Off-label promotion of drugs in Bangladesh: evidence from promotional brochures circulated among general practioners by pharmaceutical companies

Abstract

Abstract Aims and objectives To gauge the incidences and nature of off-label promotion of drugs in the promotional brochures circulated among general practioners (GPs) in Bangladesh. Setting A single district town of Bangladesh. Methods Pharmaceutical promotional brochures were obtained from the ten GPs seeing the most patients using convenience sampling. Data sheets for both proprietary and generic products were used to identify off-label promotion in the brochures. This was done because drug formulations as well as other scientific information are copied from the original brands in Bangladesh. Data management and statistical analysis were performed using Microsoft Excel. Key findings Of the total promotional claims, 32% were found to be off-label while the rest were as per the approved indications. Brochures for drugs used in cases of diabetes contained the highest rates (66.7%) of off-label claims followed by centrally acting drugs (56.3%). Among the centrally acting drugs, clonazepam was found to have the highest (44%) level of off-label claims. Brochures on vitamin and mineral preparations were reported to promote off-label use with mecobalamin alone having 50% off-label claims. Brochures on flucloxacillin were reported to have the highest (19%) level of off-label claims among the antibiotics. Significant levels (35%) of off-label claims were found in brochures for anti-ulcerant drugs, with ranitidine having about 58%. Promotional brochures on cardiovascular drugs and non-steroidal anti-inflammatory drugs (NSAIDs) showed 29.7% and 19.4% off-label claims respectively. Conclusion In this study, a high level of off-label promotional claims was reported in the pharmaceutical promotional brochures distributed among GPs in Bangladesh.