Informational Shocks, Off-Label Prescribing, and the Effects of Physician Detailing

• 成果类型: Article
• 署名作者: Shapiro, Bradley T.
• 署名单位: University of Chicago
• 刊物名称: MANAGEMENT SCIENCE
• ISSN/ISSBN: 0025-1909
• DOI: 10.1287/mnsc.2017.2899
• 发表日期: 2018
• 页码: 5925-5945
• 关键词: Pharmaceutical industry; promotion; SALES FORCE; product policy; advertising and media

摘要

The relationship between pharmaceutical detailing and prescriptions for non-FDA-approved (off-label) use has been the subject of regulatory scrutiny, with more than $12 billion in regulatory settlements for off-label promotion since 2004. Using the case of AstraZeneca's antipsychotic drug, Seroquel, I study the extent to which off-label prescriptions are caused by detailing. Using a physician panel that connects detailing exposure to medical charts, I exploit within-physician variation to identify detailing effects. I find the effect of detailing on off-label prescriptions is small in both absolute and relative terms. Detailing on net tilts the prescribing distribution toward on-label.