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How physicians choose drugs

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  • Denig, P.
  • Haaijer-Ruskamp, F.M.
  • Zijsling, D.H.

Abstract

A drug choice model which includes the physician's attitudes, norms and personal experiences with drugs, was tested. One hundred and sixty-nine physicians were asked the estimate the model's components for the treatment of irritable bowel syndrome (IBS) and of renal colic. Given three drugs for both indications, the physicians gave their expectancies about the treatment outcomes, professional acceptability, patient demand and their personal experiences with the drugs. They also stated the value they assign to each of these components when choosing a drug for IBS and for renal colic. The influence of patient demand on the choice of a specific drug appeared to be negligible. The combined effect of the other three elements of the model predicted the stated drug of first choice correctly in 74% (for IBS) and 78% (for renal colic) of the cases, but further analysis showed that only the drug choices for renal colic were as reasoned as the model assumed. Expectancies and values about treatment outcomes determined the drug choice only in part. For choosing a drug for renal colic, the professional environment was more important. Moreover it was found that drug preferences were more related to expectancies about efficacy than to expectancies about side effects for both disorders. The findings can be useful when trying to change prescribing behaviour. Only a limited effect can be expected from the provision of technical drug information. Especially information about costs is unlikely to change prescribing easily, unless values and norms are changed as well. The importance of the professional environment implies that educational programmes in groups might be more effective than individual approaches.

Suggested Citation

  • Denig, P. & Haaijer-Ruskamp, F.M. & Zijsling, D.H., 1988. "How physicians choose drugs," Social Science & Medicine, Elsevier, vol. 27(12), pages 1381-1386, January.
  • Handle: RePEc:eee:socmed:v:27:y:1988:i:12:p:1381-1386
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    Citations

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    Cited by:

    1. Scott, Anthony & Shiell, Alan, 1997. "Do fee descriptors influence treatment choices in general practice? A multilevel discrete choice model," Journal of Health Economics, Elsevier, vol. 16(3), pages 323-342, June.
    2. Cho, Mee-Hyun & Yoo, Ki-Bong & Lee, Hoo-Yeon & Lee, Kwang-Sig & Kwon, Jeoung A & Han, Kyu-Tae & Kim, Jae-Hyun & Park, Eun-Cheol, 2015. "The effect of new drug pricing systems and new reimbursement guidelines on pharmaceutical expenditures and prescribing behavior among hypertensive patients in Korea," Health Policy, Elsevier, vol. 119(5), pages 604-611.
    3. Bautista, Cristina M., 1992. "Determinants and Policy Implications of Drug Utilization in the Philippines," Working Papers WP 1992-05, Philippine Institute for Development Studies.
    4. Anthony Scott & Alan Shiell, 1997. "Analysing the effect of competition on General Practitioners' behaviour using a multilevel modelling framework," Health Economics, John Wiley & Sons, Ltd., vol. 6(6), pages 577-588, November.
    5. Greving, Jacoba P. & Denig, Petra & van der Veen, Willem Jan & Beltman, Frank W. & Sturkenboom, Miriam C.J.M. & Haaijer-Ruskamp, Flora M., 2006. "Determinants for the adoption of angiotensin II receptor blockers by general practitioners," Social Science & Medicine, Elsevier, vol. 63(11), pages 2890-2898, December.
    6. Paraponaris, A. & Verger, P. & Desquins, B. & Villani, P. & Bouvenot, G. & Rochaix, L. & Gourheux, J. C. & Moatti, J. P. AU -, 2004. "Delivering generics without regulatory incentives?: Empirical evidence from French general practitioners about willingness to prescribe international non-proprietary names," Health Policy, Elsevier, vol. 70(1), pages 23-32, October.
    7. de Jong, Judith D. & Groenewegen, Peter P. & Spreeuwenberg, Peter & Schellevis, François & Westert, Gert P., 2010. "Do guidelines create uniformity in medical practice?," Social Science & Medicine, Elsevier, vol. 70(2), pages 209-216, January.
    8. Marisa Elena Domino & David S. Salkever, 2003. "Price elasticity and pharmaceutical selection: the influence of managed care," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 565-586, July.
    9. Monteiro, Carlos M.F. & Dibb, Sally & Almeida, Luis Tadeu, 2010. "Revealing doctors' prescribing choice dimensions with multivariate tools: A perceptual mapping approach," European Journal of Operational Research, Elsevier, vol. 201(3), pages 909-920, March.

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