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

Bradley T. Shapiro

Management Science · 2018 · Volume 64 · Issue 12

DOI: 10.1287/mnsc.2017.2899

Abstract

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. This paper was accepted by Eric Anderson, marketing.

Keywords

pharmaceutical industry, promotion, sales force, product policy, advertising and media

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