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\title{Study on Influence of Medical Representative in Conversation of Doctor's Prescription in India}
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             \author[1]{Purti  Bhatt}

             \affil[1]{  Madhav University, Rajasthan.}

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\date{\small \em Received: 12 December 2017 Accepted: 3 January 2018 Published: 15 January 2018}

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\begin{abstract}
        


Objective to investigate whether medical representative has an effective role in making doctor to convince about their company?s product with outcome that are favorable to pharma companies or whether medical representative does not much effect in selection of drug by the doctors. Pharmaceutical marketing is all together different selling concepts from all other business because of its target consumer is doctors and that faculty consider as the most knowledgeable and highly updated with current product scenario and their results. While majority of the business target customers directly, pharmaceutical company designs different promotion strategy mainly targeting doctors. Drug promotion by medical representatives is one of the factors that influence physicians? prescribing decisions and choice of drugs. Drug promotion is all information and persuasive activities by pharma companies and distribution, as a result of which that influence the prescription , increase supply, purchase or use of medicinal drugs.

\end{abstract}


\keywords{medical representative, product, prescription, promotion strategy, doctors prescription, effective detailing, personal selling.}

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\let\tabcellsep& 	 	 		 
\section[{Introduction}]{Introduction}\par
ommunication is a core to any successful relationship. It is much more than a common talk between two parties. It usually means speaking and writing or sending the messages to another person. The promotional activities by medical representatives (MRs) of the pharmaceutical companies can impact the prescribing pattern of doctors and MRs has given a decided doctor list to visit them on regular basis ex. Some may visit doctors on monthly, half monthly or three times in a month. Hence, the interaction between doctors and medical representative is coming under increasing scrutiny and comes with the result of doctors prescription of companies drug. Doctors share very strong and unusual relationships with Medical Representatives because of their continuity and drug updating along with different promotional tool. Medical Representative is essentially a catalyst who conveys knowledge on most recent trends in medical diagnostic and treatment to the doctors. However, medical representatives are being treated only as sales personals, but in reality they are channel for conveying information to medical fraternity. Doctor who often interacts with MR said "most of the MR is just sales persons, only few maintain their subject knowledge deeply \& share updates about the medicines. Because there is a lack of dedication towards profession on the contrary MRs integrity with them because of their persistency. Personal detailing forms the backbone of the entire marketing activities. MR meets doctors, chemists and stockists to influence prescription pattern of doctors in favor of their brand. 
\section[{II.}]{II.} 
\section[{Personal Selling}]{Personal Selling}\par
In general sales product has to sale via a different communication tool but in pharmaceutical marketing pharma company appoint Medical Representative and they has to do personal selling while meeting the doctors and ultimately make the doctors to prescribe his company's product on the basis of his regularity, communication, follow up and following companies communication strategy. The main advantage of personal selling is that we can make better relations and have good contacts with the customers which ultimately leads to maximum doctors prescription. As we know that it is only sales force that facilitates the movement of products and brands in the market and promotes the organization by multiplying customers and making profitable relationships, hence it is all about the way how we communicate with the customers and make them ready to buy our products (Today Cut). The MRs is the only person who drives all movements of the product and company appoint all the MR on the basis of their specialty target audience. So it becomes mandatory for the sales person to be dominant, creative and strategist. The MRs is not only an achiever in sales but also has all the personality traits for making lifelong relation with the doctors. For this the sales person is having some of selling styles like need satisfying , problem solving , friendly and hard selling to entice the customers(Brand Speak), RCPA (Retail counter prescription analysis). The personal selling is eight steps process of managing the relations and getting the profit which includes Prospecting, Pre-approach, Approach, Assigns the needs, Presentation, Meeting out the objections, Gaining the profit and Follow up. The prospecting includes the right approach of sales person and indenting the potential doctors of the territory. After prospecting just plan for the preapproach strategy for doctors call and then present the product with defined strategy. During presentation try to solve all the objections of your customers and to make them involve fully with your product and try to get follow up and manage routine visit to get updated with your customers. Personal selling becomes more easy tool when we follow the 4 c's i.e. convince, convert, consolidate and consistent approach. \hyperref[b0]{1} Personal meeting to doctors means exposure to brand message with the communication tool like visual aid, literature, laptop, or tablet. How this exposure gets converted into increase in sales and how much it makes impact on the customer's prescription habit will depend on the and involved by the pharmaceutical companies. The significant change in mentality to make a quantum leap in the business lies in answering to the questions-What does exactly a customer want and need? How can we fulfill these needs? Unique Selling Point and Unique Perceived Benefits are the tools being adopted by the pharmaceutical companies that consider the business as a never ending activity. Whereas RCPA identifies potential of the customers, segmentation and targeting, on the other hand, helps in preparing Master Call List. Traditional methods such as "personal selling" and the modern technique like e-detailing and digital marketing" run simultaneously to achieve the goal. Daily Call Report ensures better supervision, management and accountability of sales team. It becomes a reliable feedback to evaluate their efficacy without which quantum increase in sales (the ultimate goal of fruitful communication) may remain a far -fetched dream. 
\section[{III. How Medical Representative Increase Drug Sales by Influencing Physicians}]{III. How Medical Representative Increase Drug Sales by Influencing Physicians}\par
For the common people to belive that drug representative can convert prescription of product is not practical. Its very hard process but generally happens all the time. Doctors are also human being and they also notice the visit, regularity, character and company of the MRs even though doctor's priority are first their patient and quality of products but medical representative role is equally important in fetching their product prescriptions. "Drug reps increase drug sales by influencing physicians, and they do so with finely titrated doses of friendship." 2 Following are the tool through which MR influence doctors and get more number of prescriptions. 
\section[{a) Pramotional Strategy of Products}]{a) Pramotional Strategy of Products}\par
Today in this competitive era promotion with unique marketing strategy plays a vital role in promotion of products and services. Pharma Company appoints special product management team for the promotion and decision making of upcoming drug to the market and they are considered as the brains of the company. In India many pharmaceutical companies who are registered in the industry competing with each other having a same products and try to cover the market through the different promotional strategy, medical representative training, and communication and using different tools through customer relationship management. Pharmaceutical companies are changing their marketing strategies to cope up with new challenges in the business environment. For last decade the Marketing strategies have changed significantly in Indian pharmaceutical industry. The companies are hugely advertising may be in the conference, medical journals and other ways to promote their products in the market. Marketing is defined as fulfilling requirements of doctors through an exchange of medical information. This leads to greater the benefit provided the higher transactional value an organization can charge.  {\ref 4} This communication between MRS and doctors is often referred to as "marketing and promotion." Without it, doctors would be less likely to have the latest, precise information available regarding prescription products, which play an increasing role in effective health care. \hyperref[b2]{5} Pharmaceutical marketing can have direct effects and indirect effects. Direct effects, also called reminder effects, are effects that directly influence physician adoption of drugs, here goodwill, achieved by constant interaction between pharmaceutical representatives and physicians, influences the preferences for certain drugs and products \hyperref[b3]{6} Pharmaceutical promotion often assumes that small promotional items are unlikely to influence prescribing behavior because generally doctors priority are patient so they may forget new product so small brand reminder gifts plays a vital role in making remember the doctors about their products and MRs effectively follow it. \hyperref[b9]{12}  
\section[{b) Gifts as a Tool to Influence Doctors Prescription}]{b) Gifts as a Tool to Influence Doctors Prescription}\par
More than 5,000 drugs and 45,000 formulations are available in India. \hyperref[b5]{8} One of the tools used by pharmaceutical industry is to give gifts to the doctor and this tradition comes from the long way. The variety of gifts include table top, table clock, reminder bag, academic journals , books, paper folders, medical instrument like BP meter, weight scale, household items, personal and innovative items. [9] The list includes small and big -alarm clocks to air-conditioners, calendars to cars, rubber bands to refrigerators, telephone index to television and office items to overseas trips. [9] Although this apparently innocuous practice is generally accepted as a norm many doctors feel uneasy about its ethical repercussions. \hyperref[b7]{10,}\hyperref[b8]{11} Physician accepts a gift, an mutual understanding of relationship is established between the doctor and the corporate or its MRs and there is an some kind of reward in the term of Rx to respond to the gift.\par
Exposure to promotion influences prescribing some doctors realize  {\ref . 7} Volume XVIII Issue III Version I Year ( ) E 2018 © 2018 Global Journals 
\section[{c) Effective Detailing}]{c) Effective Detailing}\par
Communication is the core heart of the products. Doctors easily remember on the basis of detailing done by MRs. Special training has been provided by the company to sales personal for the updating of the molecule, their references and latest research of the products. Pharmaceutical detailing is the major marketing and promotion tactics utilized by the pharma companies to promote their brands to the doctors and to influence the prescribing habit by creating interest. It's an important tool for creating awareness of product among the doctors. This detailing process directly has financial links which, after all, helps in the culmination of a big business. Most of the pharmaceutical companies' emphasizes on detailing part as it plays a vital and decisive part in marketing. . As we know that new trends have come up in the market for improving the detailing part like e-detailing, and other online services but these digital tools will be discussed later on. Let's have a look on the traditional detailing pattern to understand the main concept in true spirit. Till now, we all are following the traditional ways of using templates and medical journals which require detail / discussion face to face so as to create the magnetic relations with doctors and force out the products from their territory by improving the sales. Now a days e journals are also consider as a best tool to upgrade doctors about latest research or trail and publications of the products. 
\section[{d) Involvement of Medical Representative Inside and}]{d) Involvement of Medical Representative Inside and}\par
Outside Clinic Every pharmaceutical company employs and trains medical representatives to promote and sell drugs, using printed product literatures, drug samples and gifts. The size of worldwide sales force of different companies ranges from 2,500 to 8,000 \hyperref[b10]{13} and the number has been increasing. In India, an estimated 80,000 representatives are employed by the industry. Company specify their area of working on the basis of zone, district or specialty of doctor wise. Besides the salaries, they also receive incentives, Increment in salaries, aboard tour, promotions for achievement of sales targets, which might tilt the balance in favor of aggressive drug promotion. Many company now motivate their employee by providing lucrative incentive like international trip, car, bike and many more things to full fill their companies desired goal so that MRs works with full integrity and achieve their goal by meeting and converting maximum numbers of doctors through their prescription. While doctors uniformly deny that their understanding of drug is influenced by the activities of industry, there is considerable evidence to support the efficacy of the personal encounter with medical representative in shaping doctors' attitude towards drugs.\par
The number of calls (including attendance at a medical meeting or a visit to follow up a report of an adverse reaction) made by a medical representative each year should not exceed, on an average three visits to each doctor. \hyperref[b11]{14} In India now the daily visit of the doctors should be twelve and four visit to each doctor in a month. Drug samples can only be provided to a doctor in response to a signed request and should not exceed four days' treatment for a single patient. \hyperref[b11]{14} IV. 
\section[{Conclusion}]{Conclusion}\par
There is a wide range of evidence on different topics, using a range of different designs, suggesting that promotion affects attitudes and behaviour. However there are gaps in the evidence, and more high-quality studies are needed to establish causal relationships between promotion and attitudes and behaviour of doctors and others, to provide more nuanced information about people?s attitudes to promotion, and to investigate the impact of interventions to regulate or counter the effect of promotion. 		 		\backmatter   			 
\subsection[{Acknowledgement}]{Acknowledgement}\par
The feeling of joy and satisfaction coming with completion of my work which is incomplete without conveying my heartiest gratitude to my guides Dr. Rajesh Rathore my company Corona Remedies Pvt. Ltd and their staff and all medical representative working with me in the field who made this work possible with their constant guidance and encouragement. 			  			  				\begin{bibitemlist}{1}
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\bibitem[Walker ()]{b11}\label{b11} 	 		‘Code of practice for the pharmaceutical Industry’.  		 			G Walker 		.  	 	 		\textit{ABPI Data Sheet Compendium. Association of British Pharmaceutical Industry}  		1993. Datapharm Publications. p. .  	 
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\end{document}
