The effects and role of direct-to-physician marketing in the pharmaceutical industry: an integrative review.

The pharmaceutical industry plays a vital role in the world's economy, as well as in ensuring the welfare of its citizens. In the United States, this industry constitutes a large and important part of the economy. In 2002, health care expenditure in the United States reached $1.6 trillion, accounting for fifteen percent of total GNP.' This percentage is also growing over time-it was seven percent in 1970.2 An important component of the health care industry is the pharmaceutical industry-in 2002, its size was estimated at $193 billion. 3 While the pharmaceutical industry is driven by innovation, it spends more money on marketing than on research and development.4 For example, this industry spends more than any other U.S. industry on its sales ,force ($7 billion annually) and on media advertising ($2.8 billion annually). 5 Pharmaceutical companies typically direct their marketing efforts toward physicians and, as of late, directly to patients (consumers). The marketing efforts directed at physicians comprise personal selling through sales representatives