Measures aimed at influencing prescription as applied in some EU countries

According to the Spanish regulations, the cost of promoting medicines must not exceed 12 per cent of their price. This percentage [.. . ] appears to be far removed from reality [.. . ] Some estimates indicate that commercial processes, comprising promotion and marketing, may amount to between 22 and 28 per cent of the volume 

Another peculiarity of the Spanish situation as regards advertising is its lack of control. The transcription of a Community directive on this issue gave rise to control over advertising being devolved to the autonomous communities, resulting in the virtual disappearance of control over advertising due to the interterritorial nature of promotion activities. 

Each physician in a primary care centre who kept an electronic diaiy and recorded actual visiting times dedicated 2.6 weeks a year to receiving laboratory sales representatives, which translated into costs totals approximately 475 000 pesetas per doctor per year.17 

Research is also strongly influenced by the admittedly legitimate interests of the pharmaceutical industry examples of this include contract clauses reserving copyright, the initial selection of researchers and topics, and the recent consolidation of the position of companies specializing in clinical trials (to the detriment of academic centres). Frequently there is a conflict of interests between social welfare and private welfare that does not necessarily amount to fraud or malpractice, but which should be made public - through 

In addition to the health care aspect, the act of prescribing involves an economic aspect, doctors in effect making payment orders, although then-orders do not require prior auditing or examination, as is the case for most public administration expenses.19 

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Table 9.2 Measures aimed at influencing prescription as applied in some EU countries...

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