Pharmacy World and Science

, Volume 28, Issue 4, pp 199–206 | Cite as

What patients think about promotional activities of pharmaceutical companies in Turkey

  • Semih SeminEmail author
  • Dilek Güldal
  • Nilgün Özçakar
  • Vildan Mevsim
Original Paper



Drugs, as commercial products, are subject to diverse marketing methods including promotional activities. Although the legal/ethical aspects of promotional activities have been discussed in a limited manner, the patient has remained the neglected variable of this equation. The goal of our study, therefore, is to investigate the patients’ opinion on the promotional activities of pharmaceutical companies.


A descriptive study was conducted at 44 primary health care centers in Turkey and 584 volunteers who applied to these centers were included. A questionnaire consisting of 42 questions was developed with demographic information in the first section, and drug ads and promotions included in the second section. Chi-square test and logistic regression analysis were used for statistical analysis.

Main outcome measure

The awareness and ethical evaluation of patients of the promotional activities.


Nearly 83% of the participants were aware of the promotion issue. Eighty percent found it unethical, 82% suggested that promotional activities should be forbidden, restricted or regulated. 1/3 of the participants believed that physicians made their drug choices based on the gifts and ads of pharmaceutical companies. Half of them had low confidence in the prescriptions of physicians who accepted gifts from the pharmaceutical companies. 54.5% of patients also considered promotional activities as a factor which increased drug prices.


In our study, a considerable number of patients were aware of promotions and the effects of promotion on prescriptions. The findings of our study may contribute to the development of effective regulations on this issue. Very strict measures controlling drug companies’ promotion activities must be formulated. Further, these regulations must incorporate and take into consideration the patients’ opinion. Today, the basic need for the proper use of drugs does not rest in pharmaceutical promotion, but in providing adequate health services and effective education for both people and physicians.


Patient involvement Patient opinion Pharmaceutical industry Pharmaceutical promotion Turkey 


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The authors want to thank Sahbal Aras, Cengiz Çelikoğlu, Yücel Demiral, Belgin Unal, and Aksel Epik for their assistance with this manuscript.

Funding: A research grant from the Dokuz Eylul University, Turkey (04.KBS.011).


  1. 1.
    Windmeijer F, de Laat E, Douven R, Mot E. Pharmaceutical promotion and GP prescription behaviour. Health Econ 2006;15:5–18PubMedCrossRefGoogle Scholar
  2. 2.
    Jureidini J, Mansfield P. Does the drug promotion adversely influence doctors’ abilities make the best decision for patients. Aust Psychiatry 2001;9:95–9CrossRefGoogle Scholar
  3. 3.
    CAM Group. Promotional activity. CAM Group News 2005;4:1. download/CAMNewsletterQ403.pdf (20 November 2005)
  4. 4.
    Şemin S, Aras S. İlaç ve Promosyon (Pharmaceuticals and promotion). Toplum ve Hekim 2005;19:350–8Google Scholar
  5. 5.
    Families USA. Profiting from pain: where prescription drug dollars go? Publication No: 02-105, 2002. (21 December 2003)
  6. 6.
    Mintzes B. Blurring the boundaries: new trends in drug promotion. Health Action International, 1998. (15 April 2005)
  7. 7.
    Guldal D, Semin S. The influences of drug companies’ advertising programs on physicians. Int J Health Serv 2000;30:585–95PubMedCrossRefGoogle Scholar
  8. 8.
    Ziegler MG, Lew P, Singer BC. The accuracy of drug information from pharmaceutical sales representatives. JAMA 1995;273:1296–8PubMedCrossRefGoogle Scholar
  9. 9.
    Katz D, Caplan AL, Merz JF. All gifts large and small. Am J Bioeth 2003 Summer;3:39–46Google Scholar
  10. 10.
    Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA 2000;283:373–80PubMedCrossRefGoogle Scholar
  11. 11.
    Ma J, Stafford R, Cockburn L, Finkelstein SA. Statistical analysis of the magnitude and composition of drug promotion in the United States in 1998. Clin Ther 2003;25:1503–17PubMedCrossRefGoogle Scholar
  12. 12.
    World Health Organization. The world medicines situation, 2004. shtml (23 October 2005)
  13. 13.
    Wager E. How to dance with porcupines: rules and guidelines on doctors relations with drug companies. BMJ 2003;326:1196–207PubMedCrossRefGoogle Scholar
  14. 14.
    Ministry of Health Turkey. Regulation regarding the promotion of medicinal pharmaceutical products for human use the official Gazette of Turkish Republic, 2003; 25268Google Scholar
  15. 15.
    Kanavos P, Üstel İ, Font JC. Pharmaceutical reimbursement policy in Turkey. New hope in health foundation, 2005. eng.htm
  16. 16.
    Yiu L, Çelik Y, Şahin B. Healthcare and pharmaceutical spending in Turkey. New hope in health foundation, 2005. eng.htm
  17. 17.
    Gibbons RV, Landry FJ, Blouch DL, Jones DL, Williams FK, Luccy CR, et al. A comparison of physicians’ and patients’ attitudes toward pharmaceutical industry gifts. J Gen Intern Med 1998;13:151–4PubMedCrossRefGoogle Scholar
  18. 18.
    Yapraklı M. İlaç pazarlamasında yöntemler. (The methods for pharmaceutical marketing) İnönü  üniversitesi Sosyal Bilimler Enstitüsü. Bilim Uzmanlığı Tezi, Malatya, 2002Google Scholar
  19. 19.
    Blake RL Jr, Early EK, Patients’ attitudes about gifts to physicians from pharmaceutical companies. J Am Board Fam Pract 1995;8:457–64PubMedGoogle Scholar
  20. 20.
    Robinson AR, Hohmann KB, Rifkin JI, Topp D, Gilroy CM, Pickard JA, et al. Direct-to-consumer pharmaceutical advertising: physician and public opinion and potential effects on the physician–patient relationship Arch Int Med 2004;164:427–32CrossRefGoogle Scholar
  21. 21.
    Berndt ER; To inform or persuade? Direct-to-consumer advertising of prescription drugs. N Engl J Med 2005;352:325–8PubMedCrossRefGoogle Scholar
  22. 22.
    Wirth M, Scherer D. Patient’s perceptions of doctors’. Relationships with pharmaceutical companies. Healthy skepticism. International 2002; 20. (18 April 2005)

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Semih Semin
    • 1
    Email author
  • Dilek Güldal
    • 2
  • Nilgün Özçakar
    • 2
  • Vildan Mevsim
    • 2
  1. 1.Department of Medical EthicsDokuz Eylul University, Medical Faculty InciraltıIzmirTurkey
  2. 2.Department of Family MedicineDokuz Eylul University, Medical FacultyIzmirTurkey

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