pharmaceutical companies promote their product
through their medical representatives by using drug sample, printed product literature and
gifts that help them to increase acceptability of their product (Goyal RR, Pareek P 2013).
Many prescriber receive pens, notepads and coffee mugs so that a targeted drug’s name
stays uppermost in subconscious mind of the prescriber (Berman, Ahari 2007). It is
known that different promotional strategies used by medical representatives in detailing
their product and the quality of information provided in developing countries is poor
compared to developed nations.
Lewi pharmaceutical uses different techniques to influence the physician prescribing

habit and they spend more money on marketing to increase their revenue and market
share. They commonly use medical representatives for promoting their product and
generating revenue. Hence, the medical representatives play a key role for the interaction
of the medical practitioner and the pharmaceutical industry. It stands to reason that
medical representatives can impact prescribing habits for a particular brand by visiting
medical practitioner to promote their products (Zaki, 2014). The achievement of a
marketing strategy depends on different factors with some strategies generating far
superior outcomes than others. Focusing on the most effective marketing approaches
could save pharmaceutical companies in investing more money in advertising and
increase their sales. But, unethical and inappropriate drug promotion has been a
continuing concern. At the 1997 roundtable on world health organization’s ethical criteria
for medical drug promotion there was firm agreement that inappropriate promotion of
medical drugs remains a problem both in developing and developed countries (review of
materials in the WHO/HAI database on drug promotion). But this company can minimize
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expenditure by knowing promotional technique that has an influence on the medical
practitioner.
It is well established in the literature that pharmaceutical companies commonly employ a

wide range of marketing strategies to increase their drug sales (Parker & Pettijohn, 2005).
Most pharmaceutical companies commit a great deal of time and money to marketing in
hopes of convincing medical practitioners and pharmacists of the merits of their products
(Al-Haddad, Hamam, & Al-Shakhshir, 2014). This study will certainly provide baseline
information about the extent of influence of medical representatives on prescribing
decisions and practices of medical practitioners. Hence, the aim of this study was to
evaluate the influence of medical representatives on prescribing practice.
1.3 Basic research question

To address the problems noted above, this study aimed at addressing the following
research questions:
 Which promotional techniques were preferred by Lewi pharmaceutical company?
 What is the attitude of medical practitioner toward the promotional techniques?
 How far do the promotional techniques used by medical representatives influence
the prescription decision of the medical practitioner?
1.4 Objective of the study

This study aims to achieving the following objectives;
1.4.1 The general objective

The general objective of the study was to describe the role of promotional techniques in
terms of influencing the medical practitioners prescribing behavior and to determine the
magnitude of the influence.
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1.4.2 The specific objectives
 To explore the different promotional techniques being used by Lewi
pharmaceutical company;
 To determine the attitude of medical practitioner toward promotional techniques;
 To determine the extent to which promotional techniques that Lewi
pharmaceutical company are using could make an influence on prescription
decision of medical practitioner.
1.5 Definition of terms

 Pharmaceutical promotion is any activity of advertising, detailing and sponsoring
of conferences and symposia by a drug company which is intended to increase the
sales of its products.
 Promotional technique means an overall promotional plan designed to meet the
needs and requirements of customers. It helps for target groups to be aware of the
existence and availability of the product through promotion.
 Medical representative means a representative of a manufacturing firm directly or
through the distributor, licensed by the authority to conduct promotional activities
through provision of information on the drugs manufactured by the firm.
(Guidelines for the regulation and advertisement of drugs (second edition) drug
administration and control authority of Ethiopia
 Prescriptive decision relied heavily on data of medical representatives. Medical
representatives present physicians with the results of clinical trials, statistics and
brand comparison charts to prove that their products were superior to others on
the market. And based on this convenient data, medical practitioners would
prescribe those products over others in their category.
 Medical practitioner is a practitioner who, having been admitted to a medical
doctorate degree program, duly recognized in the country and has successfully
completed the prescribed course and licensed by the regulatory authority to
practice medicine.(Ethiopian food, medicine and health care administration and
control authority, 2014).
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1.6 Significance of the study
This study is useful to Lewi pharmaceutical company in determining the most effective
promotional techniques and engaging it to their company. This will help the company in
improving their past promotional practice and planning to implement based on the
research finding. This research finding will help medical representatives to create
awareness on the most effective promotional technique and address gaps and develop a
good relation with health professionals. Moreover, it will also help for academics seeking
as a reference and to pursue further studies on the matter.
1.7 Delimitation and scope of the study

The study is carried out in partial fulfillment of securing Master’s Degree in business
administration; the scope of the study is limited on geographical coverage, budget, study
duration, target medical practitioner and medical institution and medical representatives,
collection tools used and level of analysis.
Accordingly, the study would be carried out in Addis Ababa, Ethiopia. It is limited only
to working medical practitioners at the time of the study and may not show the practice of
other health professionals who have an authority of prescribing. It is conducted only on
Lewi pharmaceutical company. The finding of the study covered only from January
2016- April 2017. Medical representatives from Lewi pharmaceutical company are
participating in this study. Only voluntary medical practitioners who work in Tekle
Haimonot Hospital, Kadisco Hospital, Betezata Hospital, Koria Hospital, Betel Hospital
and Amen Hospital are participating in the study. A pre-tested semi-structured
questionnaire and interview was the tool used to collect the required information from the
targeted groups.
Data collection was very difficult because of the busy schedules of the medical
practitioners. Again, because of fear of exposing the promotional strategy of the company
were afraid to revealing data. These problems could have contributed negatively to the
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quality of the output of this study. Another limitation of the study was Time and budget
to conduct in depth investigation of the study.
Pharmaceutical marketing is mainly based on personal communication in comparison to
non personal communication like advertising and publicity. The study is on Lewi
pharmaceutical on its Grossman pharmaceutical products, which are prescription drugs
thus advertising prescription drugs and publicity to the public is prohibited (Guidelines
for the regulation and advertisement of drugs (second edition)) so they are not included in
the study. And sales promotion is not applied in the company; so only personal selling
and direct marketing are applied.
1.8 Organization of the study

The framework of the study has been structured into five chapters including the
introduction, the literature review, methodology, research result and discussion, summary
of major findings, conclusion and recommendation. A brief outline of each of them is
given below. The first chapter formed part of the introductory elements of the research
work, statement of the problem, research question, objective of the study, definition of
terms, significance of the study, delimitation / scope of the study. Overall, it offers a
discussion on what the thesis intended to tackle.
The second chapter provides related literatures, both the theoretical and the empirical
studies. The discussion concentrated on how the existing literature pointed to the
concepts and issue mentioned in the aims and objective of this work. Chapter three
covers the methods and procedures that will be in this research work. The chapter covers
the models to be used in the data collection as well as other concerns which the
researcher might encounter during the course of the study. Chapter four is deals on
research results and discussions. In this part of the study, tables were used to process data
for analysis and interpretation. The last chapter contains summary of major findings,
conclusions and recommendation.
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CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.1 An overview of promotional technique

Promotion is defined as the co-ordination of all seller initiated efforts to set up channels
of information and persuasion in order to sell goods and services or promote an idea.
Promotion is most often intended to be a supporting component in a marketing mix.
Promotion decision must be integrated and co-ordinate with the rest of the marketing
mix, particularly product/brand decisions, so that it may effectively support an entire
marketing mix strategy. Pharmaceutical marketing is the business of advertising or
otherwise promoting the sale of pharmaceuticals or drugs (U.S. Department of health and
human services, 2006).
A company’s total promotion mix also called its marketing communications mix consists
of the specific blend of advertising, public relations, personal selling, sales promotion,
and direct-marketing tools that the company uses to persuasively communicate customer
value and build customer relationships. The five major promotion tools are defined as
follows:
 Advertising: Any paid form of non personal presentation and promotion of ideas,
goods, or services by an identified sponsor.
 Sales promotion: Short-term incentives to encourage the purchase or sale of a
product or service.
 Personal selling: Personal presentation by the firm’s sales force for the purpose of
making sales and building customer relationships.
 Public relations: Building good relations with the company’s various publics by
obtaining favorable publicity, building up a good corporate image, and handling
or heading off unfavorable rumors, stories, and events.
 Direct marketing: Direct connections with carefully targeted individual consumers
to both obtain an immediate response and cultivate lasting customer relationships.
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Each category involves specific promotional tools used to communicate with customers.
For example, advertising includes broadcast, print, Internet, outdoor, and other forms.
Sales promotion includes discounts, coupons, displays, and demonstrations. Personal
selling includes sales presentations, trade shows, and incentive programs. Public relations
include press releases, sponsorships, special events, and Web pages. And direct
marketing includes catalogs, telephone marketing, kiosks, the Internet, mobile marketing,
and more. At the same time, marketing communication goes beyond these specific
promotion tools. The products design, its price, the shape and color of its package, and
the stores that sell it all communicate something to buyers. Thus, although the promotion
mix is the company’s primary communications activity, the entire marketing mix—
promotion and product, price, and place—must be coordinated for greatest impact.
2.2 The role of promotional techniques in making influences on

the medical practitioner
Drug promotion has a key role to stimulate prescription and sales of pharmaceuticals (Al-
Areefi, Hassali, Mohamed Izham, and Mohamed Ibrahim 2013). Medicines are a core
part of health care services and their use has grown enormously during the last century
with the advent of effective antibiotic, painkillers, anesthetics and many other medicines.
They can cure disease, relive symptoms and prevent future ill-health. Appropriate
medicine use means providing the right medicine at the right dose, when it is needed. The
decisions of choosing, required knowledge of the medical practitioners, and
Pharmaceutical companies use many marketing and promotional tools, including sales
representatives, product samples, print advertisements, as well as medical events and
symposium sponsorships (P.Norris, 2004). The pharmaceutical companies promote their
product through their medical representative by using drug sample, printed product
literature and gifts that helps them to increase acceptability of their product (Goyal,
Pareek 2013). Many medical practitioners receive pens, notepads and coffee mugs so
that a targeted drugs name stays uppermost in subconscious mind of the medical
practitioners (Berman, Ahari 2007). Medical representatives’ visiting medical
practitioners is one of the factors that affect their medical practitioners’ practices (Lieb,
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Scheurich 2014). Message delivered with these different methods reinforce each other.
Promotional techniques can influence prescriber at different stages of this process.
2.2.1 Impact of pharmaceutical promotion on attitudes and

knowledge of medical practitioners
In a crowded marketplace with many available treatments, pharmaceutical companies
have a commercial imperative to persuade professionals that their product is the best
choice in order to maximize profits. This is done through a variety of influence
techniques that form the core of successful marketing. The aim is to persuade
professionals who are initially unaware of a medicine’s existence to move through the
following series of stages: unawareness, awareness, interest, evaluation, trial, use, repeat
use. Doctors report that they often use promotion as a source of information about new
drugs. Doctors in private practice, or who graduated long ago report the highest use of
promotion as a source of drug information. Promotion influences attitudes more than
doctors realize. Research suggests that doctorsʹ attitudes to promotion vary, and do not
necessarily match their behavior. Their opinions differ on the value of medical
representatives, on whether they should be banned during medical training, and on
whether doctors are adequately trained to interact with them. Most doctors think
information from pharmaceutical companies is biased, but many think it is useful. Health
professionals find small gifts from drug companies acceptable. Doctors who report
relying on promotion tend to be older, and more likely to be general practitioners.
2.2.2 Impact of pharmaceutical promotion on prescription

decisions behavior of health professionals
Health professionals are continually faced with decisions about whether a treatment is
needed and which of a range of available treatments to recommend. Because of the need
to constantly make pragmatic decisions to try to resolve patients’ health problems quickly
and efficiently, health professionals often rely on pharmaceutical companies’ promotional
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practices. This is the most important and most difficult area to research. People may not
be aware how much promotion influences them, and/or they may be unwilling to report
this. Research clearly shows that doctors who report relying more on promotion tend to
prescribe less appropriately, prescribe more often and adopt new drugs more quickly.
Samples appear to influence prescribing, but more research is needed on this issue.
Studies which look at the impact of promotion on overall sales usually show increased
sales after promotional activities.
2.3 Common types of promotional techniques used by

pharmaceutical industry
Pharmaceutical companies have been using a range of marketing techniques to inform
and convince medical practitioners about their products. Medical Sales representatives
are considered the most expensive and widely used of these (Schramm et al., 2007). The
goal of promotion is to persuade the target consumer to buy or consume the product
offering. The promotional element of the marketing mix also referred to as the marketing
communication or promotional mix, and includes various communication methods and
activities aimed at the target consumer. The integration of the promotional elements is
called integrated marketing communications. Promotional strategy is the direct way an
organization tries to reach its publics. Promotion strategy involves the five elements of
the promotional mix that is advertising, sales promotion, personal selling, public
relations, and direct marketing (czinkota and ronkainen, 2004). As was mentioned
previously, an integration of the various tools available to the promotional manager is
vital to reach the organization’s marketing objectives.
2.3.1 Public relations/ publicity

Public relation is essentially a function of an organization, where it tends to develop and
manage its goodwill in the market. The primary aim is to create a suitable environment
for the firm. Public relation helps the organizations create a suitable opinion about the
firm in the market through appropriate communications. An organization can develop its
public relations with several member groups such as suppliers, customers, employees, the
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government, stakeholders, distributors, members of the public etc. In the current scenario,
customers look forward to have business dealings with companies that are good citizens.
Therefore companies should not neglect public relations because though it does not
induce any immediate customer action, it persuades positive results for an organization in
the long run.
Pharmaceutical companies use public relations tactic to increase awareness of unfamiliar

medical conditions (wall street journal, April 22). Public relation programs have long
been designed to educate patients on their conditions and treatment options to help them
take a more active role in managing their health. A number of pharmacy and medical
directors view patient education as one of the more important contributions that
pharmaceutical companies can make when interacting with managed health plans.
2.3.2 Sales promotion

Sales promotion is an organized, preplanned component of the overall promotional mix
and should be used with the strategic promotional objectives. Sales promotion can be
utilized by a manufacturer to distribution chain intermediaries or organizational buyers or
retailers, or by a retailer to customers. Some of the most common pharmaceutical sales
promotion methods are: sample distribution, premium incentives, point of purchase
displays, advertising specialties, promotional licensing, sponsored events, specialty
printing, promotion fulfillment, interactive or tele promotions, refunds or rebates,
customer contests or sweepstakes, product demonstrations (physicians, nurses, patients),
and product sampling.
2.3.3 Personal selling

Personal selling has significant role in promotional mix in pharmaceutical marketing. It
can influence all steps of buying process both in terms of individual doctor or groups of
doctors. Personal selling increase awareness of the product, create interest, leads the
doctor to evaluate it, encourage them for trial and use the finally score over all elements
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like advertising, publicity, and sales promotion helps the marketer for good feedback
from market.
Personal selling or medical detailing is one of the basic elements of the promotional mix.
It refers to the direct communication between a seller and the prospective customer.
Medical detailing is an approved, regulated, and widely accepted means of
pharmaceutical marketing communications found in every major national market. The
personal selling of pharmaceutical products has its own importance to the pharmaceutical
marketing. The medical detailing is like personal selling in every other industrial sector,
it is all about providing sales support. Thus, a medical sales representative is involved in
supporting the prescribing decision of the physician, managing the implementation,
dealing with prescriber or organizational buyer dissatisfaction, and constantly enhancing
the relationship through post purchase customer service, asking for referrals, and so on.
2.3.4 Advertising
Advertising is a non personal paid form of communication by identified sponsored. So in
case of pharmaceutical marketing, advertising increases awareness, interest, evaluation,
and encourages customer for repeat usage.
Pharmaceutical advertising uses two different approaches to its target audiences:
 Push strategies: in the push strategy, pharmaceutical company marketers design a
variety of marketing items (product brochures, congress stands, medical journal
advertisements, multimedia CD- ROMs) that are carefully aimed at their target
prescriber segment to increase product awareness and liking. These activities
may, in turn, lead to prescribers’ convictions and preferences. This leads to
prescribing the company’s product to their patients.
 Pull strategies: in the pull approach, marketers target the patient audience directly
by using a set of different promotional activities. The pull approach (where the
prescriber is “pulled” by the patient, instead of being “pushed” by an
advertisement) is used increasingly in the marketing of both innovative and
generic products. This approach is called Direct to customer advertising.
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Advertising is the dissemination of information by non-personal means through paid
media where the source is the sponsoring organization. Advertising, as part of the
promotional strategy, needs to deliver a message to the target market that will lead to a
favorable reaction.
2.3.5 Direct marketing

Direct marketing consists of connecting directly with carefully targeted consumers, often
on a one-to-one, interactive basis. Using detailed databases, companies tailor their
marketing offers and communications to the needs of narrowly defined segments or
individual buyers. It is an increasingly popular technique as it enables you to target
specific customer groups very accurately. It is a flexible way to deliver your message and
because each letter can be personalized, the chances of a response are greatly improved.
The practice of direct marketing is an interactive marketing system that utilizes a variety
of media to elicit a response from a database of target customers. The media used in
direct marketing includes direct mail, telephone, broadcast, printed media and the
internet. The interactive nature of direct marketing enables it to be an integration of
advertising, selling, buying and distribution.
2.4 The role of sponsored educational programs/ presentations

Physicians consider a wide range of factors when making prescription decisions. By far,
they make decisions based on their clinical knowledge, experience, and each patient’s
unique situation. They value information from pharmaceutical company representatives
and pharmaceutical company-sponsored educational programs. Medical education has a
critical role in the resolution of conflicts of interest within the practice of medicine and
during the marketing of drugs. It is the task of the clinical educator to convey information
to medical practitioners to bring them up to professional standards of care and to keep
practicing medical practitioners’ knowledge base and skill sets current.
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Sponsored educational programs by pharmaceutical company like symposia are useful for
disseminating information. The objective scientific content of such meetings should be
paramount, and presentations by independent scientists and health professionals are
helpful to this end. Their educational value may be enhanced if they are organized by
scientific or professional bodies.
2.5 The role of medical representatives and information to

health care providers
Government regulates the marketing of pharmaceuticals, and companies strive to provide
reliable, valuable information. Delivering this information is important to make medical
practitioners aware of the latest advances. The information must be reliable. Only
products scientifically proven property should be discussed in its marketing. Furthermore,
pharmaceutical representatives strive to provide the most accurate information in order to
build credibility and earn the trust of physicians over time. Medical representatives
should have an appropriate educational background. They should be adequately trained.
They should possess sufficient medical and technical knowledge and integrity to present
information on products and carry out other promotional activities in an accurate and
responsible manner. Employers are responsible for the basic and continuing training.
2.6 The role of promotional tools to medical practitioners

In this section the role of promotional tools such as use of samples, gifts, events,
symposium, etc is discussed.
2.6.1 The role of Samples to medical practitioners

A role that pharmaceutical promotion often plays is providing samples to physicians.
Medical practitioners may distributes samples to patients for several reasons—for instant,
to get patients started on therapy right away, to optimize dosing or choice of drug before
15
committing to a particular course of treatment, and sometimes to help patients who might
not be able to afford medicines on their own.
A 2008 KRC research survey found 69% of medical practitioners believe free drug
samples are either always useful(52%) or often useful (17%). 95% of medical
practitioners surveyed agreed that samples allowed patients to start immediately
treatment and 84% said that samples provide them with useful firsthand experience(KRC
research). Free samples of legally available prescription drugs may be provided in modest
quantities to prescribers, generally on request.
2.6.2 The role of gifts to medical practitioners

The PHARMA code reaffirms that interactions between company representatives and
health care professionals should be focused on providing information on products,
scientific and educational information, and supporting medical education. Thus, medical
representatives distributes of non- educational items, such as pens, mugs notepads, pocket
guidelines and textbooks and other reminder objects adored with a company logo to
health care professionals.
2.6.3 The role of promotional events, Symposia and other

scientific meetings
Symposia are useful for disseminating information. The objective scientific content of
such meetings should be paramount, and presentations by independent scientists and
health professionals are helpful to this end. Entertainment or other hospitality, and any
gifts offered too members of the medical and allied professions should be secondary to
the main purpose of the meeting and should be kept to a modest level.
16
2.7 Ethical issues in promoting pharmaceutical product
According to World health organization, Ethical criteria for drug promotion should lay
the foundation for proper behavior concerning the promotion of medicinal drugs,
consistent with the search for truthfulness and righteousness. Promotion is defined as all
informational and persuasive activities by manufacturers and distributors, the effect of
which is to induce the prescription, supply, purchase and/ or use of medicinal drugs.
Active promotion within a country should take place only with respect to drugs legally
available in the country. Promotion should be keeping with national health policies and in
compliance with national regulations, as well as with voluntary standards where they
exist. All promotion-making claims concerning medicinal drugs should be reliable,
accurate, truthful, informative, balanced and up-to-date. They should not contain
misleading or unverifiable statements or omissions likely to induce medically
unjustifiable drug use or to give rise to undue risks. Promotional material should not be
designed so as to disguise its real nature.
2.8 Empirical studies

Pharmaceutical marketing to medical practitioner is an important part of keeping
physicians up-to-date about new treatments and their risks and benefits. However, it is
only one factor among many in the health care system. For instance, health plans may
strongly influence prescribing through formulary design and utilization management
strategies, among other factors. A recent KRC Research survey sponsored by PHRMA
found that by far the most important factors in prescribing are a medical practitioner’s
clinical knowledge and experience and the patient’s unique situation. Journal articles,
clinical guidelines and formularies are all factors that medical practitioners consider more
than pharmaceutical company representatives (Pharmaceutical Research and
Manufacturers of America). However, there is a clear need for interactions between
physicians and the pharmaceutical industry to ensure the free flow of valid scientific
information and when the information is accurate and complete; physicians have the
necessary tools to make the right prescribing decisions (American Medical Association,
Testimony).
17
Two surveys were conducted, one by The Boston Consulting Group (BCG) and the other
by the Tufts Center for about Drug Development. In the BCG survey, 54% of physicians
reported that formularies have a major impact on prescribing decisions, 50% identified
peers, and 47% identified clinical guidelines, compared to 14% who said pharmaceutical
representatives have a major impact. The Tufts Center for the Study of Drug
Development found that among factors influencing prescribing decisions in 2007,
physicians considered the following to be “very important”: continuing medical
education (68%), information from peers (43%), and payer’s decisions (37%). Only 13%
of physicians considered information from pharmaceutical companies are very important
which implies that information from pharmaceutical companies to the medical
practitioner is less significant to influence the doctors prescribing decisions and the
pharmaceutical companies spend more money inappropriately to gain advantage through
them.
On average pharmaceutical companies spend 20% or more of their sales on marketing

(De Last, 2002). Most of these marketing activities are directed to physicians and include
doctor visits, detailing, direct mail, post marketing research and conferences. “Opponents
criticize these pharmaceutical marketing activities as wasteful and excessive, and as
potential contributors to the overuse, misuse and wrong prescription of drugs by
physicians” (Kremer, Bijmolt, Leeflang & Wieringa, 2008. p.234). On the other hand,
supporters of pharmaceutical promotions claim that marketing expenditures give
innovative pharmaceutical manufacturers a fair chance to recover high R&D
expenditures. Moreover, marketing may serve as a communication channel to educate
physicians and expose consumers to information that may improve their health outcomes
and medical options (Kremer, Bijmolt, Leeflang, & Wieringa, 2008, p.236). From these
two perspectives it can be concluded that in current research a contradictory view exists
regarding the influence of pharmaceutical marketing on physicians prescribing behavior.
Doctors- targeted promotion takes a variety of forms such as gifts, like free samples,
small stationery, travel to conferences and educational events, and some argue, cash,
sponsorship of conferences and educational events. The use of key opinion leaders which
18
are senior clinicians and medical educators as speakers at learned conferences and
funding of medical journals through advertising. Pharmaceutical companies use medical
journals to advertise their products, and frequently advertising revenue is the only source
of funding of these journals, which are often sent free to doctors.
19
CHAPTER THREE
RESEARCH DESIGN AND METHODOLOGY
3.1 Research Design

The study will try to investigate promotional techniques that the pharmaceutical company
preferred to practice for influencing the physicians prescribing behavior. Accordingly, the
practices and the challenges that prohibit its effectiveness will be evaluated. Therefore,
the researcher will use descriptive research type, which helps to use both qualitative and
quantitative data analysis.
3.2 Population and Sampling Techniques

The target population of the research paper is mainly divided into three parts, which are
medical practitioners, medical representatives and medical director of the company.
There are around 70 medical practitioners in the selected six hospitals. And there are 4
medical representatives in Lewi pharmaceutical company who are employed for
Grossman pharmaceutical. However, it is very difficult to take all the members of the
medical practitioners; and hence only samples will be considered. In this study, a total of
37 medical practitioners and all the 4 medical representatives and the medical director of
the company were participated in responding to survey questions and interviews. Since
the population size of the medical practitioners are too large. It is very unmanageable to
use probability sampling approach. Consequently, non-probability sampling approach,
particularly convenience sampling technique will be used to select the participants/
respondents to this study. Convenience sampling is a statistical method of drawing
representative data by selecting people because of the ease of their volunteering or
selecting units because of their availability or easy access (saunders, M., Lewis, P. &
Thornhill, A. 2012)
20
3.3 Methods of data collection and data collection tools
In this research both primary and secondary sources of data will be utilized. The primary
data will be conducted in the form of personal interviews with medical representatives
and the medical director; and through survey questionnaire to be distributed to medical
practitioners. As the secondary data; books, articles, journals, magazines, and broachers
were reviewed.
3.3.1 Questionnaire
Close ended questionnaire in a 5 point likert scales will be used to collect data from the
sample respondents. The questionnaire has 5 rating scales ranging from 1 = strongly
disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, 5 = strongly agree. Data
gathered through questionnaires is simple and clear to analyses and it allows for
tabulation of responses and quantitatively analyzes certain factors. Furthermore to this it
is time efficient for both the respondents and researcher. The questionnaire will be
structured in such a way that it includes all relevant parts and information to clearly
acquaint the respondents.
3.3.2 Interview
In order to obtain sufficient information the researcher were make personal interview
with medical representatives and medical director. Research issues like promotional
practices by medical representatives and medical director were addressed through
interviews which are difficult to obtain through questionnaire in as much detailed as
required.
3.4 Response rate

Total number of questionnaires issued to respondents: 50
Gross total response: 37
Usable (Net) response: 37
21
Table 1: Response rate of respondents of Hospitals
Hospital No of questionnaires Not Usable
issued returned response
Tekle Haimanot Hospital 10 4 6
Kadisco Hospital 6 1 5
Amin Hospital 7 2 5
Koria Hospital 11 1 10
Betezata Hospital 8 3 5
Betel Hospital 8 2 6
Response rate (%) for questionnaire = (37 / 50) * 100

= 74%
3.5 Methods of data analysis

Data processing is an important part of the whole survey operation. Descriptive analytical
technique will be used with the aid of Statistical Package for Social Sciences (SPSS) to
analyze the data collection with the use of questionnaires. The study will use tables to
analyze the collected data. While the others were analyzed qualitatively in order to attain
the objective of the study and draw important conclusions followed by recommendations.
3.6 Ethical considerations

The consideration of these issues is necessary for the purpose of ensuring the privacy as
well as the security of the participants, so the responses of the participants are
confidential. These issues were identified in advance so as to prevent future problems that
were rise during the research process. St Mary’s university provides official letters to all
candidates to get permission to fill the data. Among the significant issues that will be
considered includes consent, confidentiality and data protection. People who were
participated in the research were given an ample time to respond to the questions posed
on them to avoid errors and inaccuracies in their answers. The data were not made
available to third party without permission from study participants.
22
CHAPTER FOUR
RESEARCH RESULT AND DISCUSSION
In this chapter the finding of the research are presented and discussed. Based on the responses of
the respondents, results are presented in graphical and tabular format. The study subjects
included thirty seven medical practitioners and eight medical representatives. Fifty copies were
issued to the voluntary respondents at the premises of six private hospitals in Addis Ababa,
namely Tekle Haimanot, Kadisco, Amin, Koria, Betezata and Betel Hospital. Out of those 50
copies of the questionnaire, 37 were properly filled-in and returned, and the rest 13 copies were
not returned. This resulted in a response rate of 74%.
4.1 Personal characteristics of the respondents

The study covered six private hospitals. A total of thirty seven medical practitioners were
participated in the thesis, of which 10(27%) of the respondents were in the koria hospital, each 6
(16.2%) of the medical practitioner were in the Tekle Haimanot and Betel Hospital, and the rest
each 5(13.5) were in the Kadisco, Amin and Betezata Hospital. The finding implies the majority
of the respondents were in the Koria hospital and the result focused more on their response.
There were 11 (29.7%) female respondents and the male respondents were 26(70.3%) which
implies the majority of the respondents were male.
Regarding the respondents’ age group, 15 (40.5%) were in between 30-40, 11 (29.7%) were in
between 41-50, 6 (16.2%) were in between 51-60, 4 (10.8%) was in the age group below 29, and
only 1 (2.7%) respondent was in the age group above 61 years. The finding implies the majority
respondents’ age groups were in between 30-40.
Concerning the respondents service year, 11 (29.7%) have a working experience between 11-15,
10 (27%) have a working experience between 5-10 years, each 7 (18.9%) have a working
experience between 16-20, another 7 (18.9%) have a working experience greater than 20 years,
and only 2 (5.4%) of the respondents have a working experience greater than 5 years. The
finding of the study implies that the respondents have enough working experience to be aware of
the different promotional techniques.
23
Table 2: Characteristics of the respondents
S.N Items Category Count %
1 Hospital Tekle Haimanot Hospital 6 16.2
Kadisco Hospital 5 13.5
Amin Hospital 5 13.5
Koria Hospital 10 27
Betezata Hospital 5 13.5
Betel Hospital 6 16.2
Total 37 100%
1 Gender Male 26 70.3
Female 11 29.7
Total 37 100%
2 Age (in years) Below 29 4 10.8
30-40 15 40.5
41-50 11 29.7
51-60 6 16.2
Above 61 1 2.7
Total 37 100%
3 Service year Less than 5 years 2 5.4
5-10 years 10 27
11-15 years 11 29.7
16-20 years 7 18.9
Greater than 20 years 7 18.9
Total 37 100%
24
4.2 Promotional techniques in influencing physicians’
decisions on prescription
The pharmaceutical industry depends more on prescription from medical practitioners because
the patient do not make a choice, rather depends on the belief of the doctor. So the key to drug
sales lies on influencing the medical practitioners. To give information about the products to the
medical practitioners’ strategies such as promotional events, promotional materials and
sponsored educational materials are employed. From which the most influential promotional
strategy will be analyzed on this research.
For the sake of data analysis, the five point scale is consolidated to a three point in that - strongly
agree and agree reflect respondents’ tendency to agree (agreement), whereas, strongly disagree
and disagree reflect respondents’ tendency to disagree (disagreement). And also mean values
ranging from 1-2.49 are low, 2.5-3.49 is medium, and 3.5-5 are high.
25
Table 3: professional characteristics of medical representatives and how they provide information
Statistical
Level of Agreement Comparison
Questions Mea Std. St.

N regarding desirable SA AG NA DA SD n Dev. error
Total
o professional D
characteristics…
1 providing useful Count 15 20 2 0 0 37 4.35 0.59 0.1
information about
pharmaceutical %
40.5 54.1 5.4 0 0 100
products
2 providing unbiased Count 2.86 1.13 0.19
4 4 17 7 5 37
info about their
products % 13.
10.8 10.8 45.9 18.9 100
5
3 providing up to date Count 22 11 2 1 1 37 4.40 0.93 0.15
info about their
product %
59.5 29.7 5.4 2.7 2.7 100
4 having excellent Count 4.32 0.82 0.13
19 12 5 1 0 37
communication skill
%
51.4 32.4 13.5 2.7 0 100
5 having persuasive Count 10 18 9 0 0 37 4.03 0.75 0.12
manner and ability
%
to deal with people 27 48.6 24.3 0 0 100
6 Having patience Count 3.46 1.02 1.67

5 14 13 3 2 37
% 13.5 37.8 35.1 8.1 5.4 100
7 having self Count 4.24 0.68 0.11
14 18 5 0 0 37
confidence
% 37.8 48.6 13.5 0 0 100
8 Having professional Count 7 14 14 1 1 37 3.67 0.91 0.15
integrity (eg keeping
% 18.9 37.8 37.8 2.7 2.7 100
their promise)
(Level of agreement: SA= strongly agree; AG= Agree; NAD= neither agree nor disagree; DA=
Disagree; and SD= strongly disagree).
26
On factors that accounted for desirable professional characteristics of the medical
representatives, 86.4% respondents agreed to consider the medical representatives self-
confidence the most important factor with a mean of 4.24, while 83.8% agreed medical
representatives having excellent communicational skill was more important with the highest
mean of 4.32. And 75.6% respondents considered medical representatives having persuasive
manner and ability to deal with people with a mean of 4.03. The respondents reported medical
representatives having professional integrity and having patience on the responded rate of 56.7%
and 51.3% respectively with a mean of 3.67 and 3.46.
On factors that account what information to provide more, 94.6% of medical practitioners
recognized that receiving useful information like drug indication, side effects, adverse effects
and drug interaction with mean of 4.35 are most important promotional strategy, while 89.2%
recognized about receiving up to date information with a mean of 4.40 the highest mean, and
only 21.6% respondent reported on providing unbiased information with a mean of 2.86. Which
implies the medical practitioners’ accounts more on receiving scientifically proven up to date
information and also useful pharmacologically related information.
27
Table 4: promotional practices of medical representatives/ pharmaceutical company
Statistical
Questions Level of Agreement Comparison
regarding
promotional Mean Std. Std.
N practice to SA AG NAD DA SD Dev. Error
Total
o know about the
product…
1 Pharmaceutical Count 4 14 10 5 4 37 3.24 1.16 0.19
company
sponsored gifts % 10.8 37.8 27 13.5 10.8 100
2 Pharmaceutical Count 4.11 1.22 0.20
19 10 4 1 3 37
company drug
sample % 51.4 27 10.8 2.7 8.1 100
3 Pharmaceutical Count 20 12 3 1 1 37 4.32 0.94 0.15
company printed
product literature % 54.1 32.4 8.1 2.7 2.7 100
4 Pharmaceutical Count 4.22 1.06 0.17
19 12 2 3 1 37
company
sponsored %
educational 51.4 32.4 5.4 8.1 2.7 100
program
5 Information from Count 15 12 3 6 1 37 3.92 1.19 0.19
medical
representatives % 40.5 32.4 8.1 16.2 2.7 100
6 Personality, Count 3.49 1.24 0.20
10 9 9 7 2 37
knowledge, and
approach of %
medical 27 24.3 24.3 18.9 5.4 100
representatives
7 Frequency of Count 3.70 1.49 0.24
14 13 2 1 7 37
medical
representatives %
37.8 35.1 5.4 2.7 18.9 100
visit
8 Availability of Count 11 17 5 2 2 37 3.89 1.07 0.18
promotional aids
% 29.7 45.9 13.5 5.4 5.4 100
provided by
pharmaceutical
company
(Level of agreement: SA= Strongly agree; AG= Agree; NAD= Neither agree nor disagree; DA=
Disagree; and SD= Strongly disagree).
About 86.5% of respondents agreed that pharmaceutical company printed product literature were
useful to broaden their knowledge concerning a particular medication with a mean of 4.32, while
83.8% of respondents were of the opinion that pharmaceutical company sponsored educational
program with a mean of 4.22 were important to extend their knowledge concerning the product,
About 78.4% agreed pharmaceutical company drug sample with mean of 4.11 had an importance
28
to know about the product and 75.6% agreed on availability of promotional aids provided by
pharmaceutical company with mean of 3.89 helped in educating the patients on how to use the
product; and 72.9% responded the information from medical representatives with mean of 3.92 is
more important to gather more about the product and the frequency of medical representatives
visit with mean of 3.70 is also important in reminding of the drugs and collecting information
about the product and 51.3% of respondents were of the opinion that the personality, knowledge
and approach of medical representatives had an influence to know about the product with mean
of 3.49, while only 24.3% of respondents agreed pharmaceutical companies sponsored gift with
mean of 3.24 had a benefit to know about the product.
Table 5: medical practitioner’s response regarding the appropriateness of promotional

products, events and items from pharmaceutical company
Questions regarding
appropriateness of Level of Agreement
promotional product,
Yes No
event and items from
Total
No pharmaceutical
company…
Do you believe its
appropriate to accept
Count 37 0 37
promotional products, drug
samples, educational
1
information or gifts from
pharmaceutical company
% 100 0 100
representatives
In regard to the correctness of accepting promotional products, drug sample, educational

information or programming or gifts from pharmaceutical company representatives, all medical
practitioners agreed it is appropriate.
29
Table 6: the extent of promotional products to be delivered as a gift
Questions Statistical
regarding Level of Agreement Comparison
the desired
promotiona Mean Std. St.
N l products SA AG NAD DA SD Dev. error
Total
o delivered as
gift…
1 Pens Count 8 18 1 2 8 37 3.43 1.46 0.24
% 21.6 48.6 2.7 5.4 5.4 100
2 Notepads Count 4.00 1.03 0.17
11 21 1 2 2 37
% 29.7 56.8 2.7 5.4 5.4 100
3 Coffee mugs Count 0 3 9 4 21 37 1.84 1.07 0.17
% 0 8.1 24.3 10.8 56.8 100
4 Paper clips Count 1.86 0.98 0.16
0 2 9 8 18 37
% 0 5.4 24.3 21.6 48.6 100
5 Pocket Count 26 9 1 0 1 37 4.59 0.8 0.13
guides and
text books % 70.3 24.3 2.7 0 2.7 100
6 Calculator Count 2.86 1.23 0.20
3 10 9 9 6 37
% 8.1 27 24.3 24.3 16.2 100
7 Small desk Count 3.43 1.48 0.24
13 7 5 7 5 37
clocks
% 35.1 18.9 13.5 18.9 13.5 100
8 Sample drug Count 11 14 8 1 3 37 3.78 1.16 0.19
for personal
% 29.7 37.8 21.6 2.7 8.1 100
use
Sample drug Count 33 3 1 0 0 37
9 for patient 4.86 0.42 0.07
% 89.2 8.1 2.7 0 0 100
Patient Count 33 3 1 0 0 37
1 educational
% 4.86 0.42 0.07
0 materials 89.2 8.1 2.7 0 0 100
About 97.3% of respondents agreed that patient educational material and sample drug for patient
with a mean of 4.86 reported as a more desirable promotional property to be delivered as a gift,
94.6% responded that receiving pocket guides and text books with a mean of 4.59 were reported
as the more desired promotional item used to up dating information, 86.5% of medical
practitioners responded that receiving pens with a mean of 3.43 were important preferable
30
property as a promotional item to receive from the medical representatives, 67.5% responded
that receiving sample drug for personal use with mean of 3.78 were the more important
promotional product, another 54% reported on receiving small desk clock with mean of 3.43
were vital to receive from medical representatives as a promotional product, while receiving
calculator, coffee mugs and paper clips have a respond rate of 35.1%, 8.1% and 5.4% with mean
of 2.86, 1.84 and 1.86 respectively were the most preferable promotional product.
Table 7: Medical practitioners’ response through promotional events
Statistical
Questions
regarding Mean Std. St.
N desirable SA AG NAD DA SD Dev. error
Total
o promotional
events…
1 Having snacks or Co
6 7 6 7 11 37
other foods in your unt
clinical practice
site while listening 2.73 1.48 0.24
to a presentation
16.2 18.9 16.2 18.9 29.7 100
about %
pharmaceutical
product
2 Having lunch or Co
13 13 6 2 3 37
dinner on unt
educational 3.84 1.21 0.2
meeting at a % 35.1 35.1 16.2 5.4 8.1 100
conference
3 Day trip or event Co
5 12 4 8 8 37
such as theater, unt
concert or sports
event which
includes an 2.94 1.41 0.23
educational
13.5 32.4 10.8 21.6 21.6 100
presentation which %
is paid for by a
pharmaceutical
company
4 Having holiday Co
3 12 10 2 10 37
gifts unt 2.89 1.35 0.22
% 8.1 32.4 27 5.4 27 100
5 Vacation abroad to Co
24 11 2 0 0 37
a company visit unt 4.59 0.6 0.1
% 64.9 29.7 5.4 0 0 100
31
On factors that accounted for choice of promotional events, 94.6% respondents agreed on
vacation abroad to a company visit with mean of 4.59 were the most desirable promotional
events to know about the company, while 70.2% favored having lunch or dinner after
educational meeting at a conference with mean of 3.84 were important as a more preferable
promotional event to discuss about the product with other co workers, and the medical
practitioners responded day trips, having holiday gifts and having snack in a clinical practice site
while listening to a presentation about pharmaceutical products had a response rate of 45.9%,
40.5% and 35.1% with mean of 2.94, 2.89 and 2.73 respectively which were the more desirable
promotional property.
Table 8: attitude toward prescription decision after promotional practices
Statistical
Questions regarding
Total
attitudes of medical Mean Std. St.
N practitioners after SA AG NAD DA SD Dev error
o promotional practice .
…
1 Do you have ever
changed or modified
your prescribing Co 20 12 2 3 0 37
practice after attending unt
a pharmaceutical 4.32 0.91 0.15
company sponsored
educational program or % 54.1 32.4 5.4 8.1 0 100
presentation
2 Do you have ever Co
11 12 7 4 3 37
changed or modified unt 3.65 1.25 0.20
your prescribing %
10.
decision after exposing 29.7 32.4 18.9 8.1 100
8
on promotional events
3 Do you have ever Co
10 9 9 6 3 37
changed or modified unt 3.46 1.28 0.21
your prescribing %
16.
practice after receiving 27 24.3 24.3 8.1 100
2
promotional items
In accordance of prescription decision of the medical practitioners, 86.5% responded that their
prescription decision was changed after attending pharmaceutical company sponsored
educational programs with mean of 4.32, 62.1% were altered their prescription decision after
32
exposing on promotional events with mean of 3.65, while 51.3% respondents changed their
prescription behavior after received promotional items with mean of 3.46.
4.3 Interview with medical representatives and medical

directors
Throughout the analysis of the interview with medical representatives and medical director; one
topic that addressed was promotional approaches of medical representatives of Lewi
pharmaceutical company to influence medical practitioners prescribing decisions. This idea
cross-cut into four categories, including what information to provide and how to provide
information about the product, promotional products that are applicable in the company and
pharmaceutical promotional events applicable in the company and promotional techniques that
the company will think generate superior outcome. Another topic is an interview with medical
director about the professional characteristics of the medical representatives.
4.3.1 Interview with medical director

This study finding describes crucial professional characteristics that the medical director of the
company gives concern on recruiting medical representatives. In order to sell the products and
give information to the medical practitioners, the medical director recruit medical representatives
who have excellent communication skill as a first choice, and medical representatives having
self-confidence and medical representatives having ability to deal with people, are the next point
that medical director is concerning.
4.3.2 Interview with medical representatives

The finding describes promotional techniques that the company practices. The medical
representatives are providing valuable information to medical practitioner. The information that
they provides are detailed information including product different feature from competitors
product, and pharmacological detailed information about the product that is drug dosage form,
dosage regimen, major indication and other information like product availability are also
addressed by the medical representatives. The medical representatives also pointed out how they
provide information and they reported that they present information by giving printed brochure
and promotional materials.
33
Pharmaceutical promotional products like pens, calculator, and printed brochures are provided
by the company. And the medical representatives provide product name printed pens as a more
influential promotional material.
The company sometimes provides holiday gifts like post cards to the medical practitioners but
there is no other promotional event that the company is practicing until now.
The medical representatives think those promotional products are the more influential
promotional technique that has superior outcome to influence the medical practitioners
prescribing behaviors.
4.4 Triangulation of qualitative and quantitative data

Medical practitioners were reported on the desirable professional characteristics, and
professional characteristics like having excellent communicational skills, medical
representatives’ self-confidence, medical representatives having persuasive manner and ability to
deal with people and having professional integrity have a high mean respectively. And medical
representatives having patience has a medium mean value.
The medical director of the company is also recruits medical representatives having professional
characteristics of excellent communicational skill, self confidence and employee by observing
their ability to deal with people. This finding presents the desirable professional characteristics
and the practice of the company is similar.
Medical practitioners were reported, medical representatives providing up to date information

about the product and providing useful information about the drug has a high mean respectively.
The medical representatives of the company reported that they provide valuable information
including products different feature from competitor product, pharmacological detailed
information and product availability to the medical practitioners. This finding implies that
medical practitioners need also to provide current up to date pharmacological information.
Pharmaceutical promotional materials that the medical practitioners presented with a high mean
values are patient educational materials and sample drugs for patient use and personal use.
Consecutively, pocket guides and text books has also a high mean value. While providing pens
or calculators, has a medium mean value.
34
The company is commonly providing pens and calculators as a promotional materials and this
finding shows a medical practitioners preferred to obtain other products than what the company
is currently providing.
Regarding on desirable promotional events, the medical practitioners reported that vacation
abroad to company visit has a high mean value, and next to this having lunch/dinner after
educational meeting at a conference has high mean value.
The company medical representatives reported that there was no promotional event that has been
practiced by the company but sometimes they provide holiday gifts like post cards to the medical
practitioners, this practice is reported by the medical practitioners as a medium mean value.
In accordance to changing medical practitioners prescribing behavior, the medical practitioners

alter their prescribing behavior after attending pharmaceutical company sponsored educational
program which has the highest mean value, and consecutively medical practitioners alter their
prescribing behavior after exposing on promotional event which has a high mean value, but the
medical practitioners were also altered prescription decision after receiving promotional items
has a medium mean value.
The company promotional practice is concentrating more on promotional materials than
promotional events and sponsored educational presentations by the company, this finding implies
the company is practicing only by using promotional materials than other promotional practices.
35
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
This chapter summarizes the major findings of this study. This study required to find out the role
of promotional techniques in influencing the medical practitioners’ decisions on prescription. In
addition, this chapter provides conclusion and a direction for further studies and also gives some
recommendations for company policy makers.
5.1 Summary of major findings

This study established to find out the role of promotional techniques in influencing medical
practitioners’ decision on prescription. The summary pointed the major findings of the study.
The finding of the study reflects that the desirable professional characteristics by the medical
practitioners are medical representatives having self confidence and having excellent
communicational skill and also having persuasive manner and ability to deal with people.
Moreover, most medical practitioners’ believed that their prescription decision was affected by
receiving useful information and up to date information about the product from the medical
representatives so the information delivered from medical representatives and the frequency of
their visit has an influence. However, concerning their agreement on receiving information,
printed product literature and sponsored educational programs were useful to broaden their
knowledge concerning particular medication. And also pharmaceutical company drug samples
and availability of promotional aids provided by pharmaceutical company are important.
In regards of appropriateness of receiving promotional products and gifts, and participating on
promotional events, all medical practitioners agreed it’s appropriate but the degree of influence
varies.
The finding of this study revealed, the desired promotional gifts that medical practitioners need
to receive are patients educational materials, sample drugs for their patient and also pocket
guides and text books are important in updating information. While pens, sample drugs for them
self and small desk clocks have a medium desirable property.
36
Regarding the desirable promotional events, vacation abroad to company visit has a maximum
response and also having lunch or dinner after educational meeting at a conference are favored
by the medical practitioner.
In general, promotional practices of medical representatives affects the medical practitioner
attitude toward prescription decision, the finding reflects, medical practitioner altered or changed
prescription decision after attending sponsored educational programs, after exposing on
promotional events and after receiving promotional items respectively, so the result reflects
sponsored educational program has a better influence and then promotional events and
promotional items.
Furthermore, the result of the interview with the medical director and medical representatives
reveled that the company gives concern when they recruits the medical representatives, and they
choose those who have excellent communicational skill as their first choice and medical
representatives having self confidence and having persuasive manner and ability to deal with
people, and the medical representatives provide valuable detailed pharmacological information
about their product and its different feature from competitors products. They provide information
to medical practitioners by using printed brochures and promotional materials like pens and
calculators. They thought the more influential promotional product is pen with printed product
name.
Promotional events and sponsored educational programs were not practiced in the company but
sometimes they provide holiday gifts like post cards to medical practitioners are practiced in the
company. And medical representatives believed promotional products are the more influential
promotional technique than sponsored educational programs and promotional events. Finally, the
finding of the study is important to Lewi pharmaceutical company in practicing the more
influential promotional technique.
The thesis need to describe the role of promotional techniques in terms of influencing the
medical practitioners prescribing decision and the attitude of the medical practitioner towards
promotional techniques and how far they are influenced are presented in the finding of the study,
so based on the results obtained; Lewi pharmaceutical company can make a promotional
adjustment as per the findings.
37
5.2 Conclusions
Lewi pharmaceutical company imports pharmaceutical products from Switzerland, Grossman’s
company. They are using promotional approach to sell their products that is line with their
marketing strategy. The company has 4 medical representatives. They visit the medical
practitioners and promote their products. The company offer promotional materials to medical
practitioners. Promotional materials like pens and calculators are provided to the medical
practitioners. The company provides product name printed pens to medical practitioners as a
more influential promotional product. The company never experienced sponsored educational
programs or promotional events. But they sometimes provide holiday gifts like postcard to
medical practitioners.
The study covered medical practitioners from six selected private hospitals namely Tekle
Haimanot Hospital, Kadisco Hospital, Amen Hospital, Koria Hospital, Betezata Hospital and
Betel Hospital. Promotion is a key element in putting across the benefits of a product to the
medical practitioners and pharmaceutical companies use different approaches to inform about
their product to medical practitioners, and the medical practitioners reported the more preferable
method of receiving informing about a product is listed respectively as printed product literature,
sponsored educational program, drug samples, educational promotional aids, information from
medical representatives, the frequency of medical representatives visit, the personality,
knowledge and approach of medical representatives, and pharmaceutical company sponsored
gifts.
In terms of professional characteristics of medical representatives, the medical practitioners
reported the more desirable professional characteristics of the medical representatives were
having excellent communicational skill, having self confidence, having persuasive manner and
ability to deal with people, having professional integrity and having patience on waiting them
respectively.
Medical practitioners reported, it’s appropriate to receive pharmaceutical company promotional
product, drug samples, and promotional gifts. Items like patient educational materials, sample
drug for patient, pocket guides or text book, pens, sample drug for personal use, small desk
clock, calculator, coffee mugs and paper clips, respectively were their preference. According to
promotional events, the medical practitioners respond their preference were vacation abroad to a
38
company visit, having lunch or dinner after educational meeting, day trips, holiday gifts, having
snack in a clinical practice site while listening to presentation about pharmaceutical products
respectively. And, the medical practitioners responded on their attitudes toward their prescription
decision, they changed their prescription decision after attending sponsored educational
programs, followed by promotional events, and then promotional product respectively.
Finally, the finding of the thesis reflected, the medical representatives used promotional products
and printed brochures as a more preferable promotional technique. Even though these
promotional techniques were important for the medical practitioners’, there are also other
promotional practices that the medical practitioners preferred more than promotional product,
these are printed product literatures, sponsored educational programs, and promotional events.
5.3 Recommendations
Promotional strategies are crucial for every business for it to survive the current economic
turbulent and environmental challenges. It is through these practices that the objectives of
business are achieved. Lewi pharmaceutical company should include other promotional
techniques in order to promote their products to medical practitioners which may help marketing
managers to improve the allocation of their marketing budget over the most influential strategies
to medical practitioners and saving money of expense. The following recommendations are listed
as follow:
 The company should prepare printed product literature which includes pharmacological
information about the product to be delivered to the medical practitioners.
 The company should prepare educational programs or presentations to present about their
product or make connection with medical practitioners
 The company should prepare promotional events like vacation to a company visit or
lunch/dinner after educational presentations
 The company should prepare promotional products like patient educational materials,
sample drug for patient, pocket guides or text book
39
Reference
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representative visits in Yemen: a qualitative study. BMC Health services Research 13: 331
Al-Haddad, M.S., Hamam, F., & Al-Shakhshir, S.M. 2014. General public knowledge,
perceptions and practice towards pharmaceutical drug advertising in the western region of KSA.
Saudi pharmaceutical Journal, 22(2): 119-126.
American Medical Association, “Paid to Prescribe?: Exploring the Relationship Between

Doctors and the Drug Industry,” Statement to the special committee on Aging, United States
Senate, (Washington, DC: Statement of Robert M. Sade, 27 June 2007)
http://aging.senate.gov/events/hr176rs.pdf.
Belch, G., Belch, M. 2003. Advertising and Promotion, sixth edition, McGraw-Hill.
Berman, F., Ahari, S. 2007. Following the script: how drug reps make friends and influence
doctors. Med, 4 (4): e 150
Czinkota, M.R., Ronkainen, I.A 2004. International Marketing, 7th edition, Ohio: Harcourt. Inc.
De Laat, E. 2002. How does pharmaceutical marketing influence doctors' prescribing behavior?
Ethiopia food, medicine and health care administration and control authority report. 2014.
Goyal, R., Pareek, P. 2013. A review article on prescription behavior of doctors, influenced by
the medical representatives in rajasthan, India. IOSR-JBM 8: 56-60
Guidelines for the regulation and advertisement of drugs. 2014. Second edition. Drug
administration and control authority of Ethiopia.
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Kerridge, I., Maguire, J., Newby, D., McNeill, M., Henry, D., Hill, S., Day, R., MacDonald, G.,
Stokes, B., and Henderson, K. 2006. Cooperative partnerships or conflict-of-interest: A national
survey of interaction between the pharmaceutical industry and medical organizations. Internal
Medicine Journal, 35: 206-210.
Kotler, P., Armstrong, G. 2010. Principles of marketing. 14th edition. Pearson prentice hall.
KRC Research, “physicians’ options about pharmaceutical and Biotech research company
activities and information,” 2008, sponsored by pharmaceutical research and manufacturers of
America.
Kremer, S.T., Bijmolt, T.H., Leeflang, P.S., & Wierringa, J.E. 2008. Generalizations on the
effectiveness of pharmaceutical promotional expenditures. International journal of Research in
Marketing, p. 234.
Kremer, S.T., Bijmolt, T.H., Leeflang, P.S., & Wierringa, J.E. 2008. Generalizations on the
effectiveness of pharmaceutical promotional expenditures. International journal of Research in
Marketing, p. 236.
Lieb, K., Scheurich A. 2014. Contact between doctors and the pharmaceutical industry, their
perceptions and the effects on prescribing habits.
P.Norris, A.H., J. Lexchin, P. 2004. Drug Promotion- What We Know, What We Have Yet to
Learn. Mansfield.
Parker, R. S., & Pettijohn, C.E. 2005. Pharmaceutical drug marketing strategies and tactics: A
Comparative analysis of attitudes held by pharmaceutical representatives and physicians. Health
marketing quarterly, 22(4):27-43.
Pauline, N., Andrew, H., Joel, L., Peter, M. 2005. Review of materials in the WHO/HAI database
on drug promotion.
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Pharmaceutical research and manufacturers of America, Tough Questions- Straight Answers
pharmaceutical Marketing & Promotion, “(Washington, DC: PhRMA, fall 2004). Available
online from http://www.phrma.org/files/Tough_Questions.pdf.
Schramm, j., Andersen, M., Vach, K., Kragstrup, J., Kampmann, J.P., & Sondergaard, J. 2007.
Promotional methods used by representatives of drug companies: A prospective survey in
general practice. Scandinavian journal of primary health care, 25(2): 93-97.
U.S. Department of Health and Human Services. 2006. Prescription drug marketing Act.
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Zaki, N.M. 2014. Pharmacists’ and physicians’ perception and exposure to drug promotion: a
Saudi study. Saudi pharmaceutical journal (0).
42
Appendix-1
GENERAL MBA
A questionnaire to be filled by medical practitioners who work in Hospitals

This study is entitled, “The role of promotional techniques in influencing physicians’ decisions
on prescriptions: The case of Lewi pharmaceutical company and some selected medical
practitioners in Addis Ababa.” It is conducted as a partial requirement for the degree of Masters
of Business Administration (MBA) at St. Mary University. It is my belief that you as my
respondent would provide practical and convincing answers to the questions below to enable me
present a valid research report. Thank you in advance for your contribution to this research
study. Moreover all of your responses to any of the questions will be treated with highest
confidentiality and no report of the study will ever expose your identity. I am hereby asking for a
little of your time.
Part one: Background (Personal characteristics)
The following four items are meant to specify your personal characteristics as a respondent.
Please tick in the appropriate box which fits into your characteristics.
1) Hospital
Tekle Haimanot Hospital Koria Hospital

Kadisco Hospital Betezata Hospital
Amen Hospital Betel Hospital
2) Sex
Male Female
3) Age
Below 29 51-60
30-40 Above 61
41-50
4) Year of practice
Less than 5 years 16 to 20 years
5 to 10 years Greater than 20 years
11 to 15 years
I
Part two: Questions meant to explore the role of promotional techniques in influencing
Physicians’ decisions on prescriptions
5) What is your desirable level of confidence in the professional practice of medical

representatives in terms of the following items? Please reflect your rating as follows: 5=
Strongly Agree; 4= Agree; 3= neither agree nor disagree; 2= Disagree; 1= strongly disagree.
No. Items 5 4 3 2 1
5.1 Providing useful information about pharmaceutical products
5.2 Providing unbiased information about their products
5.3 Providing up to date information about their products
5.4 Having excellent communication skill
5.5 Having persuasive manner and ability to deal with people
5.6 Having patience
5.7 Having self confidence
5.8 Having professional integrity(e.g. keeping their promise)
6) How far your prescribing decisions could be influenced by the under listed promotional
practices to know about the product? Please reflect your rating as follows: 5= Strongly Agree;
4= Agree; 3= neither agree nor disagree; 2= Disagree; 1= strongly disagree.
No. Items 5 4 3 2 1
6.1 Pharmaceutical company sponsored gifts
6.2 Pharmaceutical company drug sample
6.3 Pharmaceutical company printed product literature
6.4 Pharmaceutical company sponsored educational programs
6.5 Information from medical representatives
6.6 The personality, knowledge and approach of medical representatives
6.7 The frequency of medical representatives’ visit
6.8 Availability of promotional aids provided by pharmaceutical company
7) Do you believe it is appropriate to accept promotional products, drug samples,

educational information or programming, or gifts from pharmaceutical company
representatives?
Yes
No
II
8) If your answer for question no. 7 is yes, please rate the extent to which the
following pharmaceutical promotional products are applicable to be delivered to you
as gifts. Reflect your rating as follows: 5= Strongly Agree; 4= Agree; 3= neither agree
nor disagree; 2= Disagree; 1= strongly disagree.
No. Items 5 4 3 2 1
8.1 Pens
8.2 Notepads
8.3 Coffee mugs
8.4 Paperclips
8.5 Pocket guides, textbooks,
8.6 Calculators
8.7 Small desk clocks
8.8 Sample drugs for your personal use
8.9 Sample drugs for your patients
8.10 Patient educational materials
9) Again, if your answer for question no 7 is yes, please rate the extent to which the
following events are applicable to be meant to promote pharmaceutical products.
Reflect your rating as follows: 5= Strongly Agree; 4= Agree; 3= neither agree nor
disagree; 2= Disagree; 1= strongly disagree.
No. Items 5 4 3 2 1
9.1 Having snacks or other foods in your clinical practice site while
listening to a presentation about pharmaceutical product
9.2 Having lunch or dinner on educational meeting at a conference
9.3 Day trip or event such as theater, concert or sports event which includes
an educational presentation which is paid for by a pharmaceutical
company
9.4 Having holiday gifts
9.5 Vacation abroad to a company visit
10) What is your attitude towards prescribing decision in terms of these factors?
Please rate the extent to which the following events are applicable if they are meant to
promote pharmaceutical products. Reflect your rating as follows: 5= Strongly Agree;
4= Agree; 3= neither agree nor disagree; 2= Disagree; 1= strongly disagree.
No. Items 5 4 3 2 1
10.1 Do you have ever changed or modified your prescribing practice after
attending a pharmaceutical company sponsored educational program or
presentation
10.2 Do you have ever changed or modified your prescribing decision after
exposing on promotional events
10.3 Do you have ever changed or modified your prescribing practice after
receiving promotional items
III
Appendix-2
GENERAL MBA
A semi-structured interview-guide for medical representatives and medical director
This study is entitled, “The role of promotional techniques in influencing physicians’

decisions on prescriptions: The case of Lewi pharmaceutical company and some selected
physicians in Addis Ababa.” It is conducted as a partial requirement for the degree of
Masters of Business Administration (MBA) at St. Mary University. It is my belief that
you as my interview would provide practical and convincing answers to the interviews
below to enable me present a valid research report. Thank you in advance for your
contribution to this research study. Moreover all of your responses to any of the questions
will be treated with highest confidentiality and no report of the study will ever expose
your identity. I am hereby asking for a little of your time.
1) What information do you provide about your products to the medical

practitioners?
2) How do you provide information to the medical practitioner?
3) What pharmaceutical promotional products are applicable in your company?
4) From the lists you give for question number 3 which pharmaceutical promotional
products do you think are more influential to the medical practitioners?
5) What pharmaceutical promotional events are applicable in your company?
6) From the lists you give for question number 5 which pharmaceutical promotional
events do you think are more influential to the medical practitioners?
7) Which promotional technique do you think will generate superior outcome?
8) Which professional character do you consider when you are recruiting medical
representatives?
IV
DECLARATION
I, the undersigned, declare that this thesis is my original work, prepared under the
guidance of Terefe Feyera (PHD). All sources of materials used for the thesis have been
fully acknowledged. I further confirm that the thesis has not been submitted either in part
or in full to any other higher learning institution for the purpose of earning any degree. It
is offered for the partial fulfillment of the degree of MA in Business Administration
(MBA).
----------------------------------------- ------------------------------------
Candidate’s Name Signature and Date
St Mary’s University, Addis Ababa May, 2017

ENDORSEMENT
This thesis has been submitted to St. Mary’s University, School of Graduate Studies
for examination with my approval as a university advisor.
__________________________ __________________________
Advisor’s Name Signature
St. Mary’s University, Addis Ababa May, 2017

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ST.

THE ROLE OF PROMOTIONAL TECHNIQUES IN INFLUENCING PHYSICIANS’

BY: ELESHADAY MEKONNEN

BY: ELESHADAY MEKONNEN

A THESIS SUBMITTED TO ST.MARY’S UNIVERSITY, SCHOOL OF GRADUATE

THE ROLE OF PROMOTIONAL TECHNIQUES IN INFLUENCING PHYSICIANS’

APPROVED BY BOARD EXAMINERS

External examiner Signature & Date

Internal Examiner Signature & Date

My sincere appreciation and acknowledgement also go to Ato Mesfene Assefa, Lewi

Key terms: Medical practitioner, Medical Representatives, Pharmaceutical Company,

Table 1: Response rate of respondents of hospital.....................................................22

Table 2: Characteristics of the respondents ...............................................................24

Table 3: Professional characteristics of medical representatives

Table 4: Promotional practices of medical representatives/

Table 5: Medical practitioner’s response regarding the

Table 6: The extent of promotional products to be

Table 7: Medical practitioners’ response through

1.1 Background to the study

According to world health organization, promotion is defined as all informational and

Lewi pharmaceutical company is a private limited company based in Addis Ababa,

1.2 Statement of problem

Promotional expenditures in international markets have grown. For instance, promotion

Lewi pharmaceutical uses different techniques to influence the physician prescribing

It is well established in the literature that pharmaceutical companies commonly employ a

1.3 Basic research question

1.4 Objective of the study

1.4.1 The general objective

1.5 Definition of terms

1.7 Delimitation and scope of the study

1.8 Organization of the study

2.1 An overview of promotional technique

2.2 The role of promotional techniques in making influences on

2.2.1 Impact of pharmaceutical promotion on attitudes and

2.2.2 Impact of pharmaceutical promotion on prescription

2.3 Common types of promotional techniques used by

2.3.1 Public relations/ publicity

Pharmaceutical companies use public relations tactic to increase awareness of unfamiliar

2.3.2 Sales promotion

2.3.3 Personal selling

2.3.5 Direct marketing

2.4 The role of sponsored educational programs/ presentations

2.5 The role of medical representatives and information to

2.6 The role of promotional tools to medical practitioners

2.6.1 The role of Samples to medical practitioners

2.6.2 The role of gifts to medical practitioners

2.6.3 The role of promotional events, Symposia and other

2.8 Empirical studies

On average pharmaceutical companies spend 20% or more of their sales on marketing

3.1 Research Design

3.2 Population and Sampling Techniques

3.4 Response rate

Response rate (%) for questionnaire = (37 / 50) * 100

3.5 Methods of data analysis

3.6 Ethical considerations

4.1 Personal characteristics of the respondents

Questions Mea Std. St.

6 Having patience Count 3.46 1.02 1.67